Affordable Health Insurance with Medicaid New York
What is Medicaid?
New York State Medicaid gives people free or affordable health insurance. It helps qualifying children, adults, seniors, and families get the affordable care they deserve. Medicaid includes important services, like checkups, prescriptions, hospital visits, and more. Low-cost coverage gives you peace of mind knowing you and your family are covered.
Doctor and hospital visits
Medicaid offers preventive care, including well visits, immunizations, and preventive screenings. It also offers prenatal, pregnancy, and infant care as well as hospital and emergency room visits.
Affordable health insurance
Medicaid offers free health insurance. There is no monthly premium. You may pay small co-pays for some services, but providers may waive them if you cannot afford to pay.
Dental and vision
Medicaid covers high-quality dental and vision care, including routine dental exams and cleanings, eye exams once every 12 months, and annual vision allowance for glasses or contacts.
Provider network
Our provider network includes top hospitals, clinics, and specialists known for their quality of care. All providers meet MVP quality and safety standards, so you can feel confident about your care.
Behavioral health services
Need behavior health services, too? You may qualify for the Harmonious Health Care Plan (HARP). HARP includes everything Medicaid offers plus behavioral health services.
Prescription drug (Rx) coverage through NYRx
All MVP Medicaid Managed Care members get their medicines through NYRx. NYRx is New York State’s Medicaid Pharmacy Program.
Who Qualifies for Medicaid?
MVP offers Medicaid to people in New York State who qualify. It’s available to low-income adults and children.
Medicaid income requirements made simple
You may qualify for Medicaid depending on your age, household income, family size, or immigration status.
The state uses your household income to decide if you can get Medicaid. They compare it to the Federal Poverty Level (FPL). For example, a larger household can earn more and still qualify.
These limits change based on your family size and circumstances, like pregnancy or disability.
If your income is at or below the amount on the chart for your household size, you may apply for Medicaid.
2026 Medicaid Annual Income Requirements
When choosing your household size, include all adults and all children. Pregnant mothers should also include all expected children. For example, if a pregnant mother is applying, and she is expecting twins, her household size would be three.
MVP Medicaid service area
MVP offers New York State Medicaid in the following counties:
- Albany County
- Clinton County
- Columbia County
- Dutchess County
- Essex County
- Franklin County
- Fulton County
- Genesee County
- Greene County
- Hamilton County
- Herkimer County
- Jefferson County
- Lewis County
- Livingston County
- Monroe County
- Montgomery County
- Oneida County
- Ontario County
- Orange County
- Putnam County
- Rensselaer County
- Rockland County
- Saratoga County
- Schenectady County
- St. Lawrence County
- Sullivan County
- Ulster County
- Warren County
- Washington County
- Westchester County
Eligibility by life stage
No matter what stage of life you’re in, you may be eligible for Medicaid. It’s here to help you and your family get affordable health insurance within your budget.
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If you are between the ages of 19 and 64, you may qualify for New York Medicaid based on your income. You can qualify whether you are working, between jobs, or working without health benefits.
- Employment status: You can apply for Medicaid whether you are working full-time, part-time, or not at all. The state decides your eligibility. To do this, they compare your household income to the Federal Poverty Level (FPL).
- Unemployed or underemployed: Medicaid covers unemployed people. It also helps those between jobs or in jobs that do not offer insurance.
If you don’t qualify for Medicaid based on your income, you may be eligible for the Essential Plan. This plan offers low or no-cost coverage with higher income limits. Learn more about Medicaid vs. the Essential Plan.
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Children’s Medicaid is available for kids aged 0-20.
For children ages 1-18 to qualify, their family’s household income must be at or below 154% of the Federal Poverty Level (FPL).
Children ages 19-20 must be living with a parent whose household income is below 155% of the FPL.
Other criteria such as residency and citizenship status must also be met.
If your child does not qualify for Children’s Medicaid, you have other options.
Child Health Plus is low-cost or free health insurance for children. It’s for families who are above the income limit for Medicaid.
