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 decides whether Medicaid coverage continues or lapses: eligibility is set at application, then redetermined every 12 months., Most closures are procedural: the person still qualified and simply did not return the form in time, which is 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 each year. New York calls this annual review recertification; non-MAGI cases return a mailed packet to 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, where income is verified through federal and state data sources.
  • 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 an asset test the district must verify, so plan on returning the packet with documentation.

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 resources at renewal, not only at application, through an Asset Verification System, and the district cannot run that electronic check without your signed AVS authorization, usually alongside bank, retirement-account, and life-insurance statements.

Ex parte New York Medicaid renewal: the federal mandate

The federal ex parte default lives at 42 CFR 435.916. Before the agency asks you for anything, it must try to renew your eligibility from reliable information already in your account or otherwise available to it, including electronic data sources. Only if it cannot may it request information from you.

In New York, ex parte renewal draws on the electronic data sources the federal rules point to: Social Security records, federal tax data, state wage and unemployment files. If those confirm your income and household have not changed, coverage continues automatically and you get a notice saying so; 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 a signed AVS authorization and the resource documentation behind it.
  • 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, the 90-day reconsideration below, and the ban on in-person renewal interviews 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 procedures but is not required to, so ask HRA or your county LDSS which rules apply.

How to renew New York Medicaid, channel by channel

A renewal form may be submitted through any of the modes the agency offers. 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 moved between counties, recertify with your current county.

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 a new application, and restore coverage if you remained eligible. That duty is federal for MAGI-based coverage and a state option on the non-MAGI pathways above, so ask your district.

In practice: a case closed June 30 for a missed form gives you until about September 28. 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. Resubmit the 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 trust is open only to someone certified disabled, at any age: an existing SSA disability determination (SSI or SSDI) establishes it, and otherwise New York makes its own determination from a physician's certification and medical records. Age alone does not qualify you. 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; the district then reviews the trust's activity at each renewal to confirm the deposits were actually made. One limit decides whether the trust works for you at all: if you are married and budgeted under spousal-impoverishment rules with post-eligibility rules, which is how a married Managed Long Term Care enrollee is budgeted, income you place in the trust still counts, so the trust delivers no disregard.
  • Surplus Income Program (medically-needy spend-down): 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. See New York pooled income trusts for the full mechanics.

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 service areas vary widely: some cover New York City only, others reach upstate counties including Albany, Erie, and Monroe, so read the directory row for your own county. 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, includes the resource check the Asset Verification System requires, and 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.

An MLTC case runs a clinical review as well as the financial recertification, and the two are independent: you can clear one and be flagged on the other. Enrolling in MLTC goes through the NY Independent Assessor's community health assessment on the Uniform Assessment System (UAS-NY) tool. A coverage gap is what makes that clinical track dangerous at renewal. Since September 1, 2025, a new MLTC applicant must need at least limited assistance with more than two activities of daily living, or, with a documented dementia or Alzheimer's diagnosis, supervision with more than one. Anyone continuously enrolled before that date keeps Legacy Status under the older standard, but a disenrollment or gap in coverage forfeits it, so losing Medicaid at renewal and re-enrolling means meeting the stricter floor. 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. If a parent loses Medicaid mid-year because household income climbed, the children stay covered until their next annual renewal, so report income changes honestly. Limited exceptions apply: aging out at 19, moving out of state, death, voluntary disenrollment, or fraud.

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.

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 must reinstate coverage if they 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 undeliverable, call HRA or your county LDSS.

After a move, 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 right has one carve-out: the agency need not grant a hearing when the sole issue is a federal or state law requiring an automatic change that affects some or all beneficiaries. 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 get its Final Adverse Determination (or be deemed to have exhausted it if the plan never answered, answered outside the state's timeframes, or sent a notice that did not meet federal requirements), and you then 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 never automatic; you have to ask for it, and it runs on a shorter clock than the one for filing. On a fee-for-service action, ask before the effective date on the notice, or within 10 days of its postmark, whichever gives you more time., On a managed-care or MLTC appeal, aid continuing turns on requesting the fair hearing within 10 days of the plan's Final Adverse Determination, not the 120 days you have to file. And if the agency acted without the advance notice federal law requires, reinstatement is a right rather than a hope, so long as you request the hearing within 10 days of receiving the notice. 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, and 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, a status the state determines rather than one you simply attest to. 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. Open anything from NY State of Health, HRA, or your county DSS the day it arrives.
  2. Assuming ex parte will handle everything. When it does not, the mailed form has to come 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. Refusing the AVS authorization. Federal law requires the resource check at renewal, and if you refuse to sign the authorization or revoke one you gave, the state may find you ineligible on that basis alone.
  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; 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 have a 90-day window under 42 CFR 435.916 to submit the recertification and have the case reconsidered without a new application, with coverage restored if you remain eligible. That window is federally required for MAGI-based coverage, a state option otherwise.

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., A pooled trust takes a certification of disability, and the excess must go in every month it is received, with no retroactive catch-up. Two people it does not help: anyone not certified disabled, and a married applicant budgeted under spousal-impoverishment rules, as a married MLTC enrollee is, whose trust income still counts.

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. 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. Ask for aid continuing when you file: on a fee-for-service action, request the hearing before it takes effect or within 10 days of the notice; on a managed-care or MLTC appeal, within 10 days of the Final Adverse Determination. The statewide fair-hearing line is 1-800-342-3334 through OTDA's Office of Administrative Hearings.

New York Medicaid renewal: contacts and resources

These offices handle recertification, reconsideration, and appeals.

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

Unsure whether your renewal has been processed? Log in to NY State of Health or ACCESS HRA, or call your county LDSS. The New York Medicaid hub and our Medicaid guides go deeper.

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.

Find personalized help renewing New York Medicaid at brevy.com.

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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