Many Medicaid recipients who are 65+, and/or who have a disability and receive Medicare, will now be able to have higher income and more resources while still qualifying for Medicaid.

This guide will answer common questions about how to use your Medicaid to get health care services.  It will cover:

• Understanding Your Medicaid Plan
• Finding a Doctor
• Getting Care
• Appealing a Denial

A Medicaid spenddown is when your monthly income is more than the income limit for Medicaid. The difference between your income and the Medicaid limit is called a “spenddown” or a “surplus.” You also might be told you are “over-income” for Medicaid or have “excess income.”

Information about receiving a lump sum payment from Medicaid and how it may affect your eligibility or coverage.

New York and federal law requires health insurance – including Medicaid, Child Health Plus, and private insurance – to cover most court-ordered behavioral health treatment when medically necessary.

There is a lot of information about what kind of health insurance (sometimes called “health coverage,” or “coverage”) you might be eligible for depending on your immigration status. This pamphlet is intended to provide basic information to you so that you can make an informed decision about your health coverage. Because this can be complicated, if you have questions or concerns you can contact The Legal Aid Society, another legal services organization, or a trained assistor to learn about your coverage options. Do not assume that just because you are not a citizen or a green card holder (lawful permanent resident) that you are not eligible for health coverage.

In New York, regardless of your immigration status and your ability to pay, you are entitled to hospital treatment in the case of a medical emergency. There are also many ways to access affordable health care in New York City.

Medicaid is a comprehensive health insurance program for low-income people of all ages. Medicaid covers a variety of health services including home care, nursing home, dental, vision, crisis intervention, inpatient rehabilitation, outpatient services, opioid treatment (including medication-assisted treatment), and residential treatment.

HIV/AIDS Representation Project (H/ARP) serves persons living with HIV and AIDS citywide in the areas of government benefits, disability benefits, health law, family law, consumer law, housing, estate planning, discrimination, and other general civil matters.

The Project maintains linkages with community-based organizations and can offer referrals to health services, HIV/AIDS education, counseling, substance abuse, and comprehensive case management. H/ARP conducts regular intake and outreach at designated hospital clinics as well as in our Harlem office.

In New York, coverage is available for hormone therapy (including cross-sex hormones and pubertal suppressants), surgeries, and other procedures. To receive coverage, you have to have a diagnosis of gender dysphoria and your doctor’s notification that the treatment you seek is medically necessary. The process can feel complicated and overwhelming, but you are entitled to this coverage. Here’s what you need to know.

An overpayment occurs when the Social Security Administration (SSA) states that you received more social security or SSI benefits than you were supposed to receive. Here’s what you need to know to get the benefits you deserve.

Supplemental Security Income (SSI) is a federal program that pays benefits to adults with disabilities who have limited income and resources, and who have little or no work history.

Adults with a work history might also be eligible for Social Security Disability (SSD). The Social Security Administration (SSA) runs both programs. While there are differences in the two benefits, the rules for being found “disabled” are the same for both. Learn more about eligibility and how the process works below.

Supplemental Security Income (SSI) is a federal program that pays benefits to children and adults with disabilities who have limited income and resources. Learn more about how to apply and how to appeal a denial below.