Access ny 2026

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The document outlines the application process for Medicaid coverage for individuals living in long-term care facilities or nursing homes. It details the requirements for asset disclosure, including potential liens on property and recovery of costs by Medicaid under certain conditions. The document also addresses asset transfers, annuities, and eligibility criteria for applicants who are blind, disabled, or chronically ill. Additionally, it includes instructions for completing necessary sections and provides information on related programs like the Medicaid Buy-In program for working individuals with disabilities.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the name of the facility where you are currently residing, along with the date admitted. Ensure that you provide accurate contact information including telephone number and address.
Fill in your previous address details, including city, state, and zip code. This is crucial for establishing your residency history.
Proceed to the Asset Transfers section. Answer each question regarding asset transfers truthfully, indicating whether you or someone on your behalf has transferred any assets within the specified timeframe.
Complete sections A through F as instructed. If applying for nursing home care, ensure sections G through I are also filled out accurately.
Review all entries for accuracy before signing the document electronically within our platform to finalize your submission.

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Versions	Form popularity	Fillable & printable
2010	4.9 Satisfied (477 Votes)

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