Application for Initial Eligibility 2026

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  1. Click ‘Get Form’ to open the Application for Initial Eligibility in our editor.
  2. Begin by filling out your personal information, including the Head of Household name, mailing address, and contact details. Ensure all fields are completed accurately.
  3. In the Family Composition section, list all household members. Provide their names, relationships to the head of household, and answer questions regarding disability and citizenship status.
  4. Complete the Income Information section by detailing earned and unearned income sources for each household member. Attach necessary documentation as specified.
  5. Fill out the Assets section by indicating any financial accounts or properties owned. Provide supporting documents showing current values.
  6. If applicable, complete the Expenses section related to childcare or medical expenses. Include relevant bills or statements dated within the last 60 days.
  7. Finally, ensure that all adult household members sign the Certification Statement on page 7 before submitting your application at your initial appointment.

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Visit the New York State of Health website or call 855-355-5777 (TTY 1-800-662-1220) to find out if youre financially eligible for Medicaid.
It is essential to know that Social Security benefits are not exempt from Medicaid. Payments you receive from Social Security are counted as income.
For most states, the Medicaid income limit is $2,901 per month for a single applicant and $5,802 per month for married applicants, typically set at 300% of the Federal Benefit Rate (FBR).
It could take several weeks or months to process your application, verify your eligibility and issue you a Voucher for rental assistance. You can shorten the time it takes by promptly submitting all documentation requested by the Housing Authority and showing up at your appointments on time.
NYCHA will determine final eligibility when a suitable apartment becomes available. At that time, NYCHA will perform a criminal background check for all household members 16 years of age or older. If everyone passes the criminal background check, NYCHA will offer the apartment. Learn more about priority codes.

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