Changes in Medicaid Eligibility and Processes During the COVID-19 Emergency

The NYS Department of Health (DOH) has issued a new Medicaid policy due to the COVID-19 public health emergency.  If you already have Medicaid, the new policy will help you keep your Medicaid coverage during the COVID-19 emergency.  If you want to apply for Medicaid, the new policy makes the application process easier.  


I already have Medicaid. Can my Medicaid be stopped during the COVID-19 emergency?

No.  Under the federal Families First Coronavirus Response Act (FFCRA) and the new DOH policy, you will not lose your Medicaid coverage during the COVID-19 emergency if you were covered on or after March 18, 2020.  The exception is if you voluntarily end your Medicaid coverage or if you move out of New York State.

I already have Medicaid, but I need to recertify soon. What should I do?

In general, if you have an active Medicaid case with authorization and coverage dates ending in March, April, May, or June 2020, your Medicaid coverage will be automatically extended for 12 months.  

If you already returned your recertification paperwork, then the Department of Social Services (DSS) may process the recertification.  However, DSS cannot decrease or stop your Medicaid during the COVID-19 emergency.

I need to apply for Medicaid. What’s changed due to COVID-19?

Self-Attestation:  DSS must allow “self-attestation” for all eligibility criteria, except for immigration, citizenship, and identity verification.  This means that you do not have to give DSS supporting documentation that confirms your income, assets, or other health insurance coverage.

DSS will try to verify your citizenship, immigration status, and identity.  If they are not able to do so but you are otherwise eligible for Medicaid, then DSS should authorize your Medicaid coverage.  You will get 90 days to prove your citizenship, status, or identity.  If the COVID-19 public health emergency has not ended and DSS does not receive the documents from you in 90 days, then DSS should extend your Medicaid coverage for another 90 days.  

Missing Information:  If your application is missing information, then DSS should contact you by email or telephone for the information.  If DSS is unable to reach you by phone or email after three (3) attempts, then they must send you a written request for the missing information.  This request must give you ten days to submit the missing information and must also tell you how to do so.

Applying for Other Benefits:  During the COVID-19 emergency, DSS generally will not require that you pursue other sources of income or health insurance coverage, such as Medicare, Social Security, Veterans Benefits, or child support, in order to qualify for Medicaid.

My SSI or Temporary Assistance has been discontinued. Will I lose my Medicaid? Do I need to reapply?

No.  Medicaid coverage is extended for recipients whose SSI or TA is discontinued.  DSS will not require a redetermination or a new application during the COVID-19 emergency period.

I received Medicaid because I am low-income, but now I am turning age 65. Will I lose my Medicaid? Do I need to reapply?

No.  Medicaid recipients in the Modified Adjusted Gross Income (MAGI) category normally age out of MAGI eligibility when they turn age 65.  However, during the COVID-19 emergency period, DSS must maintain Medicaid coverage as it existed on or after 3/18/20, even for individuals who turn 65 and age out of MAGI Medicaid eligibility.

I moved to a new address and forgot to tell DSS. Will my Medicaid be discontinued?

No, as long as you still live in New York State.  Even if a notice is returned to DSS with no forwarding information, DSS must continue your Medicaid coverage for the duration of the COVID-19 emergency period.  However, you should contact DSS and notify them of your change of address.  Also, if you moved to a different county, your Medicaid case should be transferred to the new county.  You should not be required to do a new application or face-to-face interview.

DSS pays the premiums for my health insurance and/or Medicare. Will this continue during the COVID-19 emergency?

Yes.  DOH is continuing payment of Medicare and other third-party health insurance premiums for extended Medicaid cases.

I receive Medicaid through the Medicaid Buy-In for Working People with Disabilities (MBI-WPD) program. I have lost my job. Will my Medicaid be discontinued?

No.  If you lose your job, you can continue your participation in the MBI-WPD program for up to 6 months while you look for a new job.  If necessary, DSS should extend this for an additional 6 months due to the COVID-19 emergency.

I have a Medicaid spenddown. Will my Medicaid coverage be extended during the COVID-19 emergency?

Yes.  If you met your spenddown for March 2020, then your Medicaid coverage is extended for 6 months.  If you have been unable to submit a bill or payment to DSS due to the COVID-19 emergency, then you should contact DSS immediately.  They should authorize your Medicaid coverage for 6 months.

My Medicaid was discontinued, I requested a fair hearing, and I received Aid to Continue. Can my Medicaid be discontinued during the COVID-19 emergency?

No.  If you were on Aid to Continue status on or after March 18, 2020, then DSS must maintain your Medicaid coverage unchanged during the COVID-19 emergency period.