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If you are pregnant, you may qualify to apply for Medicaid at a higher income level than other adults.
In New York State, pregnant adults and babies under one year of age are eligible to sign up for Medicaid if their household income is at or below 233% of the FPL. When figuring out your household size, include any expected babies. For example, if a single mother is pregnant with twins, her household size would be 3.
Medicaid covers the care you and your baby need during pregnancy, delivery, and beyond. This includes:
- Regular checkups and prenatal visits
- Hospital care during labor and delivery
- HIV counseling and testing
- Full health care coverage for at least two months after delivery
- Health coverage for your baby for at least one year after birth
- Help with applying for other support programs like WIC
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If you are 65 years of age or older, you could be eligible for a Dual Special Needs Plan (D-SNP).
D-SNP plans are for people who qualify for both Medicare and Medicaid. Not everyone is eligible, since the rules depend on your age, income, and type of coverage. You may also qualify for additional support programs.
Learn more about DSNP Plans on our Dual Special Needs Plan page.
Special circumstances
New York Medicaid also offers coverage for people with unique needs, such as disabilities, emergencies, or immigration situations.
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Some undocumented non-citizens may qualify for Medicaid. For example, undocumented people age 65 or older may be able to get Expanded Medicaid if they meet income limits.
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Medicaid has programs for people with disabilities. If you are working and make too much to qualify for regular Medicaid, you may still get coverage through the Medicaid Buy-In Program (MBI-WPD). Learn more from the NY State Department of Health.
People with developmental disabilities can also get Medicaid through the New York State Office for People with Developmental Disabilities (OPWDD). To learn how to apply, visit OPWDD’s Website.
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MVP Harmonious Health Care Plan® is for Medicaid Managed Care members who need extra support. It helps you care for your well-being, as well as your physical and behavioral health. HARP can help you stay healthy and live a full and active life.
Additional support services include help with:
- Career and school support
- Finding housing
- Crisis and mental health care
- Living independently
- Managing stress
- Substance use disorder
The New York State Office of Mental Health determines eligibility for these services.
How To Apply for Medicaid in New York
Required documents checklist
To better assist you in signing up for Medicaid, have the following information ready:
- Name and date of birth
- Social security number or an ID number from immigration or citizenship papers
- Proof of New York State residency
- Proof of income for the last 30 days, such as a pay stub, unemployment document, or a three-month financial statement
- Information about any other health insurance you have
- Specialty situation documents
Schedule a call
You can set up a meeting with an MVP representative. Just complete the form below.
Keeping Your Coverage Active
Annual renewal process
Renewal dates are different for everyone. They depend on when you first applied for Medicaid. But MVP makes your Medicaid renewal process easy. We will contact you before your coverage end date to help with your renewal.
If it’s time for you to renew, follow the instructions on our Medicaid Renewal page.
Missed your renewal deadline? Contact MVP’s Customer Care Center by calling 1-800-TALK-MVP (1-800-825-5687).
Reporting life changes
It’s important to let us know if anything in your life changes. Not reporting updates could affect your eligibility or coverage. Be sure to tell us if any of the following change:
- Your address
- Your phone number
- Your email address
- Your family size
- Your annual income
- Any other important details that affect your household
You can report changes in a number of ways, including:
- Call the MVP Member Services/Customer Care Center at 1-800-TALK-MVP (825-5687) (TTY 711)
- Sign in to your NY State of Health account
- Call the NY State of Health Customer Service Center at 1-855-355-5777
You can also report changes in Gia. To update your email address or phone number, sign into your Gia account or Mobile App, and choose Profile and Settings. To update other items, you can submit a secure message to our Customer Care Center.
Frequently Asked Questions
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How do I know if I qualify for Medicaid?
Medicaid helps people in New York State get affordable health insurance. You may qualify based on your household income, age, family size, or health needs.
The rules are different for everyone. Children and pregnant people can often qualify with higher household incomes. Seniors and people with disabilities may also qualify under special rules.
