Ignoring a recertification notice can end your Medicaid coverage even if you still qualify. Federal law (42 CFR 435.916) requires the state to attempt an automatic renewal from data it already holds before it asks you for anything, but when a form does reach you, it has to come back on time. This guide walks through how the New York Medicaid recertification and renewal cycle works in 2026, and how to recover if a deadline slips by.

Renew MAGI cases online at NY State of Health · NYC residents use ACCESS HRA · everyone else, your county LDSS

Recertification is the annual review that most often decides whether coverage under the Medicaid program continues or lapses: eligibility is set once at application, then redetermined on a standard 12-month cycle, and a missed renewal can end coverage even for someone who is still eligible., When a renewal closes for procedural reasons, the person usually remained eligible and simply did not return the form in time, which is exactly what the 90-day reconsideration window below is built to fix.

For the underlying financial rules, see New York Medicaid eligibility and income limits.

In This Guide

The New York Medicaid recertification and renewal cycle

The New York State Department of Health (NYSDOH), the single state Medicaid agency, redetermines eligibility for most enrollees on a standard 12-month cycle. Your renewal month is set when you are first approved and recurs in the same calendar month each year. New York calls this annual review recertification, and non-MAGI cases return a mailed recertification packet from the local district.

Which desk handles your recertification depends on two things: your eligibility category and where you live.

  • MAGI populations (children, pregnant enrollees, parent/caretakers, and ACA expansion adults under 65) are renewed under Modified Adjusted Gross Income methodology and recertify through NY State of Health, the state's integrated eligibility marketplace. Income is verified through federal and state data sources, so many MAGI cases renew passively with no action required.
  • Non-MAGI populations (Aged, Blind, and Disabled, nursing-home Medicaid, and the Managed Long Term Care, Consumer Directed Personal Assistance Program (CDPAP), and waiver pathways) recertify through the local district: the NYC HRA Medical Assistance Program for the five boroughs, or your county Local Department of Social Services (LDSS) upstate and on Long Island. These cases carry the asset test that ex parte data rarely clears, so they far more often require a returned packet.

The non-MAGI split matters because those cases carry an asset test. Federal law (Section 1940 of the Social Security Act, 42 U.S.C. 1396w) requires the state to verify assets at renewal through an Asset Verification System, so non-MAGI renewals far less often clear automatically and usually require the enrollee to submit bank statements, retirement-account statements, life-insurance documentation, and a signed AVS authorization.

Ex parte New York Medicaid renewal: the federal mandate

The most important federal rule in modern Medicaid renewal is the ex parte default at 42 CFR 435.916. Before the agency asks you for any information, it must attempt to renew eligibility from reliable information already in your account or otherwise available to it, including electronic data sources. Only when it cannot renew on that basis may it request information from you.

In New York, ex parte renewal draws on the electronic data sources the federal rules point to, including Social Security records, federal tax data, and state wage and unemployment files. If those sources confirm you remain within your category's income threshold and household composition has not changed, the renewal processes automatically and you receive a notice that your coverage continues and no action is required. You do not have to sign and return an accurate notice.

Ex parte commonly fails for a few recurring reasons:

  • Income that data sources cannot see: self-employment, gig, cash, or seasonal income that never lands in a wage database.
  • The asset test: ABD and long-term-care renewals need asset documentation that rarely clears automatically.
  • Household changes: a new baby, a marriage or divorce, or someone moving in or out.
  • Income near a threshold: small data discrepancies near the cutoff trigger manual review.

When ex parte fails, the agency must send a renewal form with the information it already has and give you at least 30 days from the date of the renewal form to respond, supply anything missing, and sign. The clock runs from the form's date, not the day it arrives. That window, and the 90-day reconsideration below, are federal requirements only for MAGI-based coverage; if you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, New York may follow the same procedure but is not required to, so ask HRA or your county LDSS which deadline applies. The agency may not require an in-person interview to renew.

How to renew New York Medicaid, channel by channel

A renewal form may be submitted through any of the modes the agency offers, and no in-person interview may be required. The right channel depends on your category and county.

If you are Renew through How
MAGI (children, parents, pregnant, expansion adults under 65) NY State of Health Online at nystateofhealth.ny.gov, or by phone with the marketplace; many cases renew passively
Non-MAGI in NYC (ABD, MLTC, CDPAP, nursing home, pooled trust) NYC HRA Medical Assistance Program ACCESS HRA (access.nyc.gov) or the mailed recertification packet
Non-MAGI outside NYC County Local Department of Social Services Return the mailed recertification packet to your county LDSS; some counties offer their own portal

If you have moved between counties, recertify with your current county of residence.

The 90-day reconsideration window

If your coverage closed because you missed the recertification, you usually do not have to start over.

