How to apply for New York Medicaid

Last verified: June 2026

NYC vs. upstate: two different agencies handle your application

Where you live in New York determines which agency processes your Medicaid application. This matters for wait times, in-person locations, and how renewals work.

Pregnant individuals and children can also apply at many clinics, hospitals, and provider offices. Call your county DSS to find nearby enrollment sites.

What documents you need before you apply

Gather these before starting your application to avoid delays:

• Proof of identity — driver's license, state ID, passport, or birth certificate
• Proof of New York State residency — a utility bill, lease, or recent mail with your address
• Social Security number (or proof of application) for each household member applying
• Immigration documents if applicable — green card, visa, or employment authorization card
• Proof of income for everyone in the household — pay stubs, award letters (Social Security, SSI, pension), or a self-employment statement
• Health insurance information for any current coverage (insurance cards, Medicare ID)

MAGI-based Medicaid has no asset test, so you do not need to document savings accounts, vehicles, or property for standard coverage. Long-term care applications have additional requirements — see the seniors and long-term care page.

How long does New York Medicaid take to process?

Federal regulations at 42 CFR § 435.912 set a 45-day processing deadline for most Medicaid applications — 90 days when disability must be determined. New York generally meets these timelines, though processing speeds vary by county and by volume of applications.

For pregnant individuals, hospitals are authorized to make presumptive eligibility determinations on the spot — meaning care can begin immediately while the full application is processed. Children may also receive presumptive eligibility at qualified provider sites.

If approved, New York Medicaid can be backdated up to three months before the application date if you had covered medical expenses during that period and met eligibility requirements at the time. Ask your eligibility worker about retroactive coverage when you apply.

Step-by-step: applying online through NY State of Health

1. 1

   Go to nystateofhealth.ny.gov

   Create an account or log in. Select "Apply for coverage" and choose the individual/family path. The portal guides you through the income and household questions that determine whether you qualify for Medicaid, the Essential Plan, or a subsidized marketplace plan.

2. 2

   Complete the application and submit

   Answer all household and income questions. The portal automatically routes Medicaid-eligible applicants to the DOH system. You will receive a confirmation number. Save it.

3. 3

   Respond to any requests for documentation

   Your local DSS or HRA may request documents to verify income, residency, or identity. Respond promptly — delays on your end extend the processing clock.

4. 4

   Receive your determination and choose a plan

   If approved, you will receive a notice and instructions to select a managed care plan. If you do not choose, you will be auto-assigned to a plan in your area. Your Medicaid card follows once enrolled.

What to expect after you submit

Under 42 CFR § 435.912, most Medicaid applications must be processed within 45 days (90 days when disability determination is required). If approved, coverage typically begins the first day of the month you applied. Retroactive coverage may go back up to three months if you had eligible medical expenses during that period.

1. 1

   Application recorded

   NY State of Health or HRA records your application date — this determines your potential coverage start month.

2. 2

   Electronic verification attempted

   Your local DSS or HRA checks income and identity electronically using SSA, IRS, and state wage data. If everything verifies, no further documents are needed.

3. 3

   Document request (if needed)

   If verification fails, you will receive a request to provide documents. Respond promptly — delays on your end extend the processing clock and can result in denial.

4. 4

   Eligibility determination and plan selection

   You receive a written approval or denial. If approved, you choose a managed care plan. Not choosing results in auto-assignment to a plan available in your county.