Are you in New York and need emergency care but do not have medical insurance?
Do you need attention but will not be eligible for regular Medicaid because of your immigration status?
Emergency Medicaid may be the option you have been looking for.
What is Emergency Medicaid?
As shown in an NYC.gov handout, emergency Medicaid is “Medicaid for the treatment of an emergency medical condition.” This is for certain people who temporarily reside in NYC but are non-US citizens. NYC.gov refers to these people as “undocumented and temporary immigrant New Yorkers.” Suppose you are in a situation where you need immediate medical attention, and you are not a resident of New York. In that case, Emergency Medicaid will likely cover your medical needs.
Who is Eligible for Emergency Medicaid?
If you would typically get federally issued Medicaid but are deemed ineligible because of your immigrant status, you likely will be eligible for Emergency Medicaid. Immigration status does not affect your ability to use emergency Medicaid. NYC.gov explains that to qualify, you must:
- Meet income requirements of having a low income or meager income
- Be a resident of New York State (you can be a temporary lawful resident)
- Have an emergency medical condition in need of treatment
The New York State Department of Health states that undocumented non-citizen and temporary non-immigrant are eligible for emergency Medicaid.
An undocumented non-citizen is an individual who is not lawfully present.
A temporary non-immigrant is an individual who is legally present in the U.S. but is not a resident of New York.
For temporary non-immigrants to be eligible, they must also have not entered New York for the sole purpose of receiving emergency medical care. Temporary non-immigrants are given a residency review to determine that all of these requirements are met.
If you would like to see if you meet the income requirements, benefits.gov shows an easy-to-read table here.
What Documents Do I Need to Apply for Emergency Medicaid?
To apply for emergency Medicaid, a temporary non-immigrant must have proof of identity, proof of income, and state residence information. Below is a list of documents needed to apply:
- Birth certificate or Passport; birth certificate must be translated into English, and the translation must be notarized.
- Valid photo I.D. (must be issued by the government and not expired).
- Social Security Card (if available).
- Proof of Address in the patient’s name from the last 3 months. This cannot be from a post office box.
- Proof of Income, or if the patient is a student under 21 years of age, they will need proof of enrollment.
What Does Emergency Medicaid Cover in New York
According to the New York Department of Health, an emergency medical condition is defined as a medical condition that manifests itself with symptoms that, if left untreated, could result in:
- the patient’s health is put in severe jeopardy
- serious impairment to bodily function
- serious dysfunction of any bodily function or organ
These definitions must be met at the time of medical attention for the condition to be considered an emergency. This would include emergency labor and delivery.
The bottom line is that emergency Medicaid does not cover all health costs, only emergencies. The attending physicians will determine whether or not a condition qualifies as an emergency. If the condition is not a traditional one explicitly coerced by the law, then a physician can request review.
Does Emergency Medicaid Cover Emergency Surgery?
According to the Department of Health, if emergency surgery is needed and necessary to prevent a patient from having their health put into severe jeopardy, develop a severe impairment to bodily function, or develop a severe dysfunction of any bodily function or organ, then the surgery would be covered under emergency Medicaid. Any other surgery that would be considered unnecessary or cosmetic would not be covered.
Furthermore, if a condition needs ongoing regimented care but is not an immediate danger to the individual, it will not be covered by emergency Medicaid. The New York Department of Health states that “[t]he potentially fatal consequence of discontinuing Medicaid covered care, even if such care is medically necessary, does not transform the condition into an emergency medical condition.” You must be in true immediate danger to have your services covered.
If your specific condition requires an alternate level of care in a hospital, access to a nursing facility, access to home healthcare, or if you need rehabilitation services, these will not be covered under emergency Medicaid. The Department of Health explains that neither these services nor the transportation to these services will be covered.
If you arrive at an emergency facility and apply for emergency Medicaid, you will determine whether or not you qualify. Regardless of your ability to pay, hospitals must treat you if you are eligible for emergency Medicaid.
Chemotherapy, radiation treatment, and prescription medications for stabilization and treatment of the diagnosis which caused the medical emergency are all covered. However, the New York Health Access states that the Department of Health has done a review and found that many patients had been taking advantage of the system and were having unnecessary drugs covered by emergency Medicaid (“unnecessary,” meaning that they were not needed to treat or prevent a medical emergency). As a result, they issued a new list of covered drugs to those considered therapeutic and helpful in treating an emergency medical condition. However, if a drug is needed for an emergency not included on the list, a physician may submit an override request.
Is Temporary Medicaid the Same as Emergency Medicaid?
Temporary Medicaid is also called Emergency Medicaid. The two terms seem to be used interchangeably, so do not feel confused when conducting your research.
Will Using Emergency Medicaid Count as a Public Charge?
In March 2021, the Biden administration got rid of the Trump administration’s public charge rule set in place. Therefore, you do not have to worry about receiving benefits looking negatively on you and your family when applying for permanent residency. The New York Health Access makes it very clear: “As a practical matter, immigrant families can now be advised that there are no adverse immigration consequences tied to using health, nutritional, and housing benefits.” So, do not let fear keep you from getting the emergency help you require.
Where Can I Apply for Emergency Medicaid?
The NYC.gov handout first clarifies that you can pre-apply and be pre-approved for coverage for future emergencies for up to 12 months.
- If you are under the age of 65, you can apply online at N.Y. State of Health website. If you would prefer a phone call, you can dial 1-855-355-5777.
- If you are age 65 or over, or if you have a disability, you will likely need to apply with a different application. To obtain this application, you will want to call 347-396-4705 for assistance.
- You are also able to sign up at a hospital during or after an emergency. You have up to 3 months after the emergency treatment to apply for costs to be covered.
If you want to apply to see if you qualify, you can. You would want to dial 311 for further information and assistance. Regardless of how you choose to apply, the same information and documents will be required of you. The process will go more smoothly if you have all the needed documents or know how to obtain them easily.
How Long Does Coverage Under Emergency Medicaid Last?
According to the Department of Health, the initial period will be up to 15 months. This is broken down as “three months retroactive coverage from the application date and 12 months prospective coverage from the application date.” If you have a new emergency within the initial period of coverage, you do not have to fill out a new application; however, the claim must include that it is for an emergency. The attending physician will determine whether or not the condition and treatment constitute an emergency.
In conclusion, if you are not a permanent resident of New York, do not have health coverage, and have an emergency where you need emergency medical treatment, you should not fear. The emergency Medicaid was created to assist you in getting the help you desire, need, and deserve. A hospital cannot refuse treatment to you if you qualify and will assist you in all your emergency needs. Applying is not a complicated process and can be done online, by telephone, or at a hospital at the time of the emergency or after.