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New York Medicaid Eligibility

✓ Expansion State

Program: New York Medicaid

$1,732/mo/mo
Individual income limit
$3,575/mo/mo
Family of 4 income limit
138% FPL
FPL threshold

Key Facts for New York

  • ✓New York has one of the most generous Medicaid programs in the country
  • ✓New York expanded Medicaid in 2014
  • ✓Apply through NY State of Health marketplace
  • ✓Essential Plan available for those 139-200% FPL at low or no cost

What New York Medicaid Covers

✓ Doctor visits
✓ Hospital care
✓ Prescription drugs
✓ Mental health
✓ Dental
✓ Vision
✓ Long-term care
✓ Transportation

Who Qualifies in New York?

Children
Most children under 19 qualify regardless of immigration status through CHIP or Medicaid.
Pregnant women
Pregnant women typically qualify at higher income limits than standard Medicaid in New York.
Low-income adults
Adults 19–64 earning up to $1,732/mo/mo (138% FPL) qualify.
Seniors & disabled
Adults 65+ and people with disabilities may qualify through SSI-related Medicaid programs.

About New York Medicaid

New York Medicaid is one of the most comprehensive and generous Medicaid programs in the United States, covering over 7 million New Yorkers. New York expanded Medicaid in 2014 and has gone further than the federal minimum in several areas — including robust dental and vision coverage for adults, long-term care services, and transportation assistance. New York also offers the Essential Plan, a low-cost or free health insurance option for residents earning between 139% and 250% of the Federal Poverty Level who don't qualify for Medicaid. Between Medicaid and the Essential Plan, most low-to-moderate income New Yorkers have access to affordable coverage.

How to Apply for New York Medicaid: Step by Step

1
Check your eligibility
New York Medicaid covers adults up to 138% FPL — about $1,732/month for a single person. If your income is between 139% and 250% FPL, you may qualify for the Essential Plan instead. Take our free quiz to find out which program fits your situation.
2
Go to NY State of Health
NY State of Health (nysoh.com) is New York's official health insurance marketplace. When you apply, the system automatically checks whether you qualify for Medicaid, the Essential Plan, Child Health Plus, or a subsidized marketplace plan.
3
Gather your documents
Collect your Social Security number, proof of New York residency, proof of identity, and income documentation. New York uses an electronic data-matching system that often verifies income automatically — many applicants don't need to submit additional documents.
4
Submit your application
Apply online at nysoh.com (fastest), by phone at 1-855-355-5777, in person at a NY State of Health enrollment assistant location, or through a certified navigator or broker at no cost to you.
5
Choose your health plan
Once approved, you'll choose a Medicaid managed care plan for your region. New York has robust managed care options including plans from Fidelis Care, MetroPlus, Healthfirst, and others depending on your county.

Documents You Need to Apply

  • ☐Social Security number (or immigration documents if applicable)
  • ☐New York state ID, driver's license, or other photo ID
  • ☐Proof of New York residency (utility bill, lease, or bank statement)
  • ☐Proof of income (pay stubs, employer letter, or most recent tax return)
  • ☐Birth certificates for any children applying
  • ☐Immigration documents if not a U.S. citizen

How Long Does Approval Take?

New York Medicaid applications are processed within 45 days for standard cases. Children and pregnant women may receive faster decisions. New York has robust presumptive eligibility — many applicants can receive temporary coverage immediately at a participating provider while the full application is reviewed. Retroactive coverage of up to 3 months prior to the application date is available if you had qualifying medical expenses.

New York Medicaid FAQs

What is the income limit for Medicaid in New York?

For most adults, the New York Medicaid income limit is 138% of the Federal Poverty Level — about $1,732 per month for a single person or $3,575 per month for a family of four. Children and pregnant women may qualify at higher income levels.

What is the Essential Plan in New York?

The Essential Plan is a low-cost health insurance option for New Yorkers who earn too much for Medicaid (139-250% FPL) but want affordable coverage. It typically costs $0-$20 per month with comprehensive benefits similar to Medicaid, including dental and vision.

How do I apply for Medicaid in New York?

Apply through NY State of Health at nysoh.com, by calling 1-855-355-5777, or through a certified navigator. The online application routes you to the right program — Medicaid, Essential Plan, or subsidized marketplace — based on your income.

Does New York Medicaid cover dental and vision?

Yes. New York Medicaid includes comprehensive dental coverage including cleanings, fillings, dentures, and some orthodontics, as well as vision coverage including eye exams and glasses. This is more comprehensive than many other states.

Can undocumented immigrants get Medicaid in New York?

Undocumented immigrants do not qualify for full Medicaid in New York, but may qualify for Emergency Medicaid for urgent medical situations. Children and pregnant women who are undocumented may qualify for state-funded coverage under certain New York programs.

How long does New York Medicaid take to approve?

Standard applications are approved within 45 days. Many applicants benefit from presumptive eligibility — temporary immediate coverage at a doctor's office while the application is processed. Retroactive coverage of up to 3 months prior may also be available.

Check your eligibility

Find out if you qualify for New York Medicaid in 60 seconds. Free, no obligation.

Check eligibility →

Apply directly in New York

You can also apply directly through the state portal — though our enrollment specialists can help you navigate the process for free.

Apply at state portal →
✓ Medicaid Expansion State

New York expanded Medicaid under the ACA, covering more low-income adults.