Medicaid is a federally subsidized health insurance program for low-income and disabled individuals. Because each state runs its own Medicaid program, the eligibility requirements and services covered may vary. Continue reading to find out what benefits are offered by Medicaid in New York and how to apply if you live in Monroe County. 

How Do I Apply For Medicaid in Monroe County?

In Monroe County, Medicaid is administered by the New York State Department of Health and the Financial Assistance Division. Each agency is responsible for managing the program for a particular category of the population. You can apply for Medicaid by visiting the appropriate office in person, by calling to request an application form and, in some cases, enroll online. The enrollment for Medicaid is open throughout the year.

Individuals who are eligible for Medicaid may also qualify for other types of government assistance, however, each financial support program has its own set of rules and regulations. In the State of New York, all Supplemental Security Income (SSI) recipients are automatically eligible to receive Medicaid.

Read on for more details on how to apply for Medicaid as a Monroe County resident.

New York State Department of Health

People who are under the age of 65 and not disabled, as well as pregnant women and home care services beneficiaries should apply for Medicaid through the New York State Department of Health Plan Marketplace. The Marketplace was created by the Affordable Care Act to offer affordable private and public health insurance to New York individuals and families. 

The Marketplace provides services of Navigators and Certified Application Counselors (CAS) who can assist you in your application process free of charge. You can find an assistor through the Marketplace Navigator Directory. The assistors are culture sensitive and offer help in several different languages at convenient times, including evenings and weekends.

To apply, call (855) 355-5777 or TTY: (800) 662-1220 (office hours: Monday – Friday 8 am – 8 pm, Saturday 9 am – 1 pm). 

Financial Assistance Division

The Monroe County Financial Assistance Division administers Chronic Care Medicaid for individuals who reside in a nursing home type setting.

Applications are available in two locations of the Monroe County Department of Human Services Financial Assistance Division:

691 St Paul St.

Rochester, NY 14605

111 Westfall Rd

Rochester, NY 14620

Phone: (585) 753-6960 or (585) 753-2760 for Medicaid benefit questions

Office hours: Monday – Friday 8 am – 4 pm. 

Walk-in applications are accepted during office hours.


Managed Care Organization (MCO)

Managed care is a health care delivery system where Medicaid contracts with Managed Care Organizations (MCOs) to deliver its services to beneficiaries, thus allowing the state to reduce Medicaid program costs. You can apply for Medicaid directly through a managed care organization. 

The greater Rochester New York metro area has three MCOs:

  • Monroe Plan for Medical Care
  • FLH Medical PC
  • Faith Tabernacle of Prayer.

For more information about Medicaid managed care programs and Medicaid enrollment, call New York Medicaid CHOICE enrollment program at (585) 753-6702 or (800) 505-5678.

You should keep in mind that it is not necessary to cancel your health insurance before applying for Medicaid. Medicaid may pay the premiums on your existing policy if you qualify, although your eligibility will depend on several different factors.

What Services Does Medicaid Provide for Residents in Monroe County?

In Monroe County, Medicaid health care coverage provides both mandatory and additional health services.

Mandatory Medicaid benefits 

Mandatory Medicaid benefits are common for all states and include: 

  • Doctor and clinic visits
  • Regular medical checkups
  • Follow-up care
  • Immunizations
  • Laboratory tests
  • X-ray services
  • Medicine, medical supplies, and medical equipment such as wheelchairs, canes, and crutches
  • Drug prescriptions for the cheapest drug options
  • Smoking cessation agents 
  • Emergency care
  • Hospital inpatient and outpatient services
  • Treatment in psychiatric hospitals, mental health facilities, and facilities for the mentally retarded or the developmentally disabled
  • Family planning (birth control) services
  • Prenatal care
  • Early periodic screening, diagnosis, and treatment for children.

New York Medicaid additional services 

New York Medicaid offers a wide range of additional health services to its residents that are not provided in all states, such as certain non-prescription (over-the-counter) medications, essential dental, auditory, and vision care including eye exams, medically necessary eyeglasses, and contact lenses. Dental, auditory, and vision benefits are covered as long as the beneficiaries visit a Medicaid-approved medical practitioner in Monroe County.

