Law & Legal & Attorney Insurance Law

Medical Insurance Rules in New York State

    • Medicaid is a federal and state program providing health insurance for low income and disabled individuals who meet certain eligibility standards. Each state makes its own rules (following federal guidelines) to determine who qualifies for Medicaid. New York's Medicaid rules are administered by the New York State Department of Health.

    Applying

    • The medicaid program in New york requires certain information from all applicants. The applicant must give proof of age, residence, citizenship or legal status, a health insurance or Medicare benefit card (if the applicant has Medicare or other insurance), a paycheck stub (if the applicant is employed) and proof of any income from Social Security, Supplemental Security Income, and Veteran's Benefits retirement, according to the New York state Department of Health. Also, if the applicant or someone who lives with the applicant is over 65 and blind or disabled, information concerning any bank accounts, insurance policies and other financial or medical resources is required.

    Recover Costs

    • Under certain circumstances, Medicaid is allowed to place a lien on the assets of a deceased recipient. Any amount received from the lien goes to recover the costs incurred by Medicaid for the recipient's health care. This applies to individuals who received assistance from Medicaid after their 55th birthday or when permanently residing in a medical institution.

    Breast Cancer

    • The New York Medicaid program pays only for breast cancer surgery performed in hospitals with a high volume of such surgeries. This is done to make sure breast cancer patients receive their surgical care at facilities with more experience in this type of surgery and with higher five-year survival rates than surgeries performed at low volume hospitals.

    Other Insurance

    • An individual who believes he is eligible for Medicaid, but already has other health insurance, should not cancel this insurance to apply for Medicaid. If the person is having difficulty paying the premiums, Medicaid may assist him in making the payments, if he meets eligibility qualifications.

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