Best Healthcare Plan For Young Adults - For low-income people, Medicaid is an important part of getting adequate health care. Medicaid is a federal and state funded insurance program that covers medical expenses. New York's Medicaid insurance program provides coverage for adults, pregnant women, children, disabled and senior citizens, and other eligible individuals.
If you qualify and apply for Medicaid, you may be covered for doctor visits, nursing care, ambulance rides to and from the emergency room, home health care, CDPAP, and more.
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Medicaid is offered at the state level, and each state has slightly different rules and regulations about who can apply and what medical expenses the program covers. In New York State, Medicaid is free for individuals under the age of 21, pregnant women, and long-term care patients.
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Other applicants may be required to pay a small co-payment to maintain coverage. This article will focus on the rules specific to New York State and some of the best health insurance companies that offer Medicaid in the state.
To get Medicaid in New York State, you must meet certain requirements. The government provides healthcare assistance only to eligible individuals, so it is important to analyze your situation before attempting to apply. Medicaid health care is only available to people who cannot afford medical care. Individuals who meet this criteria may receive Supplemental Security Income (SSI) or face other difficulties paying for adequate health care.
Medicaid is available for both children and adults, but different provider plans must be selected based on age group and individual health care needs. Seniors may need to choose a managed long-term care Medicaid plan, while children will need a plan that specifically pays for children's health care. People with mental or physical disabilities must also choose the plan that is right for them to ensure the best possible coverage and care.
For the average person ages 19 to 65+, to qualify for Medicaid in New York, you must meet the following requirements:
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● Proof of US Citizenship - Medicaid in New York is currently only available to US citizens. To prove your citizenship, you may provide one of the following documents: valid U.S. passport, birth certificate, certificate of citizenship or naturalization.
● Proof of New York Residency – To be eligible for Medicaid coverage in New York State, you must be able to prove your state residency status. Examples of proof of residency include a dated utility bill, a valid New York driver's license, a valid New York voter registration card, or other similar documentation proving New York residency.
● Documentation of current housing/living situation – this could be a lease agreement in your name or other similar form of proof of your living situation. People with difficult or unusual living conditions (due to low income or health conditions) are more likely to qualify for Medicaid coverage, so there are several ways to show proof of residency.
● Documentation of Monthly Income – Medicaid is only available to individuals whose income does not exceed 138% of the Federal Poverty Level (FPL). For pregnant women or infants, the income cannot exceed 218% of the FPL. Note that income requirements vary for those over 65, blind or disabled. Requirements also depend on whether the applicant is single or married and whether they have children.
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Keep in mind that the monthly income requirements for Medicaid coverage vary greatly based on your individual circumstances. A prime example is that children, pregnant women, people who are disabled or blind, and people over age 65 are eligible for Medicaid even if their income exceeds basic needs. In addition to income, your assets are also tested when you submit your Medicaid application.
● Proof of Other Insurance - If you currently have other types of insurance, you will need to submit proof and information about these other insurance plans when you apply for Medicaid.
What you will have when you apply for Medicaid. Having another health insurance plan does not disqualify you from receiving Medicaid. In fact, while not very common, in some cases Medicaid may pay the premiums of other health insurance plans you currently have. Review these rules and ask questions as you look for the best Medicaid provider for you.
In New York State, Medicaid applicants are divided into 2 distinct groups: MAGI (Modified Adjusted Gross Income) and non-MAGI applicants. The Medicaid application process varies depending on the group you belong to.
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● Childless adults ages 19 to 64 who are not pregnant, do not have Medicare, and are not eligible for Medicare, but have a documented disability,
Medicaid applicants who fall under the MAGI applicant category must apply through the New York State Department of Health marketplace.
● People who are blind or disabled but do not fall into any of the MAGI applicant categories
● Apply by Phone - Call the New York State Department of Health to get the correct phone number for your area. Then call and follow the instructions to apply.
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● Online Application - Visit the New York State Department of Health marketplace website to access the online Medicaid application.
● Mail Application - Download the appropriate Medicaid application form from the Health Marketplace website and mail it to your local District Services Office.
● Apply In Person – Visit your local District Service Office and follow their instructions for applying for Medicaid.
● Applying through the Registrar of Facilitators (FE) – If you need help gathering the proper documents for your Medicaid application, or if you want the opinion of a professional to help you get the best possible Medicaid coverage, it may be Enrollers of Facilitation ( FE ) are eligible to apply for Medicaid.
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If you are in New York City, you can easily obtain a Medicaid application form from the Human Resources Administration and complete the application process from there.
Before applying for Medicaid, make sure you have all the necessary documents listed in the previous section to prove your eligibility. Getting all your documents in order before applying can greatly increase your chances of getting Medicaid.
There are many health insurance providers in New York State that offer Medicaid insurance plans to Medicaid recipients. It can be difficult to know which plan is best for you or your family, but a little research and asking will help you determine which provider is best for your needs.
As you do your research, keep in mind that you will only be accepted for coverage by the one or two insurance companies you apply for. Of all the health insurance providers in New York, these are the best for Medicaid recipients:
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Fidelis Care offers Medicaid managed care plans for Medicaid recipients. This program is available to anyone who qualifies for Medicaid based on age, disability, income, or resource requirements. The plan covers preventive care visits, dental care, vision care, emergency room and ambulance services, hospital and outpatient care, behavioral health services, and prescription and over-the-counter drugs. Medicaid recipients can enroll in the program year-round, and not all Medicaid care providers offer this benefit.
Fidelis tops nearly every health department and rating category. Fidelis Care has broader drug coverage and ranks particularly well in disease care.
Affinity offers Medicaid managed care plans and enriched health plans to Medicaid-eligible individuals. A Medicaid managed care plan is a standard plan with a long list of covered services, including maternity services, emergency department visits, family planning services, preventive care, and dental and vision care (among other services).
Extensive wellness programs designed for individuals with complex mental health needs. The program covers substance use disorder services, group and individual counseling, and more. Affinity offers a wide range of wellness programs that set it apart. For individuals struggling with mental health issues, this Medicaid health plan ranks highly because it specifically caters to this group of people.
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The Affinity Medicaid health care plan provides excellent maternity care and family planning services. The program also places a high priority on child care. Due to its high ranking for mothers and babies, this program would be highly recommended for families.
Funded by Medicaid, it allows New Yorkers to choose who provides their care — caregivers get paid immediately after their shift.
UnitedHealthcare offers three different Medicaid health care plans, all slightly different.
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