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Where to Apply for Medicaid and Medicaid Home Care in New York City

Views: 30681
Posted: 20 Jul, 2009
by Valerie Bogart (New York Legal Assistance Group)
Updated: 16 Dec, 2014
by Valerie Bogart (New York Legal Assistance Group)

New York City's Medicaid program is run by the Human Resources Administration (HRA)  Medical Insurance and Community Services Administration (MICSA).    Changes in how people apply for and receive Medicaid personal care services are occurring in September 2012.

A.   There are two networks of offices to apply for Medicaid in the community:

         (1)   Community Medicaid offices -  process applications for Medicaid with a "spend-down," the Medicaid Buy-In for People with Disabilities, and the Medicare Savings Program  

          (2)  Home Care Services Program (CASA Since 9/14/2012, these offices will no longer accept and process M11qs to approve  home attendant (personal care) services for most adults age 21+ who also have Medicare - they must obtain home care through Managed Long Term Care Plans.  There are some exceptions.  See this article for the new procedures for applying for Medicaid home care services. 

See more info at Applying for Medicaid Personal Care Services in New York City - BIG CHANGES SEPTEMBER 2012

  1. WHERE TO FILE Medicaid applications for adults age 21+ who have Medicare and who will be seeking Medicaid Managed Long Term Care services is:

HRA--HCSP Central Medicaid Unit 

785 Atlantic Avenue, 7th Floor

Brooklyn, NY 11238                              T: 929-221-0849

Please see NYC Medicaid Alert dated January 3, 2013 explaining the relocation of the Central Medicaid Unit and other home care services programs within HRA.

  1. WHERE TO File Medicaid applications and M11q forms, for those EXCLUDED from Managed Long Term Care -- 
    1. those who need only Housekeeping services - maximum 8 hours/week, or
    2. in the Nursing Home Transition, OPWDD or TBI Waivers, or
    3. applying for Medicaid only with a spend-down,  do NOT  have Medicare and are not in a "mainstream" Medicaid managed care plan, or
    4. those under age 21, or
    5. in hospice care
CENTRAL INTAKE  
NYC HRA Home Care Services Program
          109 East 16th Street, 5th Floor,
          New York, NY 10003                                TEL 212-824-0706   FAX 212-896-8814 

B.       NYState of Health Exchange -- Apply online for Medicaid if you do not have Medicare, or if you have   Medicare and have a dependent child or other relative living with you. 

  • Call  1-855-355-5777,visit nystateofhealth.ny.gov or contact NY State of Health Assistor/ navigator  to
    learn more

  • The Exchange is for people  in the "MAGI" categories - families and children, singles and couples, generally people under age 65 who do not have Medicare.   People with disabilities may be MAGI if they do not have Medicare, but may also apply at HRA/DSS Medicaid offices using the old budgeting rules if it is more favorable to them.   

  • Hospitals often apply for Medicaid for people admitted for inpatient care.  They apply directly to the Hospital Eligibility Unit at the main administrative offices at  785 Atlantic Ave., Brooklyn NY

  • Nursing Home Medicaid -- Since 2006 changes in the law, you may only apply for Medicaid nursing home coverage once you have been admitted to a nursing home.   These applications are filed at the Nursing Home Eligiblity Department at the main office at  785 Atlantic Ave., Brooklyn NY.

C.      Other Medicaid (MICSA) contacts -- Contacts at the main MICSA administrative offices are in these lists --

SEE department head contacts obtained 3/2014 - dated Dec. 2013 -- Full list  and Directors/Unit list.  (Dec. 2013)  If you have corrections, please notify us by e-mail.     Also see this news article about the Medicaid headquarters' May 2013 move to Brooklyn.

   Unit HRA MICSA (Medicaid) Liason Name     New Contact Info
Managed Care Client Services                                          

212-273-0062 (phone)

Recipient Restriction Unit

929-221-0859/60 (phone)

Eligibility Information Services (EIS) 929-221-0865 (phone)
Medicaid Transportation 929-221-0840/41 (phone)
Medicaid Third Party Health Insurance Unit

212-630-1160(phone)                                                                          929-221-0842/43 (phone)
917-639-0675 (fax)
718-636-7767 (fax)

Medicaid Reimbursement          Evadne Duff (Homecare)  

929-221-0845 (phone non-home care)
929-221-1193 (phone home care)
718-636-7750 (fax home care)

Surplus/Spend-down

Maria Rivera

Graciela Mathews

Angel Phifer-Brown (Fax Unit)

Fax Unit Number

929-221-0833 (phone)

929-221-0838 (phone)

929-221-0835 (phone)

917-639-0645 (fax - NO CHA

D.      Other pathways to Medicaid --

  •           Job Centers - People applying for or receiving cash assistance through the state Safety Net program or Temporary Aid to Needy Families Program may also receive Medicaid and Food Stamps by applying at these centers.

  •           SSI --  Anyone receiving Supplemental Security Income (SSI) benefits, even if only $1 in benefits, automatically receives Medicaid without having to separately apply for Medicaid. 


This article was authored by the Evelyn Frank Legal Resources Program of New York Legal Assistance Group.

NYLAG

Attached files
file MICSA Contact List 12-2013.pdf (50 kb)
file Medicaid phone list.pdf (224 kb)
file MICSA Directory (08-06-13).pdf (3.07 mb)

Also read
document Medicaid Personal Care or Home Attendant Services
document CASA Contact List - NYC
document Managed Long Term Care
document Elimination of Face to Face Interview for Medicaid and Family Health Plus applicants
document New Application Form (2010) Used for Medicaid, Child Health Plus and Family Health Plus in New York State
document KNOW YOUR RIGHTS: Fact Sheet Explaining Basic Rules on NYS Financial Medicaid Eligibility for People who are Disabled, Aged 65+, or Blind
document Delays in Processing of Medicaid Applications - What are Your Rights and Lawsuits Challenging Delays
document NYS Directives on Medicaid changes under the Affordable Care Act
document KNOW YOUR RIGHTS: Managed Long Term Care - Fact Sheets and Training Announcements

Also listed in
folder Medicaid -> Home Care
folder Medicaid -> Applying For and Keeping Medicaid

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Medicaid in 2014: Understanding MAGI & the Marketplace     Access to Health Care for People with Disabilities


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