In 2022, Gov. Kathy Hochul relented and gave the green light to expand Medicaid to cover undocumented immigrants 65 and older. The state’s Department of Health launched the program last month after a year-long delay.

Lea la versión en español aquí.

For years, advocates have pushed the state to expand its low-cost health insurance to cover undocumented immigrants, who experts say make up the majority of New York’s uninsured.

So for several legislative sessions, state lawmakers have introduced—and sometimes advanced—different versions of so-called “Coverage for All” bills, which would make low-income undocumented persons between the ages of 19 and 64 eligible for the government’s essential health plans.

The bill died in the Assembly in the last legislative session and will be reintroduced this year. Its supporters, members of the Coverage4All coalition, will head to Albany Monday to rally outside the Capitol building in support of its passage.

In 2022, Gov. Kathy Hochul relented and gave the green light to a more limited change: expanding Medicaid to undocumented immigrants 65 and older. The state Department of Health (DOH) was supposed to launch the program on Jan. 1, 2023, but pushed that back a year.

City Limits created this guide on how undocumented seniors can apply for the new option, which opened to applicants last month.

What are the requirements and steps for enrollment?

To be eligible, individuals must be 65 or older and be below the Medicaid income threshold, or within 138 percent of the Federal Poverty Line (for example, $20,121 for a one-person household or $27,214 for a two-person household).

Residents who live in the city can enroll by visiting a Human Resources Administration (HRA) office; applicants in other parts of the state should go to a Local Department of Social Services (LDSS) site. The application does not have to be done in person, explained the DOH, so can also be mailed or faxed to those locations.

Once the individual is determined to be eligible, their application is transferred to the state’s insurance marketplace, NY State of Health, for enrollment in a Medicaid-managed care plan, while prescription benefits are handled through the Medicaid Pharmacy Program (NYRx). 

New enrollees must select a Medicaid-managed care plan. If the person does not select a plan, the DOH will assign one. The whole process may take up to four months, the department noted.

Those who meet the age requirement and who were previously enrolled in Emergency Medicaid, a program also available to low-income undocumented immigrants, will be automatically transferred to the new option. In that case, the DOH should have sent a letter in December detailing the change with instructions and a deadline for selecting a Medicaid-managed care plan.

What kind of documents are required?

Documentation of the applicant’s identity, resources, and income—if there is any—must be provided, as well as documentation of New York State residency.

How many people have enrolled so far? 

As of January, about 16,900 people were enrolled, most of them automatically transferred from Emergency Medicaid.

What Medicaid-managed care plans are available?

• Anthem HealthPlus
• HealthFirst PHSP
• MetroPlus
• Emblem
• Fidelis
• United Healthcare
• Affinity by Molina

What kind of medical care does health insurance cover?

The state’s health care plans include these 10 “essential health” benefits.

Want to know more or want to opt out?

For more questions, call the NY State of Health at 1-855-355-5777. Free language assistance is available if you speak a language other than English.

If you only want the emergency Medicaid plan, contact the department—at the same number above.

Launched in 2019, City Limits’ “What You Need to Know,” series aims to provide New York’s immigrant and Latino communities with practical information and explainers on a variety of topics. A Spanish-language version of this piece is forthcoming. Is there an issue you think we should tackle next? Please send your suggestions to Daniel@citylimits.org

To reach the reporter behind this story, contact Daniel@citylimits.org. To reach the editor, contact Jeanmarie@citylimits.org