GIS 23 MA/17, which is dated 08/29/2023, advises that there is a new Medicaid application form.
The new version of the Access NY Health Care Application will show this at the bottom of each page: (1/23).
The new version of the form is an attachment to the GIS.
It also may be found by going to: http://www.health.ny.gov/forms/doh-4220.pdf
If that link stops working, the form may be found on the New York State Department of Health website.
Go to www.health.ny.gov
Click on: Individuals/Families
Click on: Health Topics A to Z
Click on: the letter M
Click on: Medicaid
Click on: How to Apply (this will be on the left side of the screen)
Scroll down to: Medicaid Application for Non-MAGI Eligibility Group
Click on: DOH-4220
Posted 09/03/2023