Medicaid provides medical coverage for people who are unable to pay for their medical care and who have income below the eligibility guidelines set by the State. Individuals and families in receipt of Temporary Assistance may be eligible for Medicaid. Individuals receiving Supplemental Security Income (SSI) are automatically eligible for Medicaid.
Applying for Medicaid through the NY State of Health can be done by doing the following:
- Call: 1 (855) 355-5777
- Apply Online
- For In Person Assistance: Call (518) 447-4989 for an appointment to meet with a Certified Application Counselor (CAC) at 162 Washington Avenue, Albany, NY.
If you are applying for Medicaid and you are 65 and over and/ or in receipt of Medicare (unless they are a caretaker relative of a child age 18 or younger), people applying for nursing home coverage, Medicaid Waiver Programs for children, Medicaid Buy In program for Working People With Disabilities, and Medicare Savings Programs you would need to submit a paper application to 162 Washington Avenue, Albany, NY 12210. If you do not fit into the above categories your application will be forwarded to the NY State of Health for processing as the NY State of Health (NYSOH) determines Medicaid eligibility.
Medicaid Pays For
Medicaid pays for various medical services.
As a general reference, Medicaid will pay for:
- Medical care provided by qualified physicians, nurses, optometrists, and other practitioners within the scope of their practice as defined by State Law;
- Preventive, prophylactic and other routine dental care services, and supplies provided by dentists and other professional dental personnel;
- Inpatient care in hospitals, skilled nursing facilities, infirmaries, other eligible medical institutions (except that inpatient care is not covered for individuals from age 21 to 65 in institutions primarily or exclusively for the treatment of mental illness or tuberculosis), and health related care in intermediate care facilities;
- Outpatient hospital and clinic services;
- Home health care by approved home health agencies;
- Physical therapy, speech pathology, and occupational therapy;
- Laboratory and x-ray services;
- Family planning services;
- Prescription drugs per the Commissioner’s List, supplies and equipment, eyeglasses and prosthetic or orthotic devices;
- Transportation when essential to obtain medical care;
- Care and services furnished by qualified health care organizations or plans using the prepayment capitation principle.
Medicaid and Medicare Savings Programs
Medicaid Buy In Program for Working People with Disabilities and Medicare Savings Programs
The Medicaid Buy-In Program for Working People with Disabilities provides Medicaid coverage for people ages 16-64 who have a disability and are engaged in a work activity for which they are paid. In order to be considered for this program, the individual must be determined disabled as defined by the Social Security Administration. The person’s net income must be at or below 250% of the federal poverty level.
Medicare Savings Programs
Medicaid can assist with paying the monthly Medicare premium for low income individuals and in some cases pay the co-insurance, copayments and deductibles depending on the person’s income. Click here for more information about the Medicare Savings Program.
Medicaid Chronic Care Nursing Home Placement
Call (518) 447-7011 for:
- Placement of Albany County residents in Nursing Homes
- Pickup of Albany County residents already in Nursing Homes
- Long Term Home Health Care cases – Married couples where one is looking for a waiver program:
- Nursing Home Transition Diversion (NHTD) or Traumatic Brain Injury (TBI) or to enroll in a Managed Long Term Care Plan (MLTC). This allows a spouse to receive care at home and still qualify for Medicaid.
Please call the above number for further information.