Under 42 CFR 435.916, if you lose Medicaid for failure to return the renewal form (a procedural termination, not an eligibility-based one), the agency must treat a late-returned form as the basis for reconsideration if you submit it within 90 days of the termination, without requiring a new application. If you remained otherwise eligible, your coverage is restored. That duty is federal for MAGI-based coverage and a state option on the non-MAGI pathways above, so ask your district what applies to you.

In practice: if your case closed June 30 for a missed form, you have until about September 28 to submit it. Two distinctions decide whether the window applies:

  • Procedural termination: you did not respond, did not provide requested documentation, or missed a signature. The 90-day reconsideration applies.
  • Eligibility-based termination: the agency determined you no longer meet income, asset, residency, or categorical requirements. Reconsideration does not apply; you file a new application or appeal.

The clock runs from the termination date, not the notice date. To activate reconsideration, resubmit the recertification form through your normal channel and note the closure date so the case is routed correctly.

Over-income renewals: pooled trusts and surplus income

New York is a medically-needy state, not an income-cap state, so a senior whose income exceeds the Community Medicaid level usually keeps coverage at renewal through a spend-down mechanism. The 2026 Community Medicaid income level is $1,836 per month for a single applicant and $2,489 for a couple, and the asset limit is $33,038 single and $44,796 for a couple.

Over-income enrollees hold community Medicaid two ways, and each has a renewal rhythm of its own:

  • Pooled income trust under 42 U.S.C. 1396p(d)(4)(C). You deposit your excess income into a sub-account at a nonprofit New York trust administrator, and the trust pays your living expenses while your countable income drops to the Medicaid level. The income exclusion applies only to income deposited in the month it is received, and deposits cannot be made retroactively for a prior month, so the excess has to go in every month. A missed month counts that income as available and can break eligibility. To have the income rebudgeted, you give the local district a copy of the trust and a written statement of the monthly amount deposited. One limit decides whether the trust works at all for you: if you are married and your eligibility is determined under spousal-impoverishment budgeting with post-eligibility rules, which is how a married Managed Long Term Care enrollee is budgeted, the state counts income you place in the trust when determining your eligibility, so the trust does not deliver the disregard in that situation.
  • Surplus Income Program (medically-needy spend-down). You apply the excess against incurred medical expenses each month to reach eligibility.

The renewal trap is timing: deposits or spend-down must begin the month income first exceeds the threshold. A pooled trust preserves community Medicaid only, it does not cover nursing-home Medicaid. For the full mechanics, see New York pooled income trusts.

Long-term care and MLTC renewals

If you receive Medicaid long-term services, your case is delivered through Managed Long Term Care (MLTC) or, for dual eligibles, a Medicaid Advantage Plus (MAP) plan, and losing Medicaid at renewal means losing that plan enrollment. Eleven MAP plans appear in the state's Managed Long-Term Care Plan Directory (revised April 2026), and their service areas vary widely by plan: some cover New York City only, while others reach upstate counties including Albany, Erie, and Monroe, so read the directory row for your own county rather than assuming MAP is a downstate product. NY Medicaid Choice (1-888-401-6582) is the enrollment broker.

The financial recertification for a long-term-care case runs on the standard 12-month cycle through HRA or your county LDSS and includes the asset test the Asset Verification System requires. The long-term-care financial recertification re-verifies income, countable assets, and (for married couples) the spousal-impoverishment protections: on or after January 1, 2026 the community spouse may keep the greater of $74,820 or the spousal share up to a federal maximum of $162,660 in countable assets, and the community-spouse monthly income allowance is $4,066.50. For a nursing-home resident, the personal needs allowance re-applied at renewal is $50 per month.

MLTC enrollees also stay subject to periodic clinical assessment on the Uniform Assessment System (UAS-NY) tool through the NY Independent Assessor Program, separate from the financial recertification. The two reviews are independent: you can clear one and be flagged on the other. See New York Managed Long Term Care for the assessment framework and New York long-term care Medicaid for the nursing-home rules.

Children, pregnancy, and continuous eligibility

Two federal protections keep coverage in place at renewal for families.

Children under age 19 enrolled in Medicaid or CHIP get 12 months of continuous eligibility running from the date they are determined eligible, made mandatory nationwide effective January 1, 2024. Once a child is enrolled, coverage is locked in for 12 months regardless of a rise in family income. If a parent loses Medicaid mid-year because household income climbed, the children stay covered until their next annual renewal. Limited exceptions apply: aging out at 19, moving out of state, death, voluntary disenrollment, or fraud. The practical takeaway is to report income changes honestly, your children keep coverage through their 12-month period either way.

