Eligibility and Enrollment | New York Medicaid

Are you eligible in NY?

Eligibility can be hard to understand, but we’re here to help you find the right plan. Use this list to review key plan benefits and find out if you’re eligible.

Who’s eligible?

Children, adults, and pregnant women who:

Live in the Bronx, Brooklyn (Kings), Manhattan (New York), Queens, Staten Island (Richmond), Dutchess, Nassau, Orange, Putnam, Rockland, Suffolk, Ulster, or Westchester County.
Meet certain income, resource, age, or disability requirements.

What are the benefits?

Medical care, including doctor visits and checkups, emergency care, and urgent care
Dental care
Vision care
Behavioral health services

Review all Medicaid benefits

Who’s eligible?

Adults between the ages of 19 and 64 who:

Live in the Bronx, Brooklyn, Manhattan (New York), Queens, Staten Island (Richmond), Delaware, Dutchess, Nassau, Orange, Putnam, Rockland, Suffolk, Sullivan, Ulster, or Westchester County.
Are not eligible for Medicaid or CHPlus.
Are not eligible for minimum essential coverage.
Meet certain income requirements. Visit the New York State of Health website to learn more.

What are the benefits?

Medical care, including doctor visits and checkups, emergency care, and urgent care
Dental care
Vision care
Prescription drugs
Behavioral health services

Review all Essential Plan benefits

Who’s eligible?

Children under age 19 who:

Live in the Bronx, Brooklyn (Kings), Manhattan (New York), Queens, Staten Island (Richmond), Nassau, Orange, Putnam, Rockland, Suffolk, Ulster, or Westchester County.
Are not eligible for Medicaid.
Have little or no other health insurance coverage.
Meet certain income requirements.

What are the benefits?

Medical care including doctor visits and checkups, emergency care, and urgent care
Dental care
Vision care
Prescription drugs
Behavioral health services

Review all CHPlus benefits

Who’s eligible?

Adults age 18 or older who:

Live in the Bronx, Brooklyn (Kings), Manhattan (New York), Queens, Staten Island (Richmond), Dutchess, Nassau, Orange, Putnam, Rockland, Suffolk, Ulster, or Westchester County.
Are enrolled in Medicaid.
Have been diagnosed with a serious mental illness or substance use disorder.
Meet criteria and risk factors determined by the state of New York.

What are the benefits?

All Medicaid benefits, plus:

Help with getting or keeping a job
Housing help
Independent living advice

Review all HARP benefits

Who’s eligible?

Adults age 18 or older who:

Live in the Bronx, Brooklyn (Kings), Manhattan (New York), Queens, Staten Island (Richmond), Nassau, Suffolk, or Westchester County.
Are eligible for Medicaid.
Have a chronic illness or disability that makes you clinically eligible for enrollment, based on an assessment.
Are expected to need at least one of the following community based long-term care services for more than 120 continuous days from the effective date of enrollment:
- Nursing services in the home
- Therapies in the home
- Home health aide services
- Personal care services in the home
- Adult day health care
- Private duty nursing
- Consumer Directed Personal Assistance Service (CDPAS)

What are the benefits?

All Medicaid benefits, plus:

Long-term services and support to help you stay in your home or community

Review all MLTC benefits

Who’s eligible?

Adults age 18 or older who:

Live in the Bronx, Brooklyn (Kings), Manhattan (New York), Queens, Staten Island (Richmond), Nassau, Orange, Rockland, Suffolk, or Westchester County.
Are enrolled in Medicare and eligible for Medicaid.
Have a chronic illness or disability that makes you clinically eligible for enrollment, based on an assessment.

What are the benefits?

All Medicaid benefits, plus:

Long-term services and support to help you stay in your home or community

You must enroll with Anthem Medicare and be eligible for Medicaid to join MAP.

Review all MAP benefits

Medicaid income limits

Visit the New York State of Health website or call 855-355-5777 (TTY 1-800-662-1220) to find out if you’re financially eligible for Medicaid.

How to enroll

Find a Community Service Center to visit in person or call us to enroll. Our team is here to help you:

Find out if you’re eligible.

Learn about what’s covered.

Complete an enrollment application.

Answer your questions.

Schedule an appointment to talk about our health plan.

Medicaid, Essential Plan, and Child Health Plus (CHPlus)

Call 844-430-1699 (TTY 711).

Managed Long-Term Care (MLTC)

Call 855-800-4683 (TTY 711).

Health and Recovery Plan (HARP)

Call 800-300-8181 (TTY 711) and ask for a care manager.

Medicaid Advantage Plus (MAP)

Call 855-220-8692 (TTY 711) to speak with a licensed Medicare agent or visit the Anthem Medicare website. You must enroll with Anthem Medicare and be eligible for Medicaid in order to join MAP.

You can also explore Anthem's Individual and Family plans for other coverage options.

On-the-go health plan access

The Sydney Health app makes it easy to find a doctor, access your ID card, and chat with a live representative.

Download Sydney Health

For general questions about state-sponsored health insurance programs, call New York State of Health, The Official Health Plan Marketplace, at 855-355-5777 or visit the New York State of Health website.