How to get Medicaid or low-cost care in New York

How Medicaid works in New York

Medicaid is a government program that pays for health care for people with low incomes. In New York, the Department of Health runs it. Your county office, called the local department of social services, also takes applications and answers questions about your case.

Medicaid expansion began in New York on January 1, 2014. Since then, adults ages 19 to 64 can qualify based on income, even when no children live at home. The limit is 138 percent of the federal poverty level, which is a yearly dollar amount the government uses to measure poverty. Your exact limit depends on how many people live in your home.

Children under 19 may qualify for a separate program called Child Health Plus. Members do not pay a monthly premium for Medicaid. Some services carry small co-payments, which are fees you pay at the visit, and these can be waived if you cannot afford them.

People with disabilities and people who are pregnant follow other rules, which our guide on who qualifies for Medicaid explains group by group.

Where to apply for New York Medicaid

NY State of Health is the state's marketplace website, and you can use it to apply for Medicaid in any month of the year. You can reach its customer service line at 1-855-355-5777. The line is open Monday to Friday from 8am to 8pm and on Saturday from 9am to 1pm.

Free, trained helpers called enrollment assistors can sit down with you and fill out the form. For paper forms or an in-person visit, write, call or stop by your local department of social services. In New York City, that office is the Human Resources Administration, and its number is 718-557-1399.

General questions go to the Medicaid Helpline at 800-541-2831. Pregnant people and children can also apply at many clinics and hospitals, according to the Department of Health. Your county office can tell you which ones nearby take applications.

Gather proof of your income and your address before you start. A full checklist is in our guide on how to apply for Medicaid.

What to know if your income is a bit higher

Some adults earn too much for Medicaid but still have a low income. New York's Essential Plan is the second program built for them. It is a low-cost health plan sold through NY State of Health, and you can sign up at any time of year.

The Essential Plan has a $0 monthly premium and no deductible. A deductible is the amount you pay yourself before insurance starts to pay. You must be lawfully present in the U.S., live in New York and be ages 19 to 64. You also cannot qualify for Medicaid or other coverage.

For 2026, the state says a single person can earn up to $31,920 a year. The limit is $43,280 for two people, $54,640 for three and $66,000 for four. A single person earning up to $23,940 pays $0 for a primary care visit. From $23,941 to $31,920, that visit costs $15.

Rules for this plan changed in July 2026. Check the current table on the NY State of Health website before you apply.

What changes on January 1, 2027

Federal law passed in 2025 adds new rules for Medicaid. Starting January 1, 2027, some adults ages 19 to 64 must show that they work, study, volunteer or join a job program. Your application or renewal is when the state checks it.

You meet the rule by earning at least $580 a month. Doing 80 hours a month of approved activities works too, and you can mix the two. Wages and tips count, and so do gig work earnings and unemployment payments. SSI and child support payments do not count toward the $580.

Many people are exempt, so the rule does not apply to them. Exempt groups include people who are pregnant and people with a disability. People with a health condition that makes work hard are exempt too. Parents and caregivers of a child 13 or younger are exempt, using the wording from the federal government. People who must follow the SNAP work rules are exempt as well.

Most adults ages 19 to 64 will also renew Medicaid every six months instead of once a year. Anyone who applies before January 1, 2027, or renews before March 1, 2027, gets 12 months first. Medicaid will also look back fewer months to cover old bills, so it helps to apply as soon as you need care.

By September 30, 2026, the state planned to mail notices to people these rules affect. A missing notice may mean the rules do not apply to you. Keep your address and phone number current in your account so a letter never goes missing.

Low-cost clinics in New York

Community health centers are federally funded clinics that set prices by what you earn. The free Find a Health Center tool from the Health Resources and Services Administration works with just your zip code. The Community Health Care Association of New York State, which supports these centers, has its own Find a Health Center page too.

Ask each center about its sliding fee scale, which is a price list based on what you earn. Ask too whether the staff will help you apply for Medicaid before your visit. For tips on comparing prices, see our guide to sliding-scale clinics.

Checking a New York doctor

A Verification Search for licensed professionals is run by the New York State Education Department. The Department of Health also publishes a New York State Physician Profile. Both let you look up a doctor by name before you book.

Flat-fee doctors and emergencies in New York

Some New York doctors run direct primary care practices. Under that model, you pay a flat monthly fee for visits, and the office does not bill insurance for them. Our directory lists cash-pay doctors, and it is wise to get the fee in writing.

Chest pain or trouble breathing means you should call 911 or go to the nearest emergency room. Federal law says a New York hospital with an emergency room must examine you whether or not you have coverage. When a hospital bill comes afterward, our guide on hospital financial assistance shows how to ask for a lower bill.