Pregnancy carries a parallel protection. The permanent state option created by the Consolidated Appropriations Act, 2023 lets a state extend Medicaid postpartum coverage to a full 12 months after the end of pregnancy, regardless of income changes, before the annual renewal cycle resumes.

When your renewal mail is returned

The federal rule that required an agency to search for a new address before acting on returned mail, 42 CFR 435.919, was removed effective July 31, 2026. Federal law now says only that the agency may act without advance notice when your whereabouts are unknown (42 CFR 431.213(d)), and that coverage must be reinstated if your whereabouts become known while you are still eligible (42 CFR 431.231(d)). New York may still have its own procedures, so if your packet came back as undeliverable, call HRA or your county LDSS and ask where your case stands.

The most protective step after a move is to update your address in more than one place:

  • At NY State of Health (MAGI cases), or with HRA or your county LDSS (non-MAGI cases).
  • With your Medicaid managed-care or MLTC plan.
  • With the Postal Service, via a change-of-address form.

Fair hearing rights when a renewal is denied

If your renewal is denied or coverage terminated, you have a federal right to a fair hearing under Section 1902(a)(3) of the Social Security Act and 42 CFR 431.220. The federal 90-day figure is a ceiling on the state's window, not a guarantee to you: 42 CFR 431.221(d) requires the agency to allow a reasonable time to request a hearing, "not to exceed 90 days" from the date the notice of action is mailed. A state may set a shorter window, and New York does, so the deadline that binds you is the one printed on your own notice, not 90 days.

New York uses a shorter window and a two-track process, handled by the Office of Temporary and Disability Assistance (OTDA), Office of Administrative Hearings:

  • For direct (fee-for-service) Medical Assistance actions, request the State Fair Hearing within 60 days of the notice date.
  • For a Medicaid managed-care or MLTC service dispute, first exhaust the plan's internal appeal and obtain its Final Adverse Determination, then you have at least 120 days from that determination to request the State Fair Hearing.

You can request a hearing online, by phone at the statewide line 1-800-342-3334, by fax, by mail, or in person. Aid continuing (benefits paid while the appeal is pending) is available only if you request the hearing before the effective date of the action, or within 10 days of the notice's postmark, whichever gives you more time., If the agency's action is later sustained, it may recoup the cost of services furnished solely because benefits continued. For a full walkthrough, see New York Medicaid appeals and fair hearings.

Refugees, asylees, and certain qualified non-citizens have their status reverified at renewal. When the agency cannot promptly verify declared citizenship or satisfactory immigration status, federal law (42 CFR 435.956) requires a reasonable opportunity period, generally ending the earlier of verification or 90 days, during which it may not deny, reduce, or terminate benefits for someone it otherwise finds eligible.

What changes after 2026: six-month renewals for expansion adults

The COVID-19 continuous-enrollment requirement ended in 2023 and the unwinding ran through 2024. What matters now is a federal change that reaches New York directly.

Section 71107 of the 2025 federal budget-reconciliation law (H.R.1, Public Law 119-21) requires states to redetermine eligibility once every 6 months, rather than every 12 months, for the ACA expansion-adult population, for renewals scheduled on or after January 1, 2027. Its only exemption covers an Indian or Urban Indian as defined in the Indian Health Care Improvement Act, a California Indian, and anyone otherwise determined eligible as an Indian for the Indian Health Service. Because New York adopted ACA Medicaid expansion, this reaches a large share of the state's working-age adult enrollees.

The same law also shortens retroactive eligibility for applications filed on or after January 1, 2027, to two months before the application month for most enrollees and one month for the expansion group, down from the long-standing three-month default.

Common New York Medicaid recertification mistakes

  1. Treating the recertification notice like junk mail. Pull anything from NY State of Health, HRA, or your county DSS out of the mail pile and open it the day it arrives.
  2. Assuming ex parte will handle everything. Ex parte succeeds for only a portion of renewals; the rest require the mailed form back by the deadline printed on it.
  3. Missing a pooled-trust deposit. Excess income must be deposited every month it is received, with no retroactive catch-up; a missed month counts that income as available.
  4. Skipping the asset documentation for ABD or long-term-care renewals. Federal law requires the asset check at renewal, and without your AVS authorization the district cannot run it, so the case stalls.
  5. Updating your address with Social Security or your plan but not your Medicaid district. The district does not auto-sync those updates.
  6. Not knowing the 90-day reconsideration window exists. A procedural closure can be reconsidered within 90 days with no new application (required for MAGI-based coverage; a state option otherwise), while an eligibility-based closure cannot.

Frequently Asked Questions

How often do I have to renew New York Medicaid?

Once a year for most enrollees. Your renewal month is tied to your original approval date and stays the same each year, so most enrollees renew on a standard 12-month cycle. One change is coming: the ACA expansion-adult population moves to a 6-month cycle for renewals scheduled on or after January 1, 2027.

