If you are blind or seriously visually impaired and need an application or these instructions in an alternative format, you may request them from your social services district. The following alternative formats are available:
Applications and instructions are also available for download in large print, data format and audio format from www.otda.ny.gov or www.health.ny.gov. Please note that applications are available in audio format and Braille solely for informational purposes. In order to apply, you must submit an application in written, non-alternative format. If you require another accommodation, please contact your social services district.
Also See
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PLEASE NOTE:
This book tells you many of the ways your local department of social services may be able to help if you or your family is in need.
Please remember that these programs and services have Federal or State rules that must be followed.
This should not keep you from asking about these programs and services when you or your family needs help.
Q. What Is Temporary Assistance?
A. Temporary Assistance is temporary help for needy adults and children. If you are unable to work, can't find a job, or your job does not pay enough, Temporary Assistance may be able to help you pay for your expenses. Temporary Assistance programs include Family Assistance and Safety Net Assistance.
Q. If I Have Or Get A Job, Can I Still Get Help?
A. You can work and still get Temporary Assistance if your income is under a certain amount.
Q. Can I Get Help To Get A Job?
A. When you apply for or get Temporary Assistance and/or Food Stamp Benefits, you may be able to get help with:
Q. What If I Have An Emergency And I Need Help Right Away?
A. You may be able to get help right away. Be sure to tell your worker that you think you have an emergency. (See Book 3 (LDSS-4148C) "What You Should Know If You Have An Emergency".)
Q. What Kinds of Expenses Will Temporary Assistance Help Me Pay?
You may be able to get help for any of the following:
NOTE: Most people who can get Temporary Assistance will also get Medical Assistance and Food Stamp Benefits if requested.
Q. What Are The Temporary Assistance Programs?
A. 1. Family Assistance provides Temporary Assistance to eligible needy families that include a minor child living with a parent (including families where both parents are in the household) or a caretaker relative. It is operated under federal Temporary Assistance for Needy Families (TANF) guidelines.
Under Family Assistance, eligible adults are limited to receiving benefits for a total of 60 months in their lifetime, including months of TANF-funded assistance granted in other states. Months of cash Safety Net Assistance (#2 below) also count toward the 60-month lifetime limit. Once this limit is reached, that adult and all members of his or her Family Assistance household are ineligible to receive any more Family Assistance benefits. The months need not be consecutive, but rather each individual month in which TANF-funded benefits (or cash Safety Net Assistance) are received is included in the lifetime count. The counting of this 60-month limit began in December 1996.
Each person who is applying for or receiving Family Assistance, is also required to cooperate in good faith with the State and local social services district in establishing the paternity of a child born out of wedlock, in efforts to locate any absent parent or putative father, in establishing, modifying and enforcing orders of support; and in obtaining support payments or any other payments or property; as a further condition of eligibility for Family Assistance. Failure to cooperate without good cause will result in a reduction of Family Assistance benefits.
2. Safety Net Assistance
If you are not eligible for other assistance programs, you may be eligible for Safety Net Assistance. Safety Net Assistance is for:
Generally, you can receive Safety Net Assistance in cash for a maximum of two years in a lifetime. The count for this time limit began in August 1997. After that, if you are eligible for Safety Net Assistance, it will be provided in non-cash form, such as a two-party check or a voucher. In addition, Non-Cash Safety Net Assistance is provided for:
NOTE: Individuals who apply for or receive Temporary Assistance are required to participate as soon as possible in work activities as assigned by the local department of social services. Individuals who are determined exempt from work requirements due to a medical condition may be required to participate in a treatment program or other services which could restore or improve the ability to work. Failure to comply with work requirements, willfully and without good cause may result in the reduction or discontinuance of Temporary Assistance and/or Food Stamp Benefits.
Q. How Do I Apply For Temporary Assistance?
A. If you live outside of New York City, call or visit your local department of social services and ask for an application package. If you live in New York City, call or visit your local Income Support/Job Center. You must fill out the Application and turn it in. Remember, you may turn in (file) the Application the same day you get it.
Q. What Happens When I Apply For Temporary Assistance?
A. You will have an interview to find out if you are able to get Temporary Assistance. You will be asked to prove certain things. (See Book 1 (LDSS-4148A) "What You Should Know About Your Rights And Responsibilities.")
You may be required to participate in an interview to find out what types of work you are able to do. We may also discuss the activities and services, including education and training activities that are available, which may help you get a job.
During the interview, you will be asked:
Unless you are determined by the local department of social services to be exempt from participation in work requirements, you must participate in work activities as assigned by the local department of social services. Individuals who are applying for or receiving Temporary Assistance and are able to work are expected to continually look for a job and take a job when one is available.
Q. What Happens If I Only Want Temporary Assistance For Children That Live With Me Who Are Not My Biological Or Adopted Children?
