New York Medicaid Income Limits – 2021

The Medicaid Income Limit is the most important criteria for deciding whether you qualify for Medicaid in your state. In this post, we are going to explain in detail the New York Medicaid Income Limits for 2021.

Based on this information, you will be able to determine whether your income qualifies you for New York Medicaid or not.

However, before we get into details about the income limit, we will first explain the Medicaid program in New York and how it works.

Next, we will discuss who is eligible for Medicaid, including how eligibility works for various categories, including Children, Pregnant Women, and Adults.

Finally, we will explain how to check if your income qualifies for Medicaid in New York and how to apply.
To learn more, please keep reading this post below.
"New York Medicaid Income Limits"

What is Medicaid?

Medicaid is a federal and state health insurance program for people with a low income.

It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.

The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.

How Many People are on Medicaid?

According to the Centers for Medicare & Medicaid Services, as of November 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:

  • 78,521,263 individuals were enrolled in Medicaid and CHIP
  • 72,204,587 individuals were enrolled in Medicaid
  • 6,695,834 individuals were enrolled in CHIP

New York Medicaid

The New York Medicaid program provides medical coverage to low-income individuals and families.

As of 2020, the program, along with the Children’s Health Insurance Program (CHIP) covered 6.6 million people.

This includes 2.5 million children as shown by the image below.

"Number of people on Medicaid in New York"

In New York, the New York State Department of Health manages the Medicaid Program.

Who Can Get Medicaid in New York?

You should apply for Medicaid if your income is low and you match one of the descriptions below:

  • You think you are pregnant
  • The parent or caretaker of a child and/or teenager under the age of 19.
  • You are a child or teenager age 18 or under.
  • An adult age 65 or older.
  • You are legally blind.
  • Living with a disability or disabled.
  • You are in need of nursing home care.

New York Medicaid Income Limit

The New York Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line.

To qualify, you must meet the New York Medicaid Income limits listed below.

Here is the Federal Poverty Level (FPL) for 2021.

2021 Federal Poverty Levels for the 48 Contiguous States & D.C.
Household Size Poverty Guideline for 48 states & DC Alaska Hawaii
1 $12,880 $16,090 $14,820
2 $17,420 $21,770 $20,040
3 $21,960 $27,450 $25,260
4 $26,500 $33,130 $30,480
5 $31,040 $38,810 $35,700
6 $35,580 $44,490 $40,920
7 $40,120 $50,170 $46,140
8 $44,660 $55,850 $51,360
Over 8 people add $4,540 for each additional person $5,680 $5,220

Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:

  • Children up to age 1 with family income up to 218 percent of FPL
  • Any child age 1-5 with a family income up to 149 percent of FPL
  • Children ages 6- 18 with family income up to 149 percent of FPL
  • CHIP for children with family income up to 400 percent of FPL
  • Pregnant women with family income up to 218 percent of FPL
  • Parents of minor children with family income up to 133 percent of FPL
  • Individuals who are elderly, blind, and disabled with family income up to 83% of the FPL
  • Adults without dependents under Medicaid expansion with income up to 200% of the FPL

New York Medicaid Income Limit Charts

The New York Medicaid eligibility income limit charts are divided by groups.

For example, the first chart is focused on income limits for children who qualify for Medicaid.

Similarly, the second chart below focuses on the Medicaid income limits for adults in New York who qualify for Medicaid.

New York Medicaid Income Limit for Children 

Below is the income limit for children by age category. Find the age category your child falls into and you will see the income limit by household size.

New York Medicaid Income Limit – Children
Children Medicaid Ages 0-1 Children Medicaid Ages 1-5 Children Medicaid Ages 6-18 Children Separate CHIP
% FPL 100% 218% 149% 149% 400%
Household Size
1 $12,880 $28,078 $19,191 $19,191 $51,520
2 $17,420 $37,976 $25,956 $25,956 $69,680
3 $21,960 $47,873 $32,720 $32,720 $87,840
4 $26,500 $57,770 $39,485 $39,485 $106,000
5 $31,040 $67,667 $46,250 $46,250 $124,160
6 $35,580 $77,564 $53,014 $53,014 $142,320
7 $40,120 $87,462 $59,779 $59,779 $160,480
8 $44,660 $97,359 $66,543 $66,543 $178,640

Next is the income limit for adults by category. Find the category you fall into and you will see the income limit by household size.

