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  1. If you recieve Medicaid through NY State of Health, you may fill out form DOH-5085 and submit to NY State of Health.

    • Medicaid Excess Income

      The fax number in New York City is 917-639-0645. If you fax...

    • OHIP-0112

      You Must Apply for Medicare. This document is also available...

    • Health Plans

      Medicaid Finance and Rate Setting. The Medicaid Finance and...

    • LDSS

      LDSS - How to Apply for NY Medicaid - New York State...

    • Medicaid Data and Reports

      New York State began sending renewal notices in the early...

    • Providers

      Medicaid Prescriber Education Program (MPEP) The Medicaid...

    • Archive

      Archive - How to Apply for NY Medicaid - New York State...

    • Members

      Information on additional programs can be found in the...

  2. Access NY Application. By completing and signing this application, I am applying for Medicaid, Family Health Plus, Child Health Plus, PCAP, and the Special Supplemen-tal Food Program for Women, Infants and Children (WIC).

  3. This application can be used to apply for Medicaid, the Family Planning Benefit Program, or for assistance paying your health insurance premiums. You can apply for yourself and/or immediate family members living with you.

  4. To help you answer whether anyone has access to health insurance through a state health benefits plan, the following describes what we mean: State Health Benefits Plan means the New York State Health Insurance Program (NYSHIP), which is offered to employees/retirees of NYS government, the State Legislature and the Unified Court System.

  5. 17 cze 2010 · Since 2010, the New York State Department of Health Medicaid application form is called the Access NY Application or Health Insurance Application or form DOH-4220. Download the most recent version of the form at this link.

  6. 20 lut 2024 · Since 2010, the New York State Department of Health Medicaid application form is called the Access NY Application or Health Insurance Application or form DOH-4220. Download the most recent version of the form at this link.

  7. This application can be used to apply for Medicaid, the Family Planning Benefit Program, or for assistance paying your health insurance premiums. You can apply for yourself and/or immediate family members living with you. IF YOU NEED HELP COMPLETING THIS APPLICATION DUE TO A DISABILITY, CALL YOUR LOCAL DEPARTMENT OF SOCIAL SERVICES. THEY WILL MAKE

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