Securing health care coverage has never been more critical, especially as government-sponsored benefits remain in a constant state of flux. While it remains accessible, eligible citizens must take advantage of programs like Medicaid to get the care they need. From the Big Apple all the way to upstate, how can you get help applying for Medicaid in New York?
Step One — Discover Eligibility
Medicaid is designed to provide health care coverage to lower-income individuals and pregnant women, among others. Qualifying criteria can vary by state. These benefits are diverse and can finance lifesaving prescriptions or mental health services. Even dental and vision are available through Medicaid.
New York has an easy-to-use eligibility tool for prospective applicants to check their likelihood of acceptance. The resource does not confirm eligibility, but the most general requirements are being a state resident and a legal U.S. citizen. Additionally, applicants must prove their income is below the threshold.
Step Two — Gather Your Documents
Citizens will need more than income documents. They will also need to send:
- Proof of citizenship
- Proof of age
- Income documentation
- Proof of residence
- Other insurance information
Applicants who are confused may seek legal assistance to ensure they are submitting everything correctly. People in complex situations, such as those with outstanding medical bills prior to applying or those planning long-term home care, should consult with Medicaid experts from Ettinger Law Firm. Sometimes, health care legal professionals are the best path to securing coverage because they know how agencies review applications.
Step Three — Choose Your Application Method
The way applicants apply is almost as important as the content. Residents should find the most convenient method for them to make the process as seamless as possible. Options include applying:
- Online.
- In-person at the Department of Social Services.
- Through a requested application via telephone.
- With a mail-in application.
- With legal aid or a certified enroller.
Step Four — Consider the Following
During the application process, there are certain things citizens should consider while waiting for a decision.
Keep Existing Insurance
There are often Medicaid denials, so if households have existing health care insurance, they should not cancel it prematurely. Continue paying premiums until there is verifiable acceptance into the program. Medicaid may also be able to help pay for premiums if you get approved, meaning you could have more comprehensive coverage with both on your side.
Do Not Move Assets Without Consultation
Investments could put individuals and households above the threshold, despite their volatile nature. Medicaid reviews examine the last five years of financial activity for an applicant. Some may deem it necessary to purge assets before applying to help their case.
However, this five-year look-back period allows reviewers to verify whether any significant financial adjustments have been made to ensure that someone is in the correct income bracket. If the Department of Social Services suspects any manipulative activity, you could be penalized.
Ask an Expert
The Medicaid application may appear accessible, but beneath it lies a complex set of rules that could make it more convoluted. Increase your chances of success by having an expert review it and your methods before submission. Many places, like Ettinger, offer no-cost consultations, so you will only gain confidence by reaching out.
Step Five — Protect Assets
While assets should not be deliberately manipulated to circumvent the system, expert Medicaid planners know how to structure and protect everything, including homes. A list of qualifying assets can remain protected under a Medicaid Asset Protection Trust, which is a type of irrevocable trust. Applicants relinquish control of expensive assets, such as property, and leave them in the hands of a designated trustee.
In these trusts, the income is separate from the applicant. The assets do not qualify as income or part of their net worth. It allows them to safely remove high-value assets from their history, thereby boosting their application’s chances of acceptance. Many choose to leave the trust to children, as spouses are ineligible.
If accepted into Medicaid, New Yorkers can still get value from the irrevocable trust. As they earn income from other sources, such as Social Security, they could also earn gains from investments within the trust if they choose. The rules do change depending on whether individuals are in a facility or receiving home care, so consulting an expert to determine the correct way to organize assets is advised.
Step Six — Appeal if Necessary
Every applicant has the right to appeal if they receive a denial. You will need to schedule a meeting with a representative, which can be done over the phone, online or in person. After scheduling, you may want to seek legal advice to ensure you know how to best defend yourself on the day. Specialist attorneys are there to fight for you, no matter what the application says. It can provide some peace of mind to have someone else in the room on your side.
FAQ About NY Medicaid
Now that you know how the process works, you can get ahead by knowing the answers to the most common questions.
How Do I Contact Medicaid NY?
There are two numbers people can call. The Helpline is available at 1-800-541-2831 to address questions about enrollment and eligibility. Individuals with a care plan can contact 1-800-505-5678 for assistance.
How Long Does It Take to Get Approved for New York State Medicaid?
Approval times vary based on the applicant. Most people receive a decision within 45 days, with children under 19 and pregnant women getting notice within 30 days. Those with disabilities can wait up to 90 days.
What Are Common Reasons for NY Medicaid Denial?
The most prominent reasons for a rejected application could include:
- Insufficient paperwork
- Inaccurate reporting
- Lack of income eligibility
- Inability to confirm discrepancies
How Can I Get Help Applying for Medicaid in New York?
Applying for something as important as health care should leave nothing up to question, especially when legislation and policy change rules from year to year. If applicants are uncertain about any aspect of the process, they can contact legal assistance. Places like Ettinger Law Firm encourage inquiries with free consultations to get the process started without fear.
