I received a notice that my Medicaid is ending. What can I do?

During COVID-19, you did not need to renew your Medicaid coverage every year. Now, that rule has changed, and you must fill out and send in your Medicaid renewal forms on time to avoid losing Medicaid coverage and services.

If you do not return your Medicaid renewal, you will receive a letter telling you that your Medicaid coverage will end or “discontinue.” Any home care services you are getting will also end.

This guide offers information and tips for what to do if you receive a notice that your Medicaid is ending because you didn’t complete & return your Medicaid renewal. It explains how to ask for more time and what to do to keep your Medicaid coverage. We recommend taking the following steps to keep your Medicaid coverage, discussed in more detail below:

  1. Request a fair hearing immediately and ask for a copy of your case file after you request the fair hearing; and
  2. Gather important documents and submit your Medicaid renewal to HRA – even while you wait for a fair hearing.

Step 1: Ask for a Fair Hearing Right Away & Obtain Your Case Files

Ask for a Fair Hearing

If you get a letter saying your Medicaid will end, you must ask for a fair hearing before the Medicaid end date on the letter (“discontinuance”). Requesting a fair hearing before the end date will help you keep your Medicaid coverage the same while you make efforts to renew.

If you weren’t able to request the fair hearing before the end date, you should still request one—you have 60 days from the date of the notice to request a fair hearing.

If you did not get a letter in the mail but find out your Medicaid ended when you try to pick up medicine or see a doctor, you should still ask for a fair hearing. When you request the fair hearing, tell them you did not get a notice.

Fair hearing requests are handled by a New York State agency called the Office of Temporary and Disability Assistance (OTDA). You can request a fair hearing:

You should get a notice from OTDA with your Medicaid fair hearing number within two weeks.

Ask for your Medicaid Case Files

You will want to see the documents that HRA has about your case so you can prepare for your fair hearing. You should request copies of your case files from Medicaid. Send your request with the fair hearing number (which you get about two weeks after requesting the fair hearing) to:

NYC HRA Office of Administrative Hearings
Attn: Rivera Unit – Medicaid 250 Livingston St, 6th Floor,
Brooklyn, NY 11201 Fax: 917-639-9355

Step 2: Gather Important Documents & Complete Your Renewal Form

Gather Important Documents for Your Medicaid Renewal

Requesting a fair hearing is an important first step. However, even if you request a fair hearing, you still need to complete the Medicaid renewal within 90 days of the end date on the discontinuance letter. Before you start, take a moment to find some important papers.

These include:

  • The letter from Medicaid saying your coverage is ending;
  • Your renewal form (if you have it);
  • Your Medicaid card & CIN #. The CIN (XX00000X) is highlighted in the card below;

    New York State Medicaid Update - May 2023 NYRx Pharmacy Benefit Transition: Part Four Special Edition Volume 39 - Number 9
  • Proof of income (Social Security, paystubs, pension etc.);
  • Recent bank statements if you are 65+ or have a disability;
  • Proof of any health insurance premiums you pay.

Complete the Medicaid Renewal Form and Return to HRA

The Medicaid renewal & any required documents must be submitted to the local district of social services within 30 days from the date of discontinuance on the notice. In NYC, that’s the Human Resources Administration (HRA).

Getting the Medicaid renewal form, filling it out, and sending it back to HRA:

  • If you have your Medicaid renewal form, fill it out, sign it, and send it to HRA as soon as possible. The renewal comes with a grey pre-stamped envelope. If you misplaced the envelope, the mailing address for renewals is on the first page of the Medicaid renewal form.

    MAIL RENEWAL PROGRAM HRA/MEDICAL ASSISTANCE PROGRAM
    PO BOX 329060
    BROOKLYN, NY 11232-9823

    Make sure to keep a copy of the completed renewal form & supporting documents and write the date you mailed it on your copy of the renewal form. You may need this proof for your fair hearing or if HRA says they never received it.

  • If you don’t have or can’t find the Medicaid renewal form:
    • Call HRA’s Medicaid Helpline, 1-888-692-6116, and ask for another copy of the Medicaid renewal. Make sure you confirm your mailing address on file. You don’t want the form to go to the wrong address;
    • Go in-person to your local Medicaid office to obtain a copy of the Medicaid renewal form. Make sure to bring all the important documents you gathered with you when you go. While you are at the Medicaid office, complete the renewal form, sign it, and submit it in-person, along with any required documents. You should take pictures of the completed renewal form & documents, and ask for a receipt as proof of submission;
    • Renew on Access HRA (AHRA) Create an account or log into your AHRA account and submit the renewal online. If renewing online is not available on AHRA, reprint the Medicaid renewal form and then submit it by mail or in-person to HRA. You will need your Medicaid Case # and CIN#. If you don’t have them, call the Medicaid Helpline, 1-888-692-6116, to get them before continuing.
      • To reprint the Medicaid renewal form, click on this link, https://a069-access.nyc.gov/accesshra/, scroll to the bottom of the page and select, “Print Medicaid Renewal Form,”
      • You will have to log into the Access HRA account with your username and password. Once logged in, enter your Medicaid Case number, Medicaid CIN #, and date of birth.
  • If you cannot obtain a copy of the Medicaid renewal form through the Medicaid helpline or Access HRA and you cannot travel to a local Medicaid office, you may need to fill out a new Medicaid application (DOH 4220 & DOH 5178A: Supplement A). Medicaid applications forms are available here: https://www.health.ny.gov/health_care/medicaid/how_do_i_apply.htm
    • Write at the top of the application form, “Renewing Medicaid Case #_____________” and mail it along with any required documents to HRA. Remember to keep a copy of the completed forms and documents and keep proof of mailing. You may need this proof for the fair hearing.

It should take about 45 days for your renewal to be reviewed and processed by HRA. If you haven’t received a letter confirming your Medicaid was renewed within 60 days, contact the Medicaid Helpline, 888-692-6116, for assistance.

If your Medicaid is restored before your fair hearing date, you can withdraw your fair hearing request. You should only withdraw the fair hearing when you’ve received written notice informing you that your Medicaid coverage has been restored or renewed.

If your Medicaid is not restored and you have to proceed to the fair hearing, see below for additional resources and legal help.

Additional Resources and Legal Help:

For general resources and information:

If you need legal advice, contact these programs for assistance:

  • Legal Services NYC: 917-661-4500 (M-F, 9:30am-4pm)
  • Community Health Advocates: 888-614-5400
  • Independent Consumer Advocacy Network: 844-614-8800
  • You can also visit, https://www.lawhelpny.org/find-legal-help.

For free legal help, call Legal Services NYC at 917-661-4500 Monday through Friday from 9:30 a.m. to 4 p.m. Learn more about our intake process here.

* The information does not constitute legal advice. You should always consult an attorney regarding your matter. Legal help subject to capacity and location.

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