What is Medicaid and How Does It Work?

Medicaid is a New York state medical assistance program that provides medical and health-related services to people who cannot afford to pay for these services on their own. It is jointly funded through the federal and state government. In New York Medicaid is being expanded to cover people and families up to 138% of the poverty level. This means that that Medicaid will be expanded to include more individuals and families in need of benefits.

After a person is approved to receive Medicaid benefits, payments are sent directly to their health care providers. In addition, some beneficiaries may be required to provide a small copayment for certain medical services. Some mandatory benefits for Medicaid beneficiaries are:

  • Hospital inpatient and outpatient services
  • Early and Periodic Screening, Diagnostic, and Treatment Services
  • Nursing home and in home health care services
  • Physician services
  • Certified Pediatric and Family Nurse Practitioner services
  • Prenatal care
  • Laboratory and X-ray services
  • Family planning services
  • Transportation to medical appointments

In order to receive these and other benefits an eligible person must first apply for Medicaid benefits. New York State Medicaid requires that beneficiaries are residents of New York State, and are either citizens of the United States or have satisfactory immigration status. Other eligibility requirements may include:

  • Low income individuals
  • Pregnant women
  • Children
  • Individuals with disabilities
  • Seniors

If you meet these eligibility requirements you can write, call, or go to your local department of social services to apply.


Jaime Venditti, State Coordinator, New York Health Works