Undocumented Non-Citizens Age 65+ Now Eligible for Medicaid

Undocumented individuals residing in NYS who are age 65 or older became eligible for Medicaid as of Jan. 1, 2024. In order to qualify, their income must be below the Medicaid income threshold or at or below 138 percent of the federal poverty level. Their coverage is available only through mainstream Medicaid managed care plans and includes long-term care services. Their pharmacy benefits will be administered through NYRx, the Medicaid pharmacy program.

Individuals seeking this coverage must apply through their local department of social services or the NYC Human Resources Administration. Once they are determined eligible, they will temporarily be eligible for Emergency Medicaid (coverage code 38) until they are enrolled in a Medicaid managed care plan. Once enrolled in a plan, they will be assigned coverage code 37. Their coverage will be administered through NY State of Health, the state's health insurance exchange. Eligibility for nursing home care must be determined separately.

More information regarding this expansion is available in the December 2023 issue of the NYS Department of Health (DOH) Medicaid Update here. Questions regarding the coverage expansion or eligibility and questions regarding documentation related to nursing home eligibility should be sent to DOH here.

Contact: Karen Lipson, klipson@leadingageny.org