New York has expanded Medicaid to include adults without dependents.

Therefore, adults without dependents can apply for Medicaid in New York.

For an update on the Medicaid expansion debate and timeline in New York, see our New York Expansion update below.

New York Medicaid Income Limit for Adults

New York Medicaid Income Limit – Adults
Pregnant Women Medicaid Adults (Medicaid) Parent/ Caretaker Seniors & People w/ Disabilities (Medicaid) Adults (Medicaid) Expansion to Adults
% FPL 100% 218% 133% 83% 200%
Household Size
1 $12,880 $28,078 $17,130 $10,690 $25,760
2 $17,420 $37,976 $23,169 $14,459 $34,840
3 $21,960 $47,873 $29,207 $18,227 $43,920
4 $26,500 $57,770 $35,245 $21,995 $53,000
5 $31,040 $67,667 $41,283 $25,763 $62,080
6 $35,580 $77,564 $47,321 $29,531 $71,160
7 $40,120 $87,462 $53,360 $33,300 $80,240
8 $44,660 $97,359 $59,398 $37,068 $89,320

 

How to Read the New York Medicaid Income Limits Charts Above

You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.

Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.

For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 218% of the Federal Poverty Level – which for a family of two is  $37,976 as shown in the chart above.

New York State has separate Medicaid Applications: one for certain categories of New York City residents and the other for the rest of the state. See below and select appropriately based on your situation.

How to Apply for New York City Medicaid

You can apply for Medicaid through New York City HRA if you:

  • Are over 65
  • Need Medicaid because of a disability or blindness
  • Get Medicare and are not a parent or caretaker of minor children
  • Are a former foster young adult under 26

If any of these categories describe your case, call the HRA Helpline at 1-888-692-6116 or visit any one of the Medical Assistance Program Offices.

Click here to Find a Medicaid Office near you.

Additionally, Low-income pregnant women, children, and adults under 65 must apply for coverage through NY State of Health (see below).

It is operated by New York State and is the Official Health Plan Marketplace. Contact the Marketplace at 1-855-355-5777.

How to Apply for New York Medicaid

There are 3 ways you can apply for Medicaid in New York State.

Option 1 – Apply online

You can apply online through the NY State of Health Portal – as shown in the image below.

If you have an account, you can log in or create your NY State of Health Portal account. Click here to be taken to the website.

Option 2 – Apply at DSS Office Near You

You can apply in person at the New York Departments of Social Services (DSS) office near you. Click here to locate a DSS office.

Option 3 – Download Application

Call the Medicaid Helpline Medicaid Helpline (800) 541-2831 to have an application mailed to you.

Complete it and mail it to your county DSS office or submit it in person.

"How to Apply for New York Medicaid Online"

New York Medicaid Phone Number

Here’s how to contact the New York Medicaid Agency:

For Medicaid Applicant & Member Services:

Call the Medicaid Helpline (800) 541-2831.

New York Medicaid Expansion Update

The state of New York expanded Medicaid as of January 1, 2014.

Between the fall of 2013 and August 2018, the state’s total Medicaid enrollment grew by 14 percent, to nearly 6.5 million people.

Medicaid expansion covers more than 2 million New Yorkers.

New York Medicaid relies on managed care, and numerous plans provide Medicaid coverage; plan availability varies by county.

New York Medicaid Income Limits Summary

We hope this post on New York Medicaid Income Limits was helpful to you.

If you have any questions about Medicaid in the state of New York, you can ask us in the comments section below.

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Be sure to check out our other articles about Medicaid.
Income limits for Florida Medicaid
Alabama Medicaid Income Limits and How to Apply
Alaska Medicaid Income Limits and Chart
NC Medicaid Income Limits