Where do I recertify my New York Medicaid?

It depends on your category. MAGI cases renew through NY State of Health at nystateofhealth.ny.gov. Aged, Blind, and Disabled and long-term-care cases renew through NYC's ACCESS HRA (access.nyc.gov) in the five boroughs, or your county Local Department of Social Services everywhere else.

What happens if I miss my New York Medicaid renewal deadline?

Your coverage closes at the end of your renewal month. If the closure was procedural (you did not return the form or respond to a request), you have a 90-day reconsideration window under 42 CFR 435.916 to submit the recertification and have your case reconsidered without a new application, with coverage restored if you remain eligible. That window is federally required for MAGI-based coverage and a state option otherwise, so ask your district.

My income is over the Medicaid limit. Do I lose coverage at renewal?

Usually not. New York is a medically-needy state, not an income-cap state. If your income exceeds the $1,836 single or $2,489 couple community level, you generally keep community Medicaid at renewal through a pooled income trust or the Surplus Income Program., With a pooled trust, you must deposit your excess income every month it is received (no retroactive deposits), and the local district rebudgets the case from the trust documents you provide. The trust route has one significant exception: if you are married and your eligibility is figured under spousal-impoverishment budgeting with post-eligibility rules, as it is for a married MLTC enrollee, income you place in the trust still counts in determining your eligibility.

My child is on Medicaid. If my income rises mid-year, does my child lose coverage?

No. Under federal continuous-eligibility rules, effective January 1, 2024, children under 19 have 12 months of continuous eligibility running from the date they are determined eligible. Even if your income rises above the threshold, your child keeps Medicaid until the next annual renewal. Exceptions: aging out at 19, moving out of state, death, voluntary disenrollment, or fraud.

Can I appeal if my renewal is denied?

Yes. For a direct (fee-for-service) action, request a State Fair Hearing within 60 days of the notice; for a managed-care or MLTC dispute, exhaust the plan appeal first, then request the hearing within at least 120 days of the plan's Final Adverse Determination. Requesting the hearing before the action takes effect (or within 10 days of the notice) keeps your coverage in place pending the decision. The statewide fair-hearing line is 1-800-342-3334 through OTDA's Office of Administrative Hearings.

New York Medicaid renewal: contacts and resources

Whether you need to complete your annual recertification, use the 90-day reconsideration window (required for MAGI-based coverage; a state option otherwise) to recover coverage after a procedural closure, or appeal a termination, these offices can help.

NY State of Health Renew MAGI and ABD community Medicaid online, update your address, and upload documents. nystateofhealth.ny.gov
ACCESS HRA (NYC) Recertify non-MAGI Medicaid, upload documents, and reach the Surplus Income Unit for pooled-trust cases. access.nyc.gov
Your County Local Department of Social Services Recertification and address updates for the 57 counties outside New York City. health.ny.gov
NY Medicaid Choice Managed Long Term Care and MAP enrollment help. 1-888-401-6582
OTDA Office of Administrative Hearings Requests State Fair Hearings on Medicaid actions. 1-800-342-3334 otda.ny.gov
NY State Office for the Aging Local senior benefits counseling and referrals. aging.ny.gov

If you are unsure whether your renewal has been processed, log in to your NY State of Health or ACCESS HRA account, or contact your county LDSS. The New York Medicaid hub and our broader Medicaid guides cover eligibility, applications, and long-term care in more depth.

Learn More

MedicaidNew York Medicaid eligibility and income limitsHow New York Medicaid works in 2026: the $1,836/month income standard, the $33,038 resource limit, pooled income trusts, and the 30-month look-back question. MedicaidHow to apply for Medicaid in New YorkHow to apply for Medicaid in New York in 2026: NY State of Health, ACCESS HRA, paper DOH-4220, NYIAP three-stage assessment, document checklist, and timelines. MedicaidNew York Community MedicaidNew York Community Medicaid in 2026: home-care eligibility limits, the Excess Income Program, pooled income trusts, MLTC, CDPAP, and the 30-month lookback. MedicaidNew York Managed Long Term CareHow New York Managed Long Term Care (MLTC) pays for home care in 2026: who qualifies, MLTCP vs. MAP vs. PACE, the new minimum-needs rule, and how to enroll. MedicaidNew York pooled income trustsHow New York's Pooled Income Trust lets a certified disabled New Yorker over the $1,836 Medicaid income level get Community Medicaid home care. MedicaidNew York Medicaid appeals and fair hearingsHow to appeal a New York Medicaid denial, request a State Fair Hearing through OTDA, exhaust a managed care plan appeal, and keep your benefits while you wait.

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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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