Medical transportation

New York Medicaid covers both emergency and non-emergency medical transportation in Monroe County, for example:

  • Emergency transportation to and from medical care and services in an ambulance
  • Non-emergency transportation to and from Medicaid billable medical care or services, including public transportation, personal vehicles, taxis, wheelchair vans, and ambulances. The approval of the Department of Social Services is required to ensure that the mode of transportation is appropriate to the medical needs and that the least costly appropriate transportation is used.

If you are a Monroe County Medicaid beneficiary, call Medical Answering Services (MAS) at (585) 288-4680 to request transportation to medical appointments. Note that all non-emergency Medicaid transportation handled by MAS requires prior authorization and services must be booked at least three days before the appointment. 

For emergency medical transportation, call 911.

Children’s Medicaid

The Children’s Health Insurance Program (CHIP) provides health coverage to eligible children through Medicaid. This is a state-run program administered through the New York Department of Health available to Monroe County residents. It is offered through local providers along with Child Health Plus, a New York health insurance plan for children.

Chronic Care Medicaid

Chronic Care Medicaid is health care coverage for those who reside in a nursing home type of setting or require long term home health care services. The program is designed to assist aging and disabled residents who can’t afford medical care. 

Home Care Services

Medicaid Home Care Services is another program available through the New York State Department of Health. It allows Medicaid beneficiaries to stay at home while receiving care instead of having to live in a nursing home or assisted living facility. Medicaid covers the cost of an assisted living program, a personal care attendant, housekeeping, home health aide, and a personal emergency response system.

Medicaid Home Care Services covers the Consumer Directed Personal Assistance Program (CDPAP). CDPAP is a New York specific Medicaid-funded program that allows consumers to hire and manage their own home care aides. Almost anyone among the beneficiary’s family members and friends can be hired as a home care assistant and is paid for their services through CDPAP.

To be eligible for CDPAP, consumers must be in need of assistance with their activities of daily living and/or skilled nursing care. Individuals who are eligible for Medicaid can also benefit from CDPAP. In order to qualify, the beneficiary or a designated representative acting on their behalf must be capable to direct the home care according to the CDPAP regulations. 

Location of Medicaid Offices in Monroe County

You may want to contact a Medicaid office in Monroe County in person for a variety of reasons, for example, if you:

  • Have questions regarding your Medicaid eligibility
  • Need assistance filing your Medicaid application form
  • Wish to renew your Medicaid enrollment
  • Were denied Medicaid benefits
  • Need to show proof that you are enrolled in Medicaid.


Monroe County Department of Public Health 

Room 952

111 Westfall Road

Rochester, NY 14620

Before visiting the office, you should call and schedule an appointment. Make sure to bring the necessary documentation to prove that you meet the requirements to enroll in Medicaid, such as:

  • Proof of citizenship (passport, immigration records, birth certificate)
  • Proof of residency (copy of lease, utility bills) 
  • Proof of income (tax return documents, pay stubs, Social Security documents).

Alternatively, you can request a Medicaid application by phone by calling (585) 753-6960.

To apply for Children’s Medicaid or inquire about the Child Health Plus program, call (800) 698-4543 or TTY (877) 898-5849 for the hearing impaired.

For information about the Consumer Direct Personal Assistance Program or Personal Care Aide Program, call (585) 753-6445.

Women who wish to apply for Medicaid to cover prenatal care can visit any of the locations below in person or call for more information:

Genesee Health Services / RGH

220 Alexander St Suite 603

Rochester, NY 14607

Phone: (585) 922–8003

Clinton Family Health / RGH

293 Upper Falls Rd.

Rochester, NY 14605

Phone: (585) 922–0200

Highland Hospital / SouthWest Dept

1000 South Ave.

Rochester, NY 14620

Phone: (585) 335–6041

Rochester General Hospital

1415 Portland Ave.

Rochester, NY 14621

Phone: (585) 922–4813 or (585) 922–4200

Strong Memorial Hospital

601 Elmwood Ave.

Rochester, NY 14642

Phone: (585) 275–2691

Westside Health Service

480 Genesee St.

Rochester, NY 14611

Phone: (585) 436–3040 x1765

Unity Health Systems

89 Genesee St.

Rochester, NY 14611

Phone: (585) 723–7000

General inquiries about Medicaid

If you have any general, non state-related questions about Medicaid or if you wish to provide feedback about the program or report fraud, contact the Center for Medicare and Medicaid Services in Baltimore, Maryland. 

Phone: (877) 267-2323



Leave a Reply

Your email address will not be published. Required fields are marked *