When you apply, the state looks at your household income and who lives with you. This can include your spouse, children, or anyone you support. The state also checks your living situation and if you have other health insurance.
Even if you’re not sure you qualify, it’s worth applying. Many people are surprised to learn they can get Medicaid, especially if their income has recently changed.
If you want help, an MVP representative can walk you through the steps to sign up for Medicaid.
You can also see the full income limits on the New York State Department of Health website.
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What is the income limit for Medicaid in New York?
The 2026 Annual Income Level Requirements for Medicaid are:
- Adults: Up to 138% FPL
- Children 1-18: Up to 154% FPL
- 19–20-Year-Old Living with Parent: Up to 155% FPL
- Pregnant Women and Children under Age 1: Up to 223% FPL
More information is available on the NY State of Health Federal Poverty Levels (FPL) Chart.
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When can I enroll in Medicaid?
There is no enrollment period for Medicaid. You can apply today, tomorrow, or whenever you need coverage. You do not have to wait to apply.
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What if I can’t afford health insurance?
If paying for health insurance feels out of reach, Medicaid may be the solution. Medicaid is for lower income individuals, providing health coverage with no monthly cost. It helps cover doctor visits, prescriptions, hospital care, and more—so you don’t have to go without care.
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Whats the difference between Medicaid and Medicare?
Medicaid gives health coverage to individuals with lower incomes. It is for adults, children, pregnant people, seniors, and people with disabilities. Both state and federal government pay for the Medicaid program.
Medicare is different. It is a federal health insurance program for people age 65 and older. People under 65 may also qualify if they have certain disabilities. Anyone with kidney failure that needs dialysis or a transplant (ESRD) can get Medicare. People with amyotrophic lateral sclerosis (ALS), commonly called Lou Gehrig’s disease, can also get Medicare.
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What does Medicaid Cover?
Medicaid benefits cover lots of things, including:
- Doctor visits and checkups
- Shots and vaccines
- Specialty visits
- Relevant medical supplies and equipment
- Lab tests and X-rays
- Vision care
- Dental services
- Pregnancy and newborn care
- Behavioral health support
- Nursing home care
- Hospital stays
- Emergencies
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Does Medicaid cover prescription drugs?
Yes. NYRx, New York State’s Medicaid Pharmacy program, covers medically necessary prescription and non-prescription drugs that Medicaid members need.
Medicaid members enrolled in MVP Medicaid Managed Care receive their prescription drugs through NYRx, the Medicaid Pharmacy Program. For more information visit the New York State of Health Website.
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Can undocumented non-citizens get Medicaid?
Undocumented non-citizens are sometimes called “illegal immigrants”. You may still be able to get care even if you don’t have legal status. It uses the same application as regular Medicaid. When you apply, the state will review your information and decide which program you qualify for.
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Does Medicaid cover dental?
Yes. Medicaid covers basic dental care. Medicaid members’ dental care is with DentaQuest.
This includes cleanings, checkups, fillings, and some dentures. Some services may need approval before you get them.
Essential Medicaid Prescription Benefits through NYRx
MVP Medicaid Managed Care members will receive prescription drugs through the NYRx Medicaid Pharmacy Program.
To learn more about applying for health insurance including Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans through NY State of Health, The Official Health Plan Marketplace, visit www.nystateofhealth.ny.gov or call 1-855-355-5777.
ATTENTION: Language assistance services and other aids, free of charge, are available to you. Call 1-855-355-5777 (TTY 711).
ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-855-355-5777 (TTY 711).
请注意：您可以免费获得语言协助服务和其他辅助服务。请致电 1-855-355-5777 (TTY 711).
Health benefit plans are issued or administered by MVP Health Plan, Inc.; MVP Health Insurance Company; MVP Select Care, Inc.; and MVP Health Services Corp., operating subsidiaries of MVP Health Care, Inc. Not all plans available in all states and counties.
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