A. Many people have children living with them who are not their children, for example, a grandparent who has grandchildren living with them, or a neighbor who is caring for their neighbor's children in the absence of the parents. If you have a child living with you who is not your child, you may apply for Temporary Assistance (TA) on behalf of that child. This type of TA case is called nonparent caregiver and provides a cash grant to be used for the care of the child.
Here are some things to consider if you are in this situation:
Q. If I Am The Caregiver Of A Child Who Lives With Me And Who Is Not My Biological Or Adopted Child, And I Need Additional Help Or Resources To Care For The Child, Can You Tell Me Where To Find Them?
A. The NYS Kinship Caregiver Program has been created to form a statewide network of community-based supportive programs that promote household stability and permanency through services for kinship caregivers and their kin. The Program includes 13 community-based programs, located in different parts of the State that provide services to help kinship caregivers who are raising their kin. Families providing informal kinship care, kin who are legal guardians or custodians of a child, as well as those providing kinship foster cares, are eligible to be served by these programs. Services offered may include:
In addition, a 14th program, the NYS Kinship Navigator Program, provides information and referral services to assist caregivers and the children in their care. A caregiver residing anywhere in New York can call a toll free number or go to a website to find information about the services that are available in or near their county. Trained specialists are also available to assess caregiver's needs and develop a plan of action. The Kinship Navigator Program can be reached, toll-free 1-877-6463 (1-877-4KinInfo) Monday thru Friday from 9:30 am to 4:30 pm, or online via the Internet at "http://www.nysnavigator.org/."
Q. What Happens If I Apply For Temporary Assistance And I Feel I Am Unable To Work Or Participate In Work Activities Because Of A Medical Condition?
A. An individual who applies for Temporary Assistance and claims he/she is unable to work or participate in work activities because of a medical condition may be required to provide documentation from their doctor. The individual may also be required to participate in a medical examination which is completed by another doctor as arranged by the local department of social services to evaluate the individual's medical condition, to identify any limitations that the individual may have and to identify medical care, rehabilitation or treatment that may help restore or improve the individual's ability to work. The local department of social services will review the medical documentation available and inform you in writing of their decision as to whether you are required to participate in work activities (non-exempt or work limited) or are exempt from work requirements. This notice will also inform you of the right to request a fair hearing if you disagree with the local department of social services decision on your ability to work or participate in work activities and the timeframes in order to request a fair hearing.
Q. Are There Certain Individuals Who Are Not Eligible For Temporary Assistance?
A. Yes, Temporary Assistance cannot be given to individuals who:
Q. Can I Get Temporary Assistance If I Am Not A Citizen Of The United States?
A. If you are not a citizen of the United States, you must document that you are an alien in one of the categories listed below in order to be eligible for Temporary Assistance (some aliens may only get Safety Net Assistance):
Q. What If An Undocumented Alien Lives In My Household?
A. Aliens who do not have documents that permit them to reside legally in the United States are eligible only for certain kinds of emergency benefits. When citizens or aliens who are legally present in the country live together with undocumented aliens all members of the household must be listed on the application. Any person who does not sign the certification in the application that he/she is a citizen or an alien with satisfactory immigration status cannot receive Temporary Assistance. However, if otherwise eligible, the rest of the household is entitled to benefits. NOTE: If the U.S. Citizenship and Immigration Services (USCIS) has made a final determination that a member of the household is illegally present in the country (for example, if USCIS has issued a final order of deportation) and that person applies for benefits, we will notify USCIS.
Q. Can I Get Extra Help When I Take Part In Training Or Education?
A. If you are receiving Temporary Assistance and/or Food Stamp Benefits and are participating in a training or education program approved by the local department of social services, you may be able to get extra help to pay for costs related to participation in training or education programs such as:
Q. What Happens If I Get A Job?
A. If you get a job, you may still be able to get Temporary Assistance and/or Food Stamp Benefits depending on how much you make.
If you have a child living with you, a large portion of your earned income may not be counted toward your Temporary Assistance.
If you get a job, and make enough money so that you no longer get Temporary Assistance, you may be able to get the following:
Q. Can I Get Help With An Expense Which, If Not Paid, May Cause Me To Lose My Job?
A. You may be eligible for a "diversion payment". This is a payment which would deal with a specific crisis situation or episode when such a payment would enable the individual or a family to avoid the need for ongoing assistance. In order to be eligible for a "diversion payment" you must be without available financial resources of your own to meet the need. Examples of "diversion payments" are employment-related expenses, including employment-related transportation expenses, or relocation costs to a living arrangement that will allow the individual or family to be self-sufficient.
Q. What Will Happen If I Do Not Agree Or Fail To Take Part In A Required Employment Program?
A. If you are able to work and you willfully and without good cause, fail or refuse to participate in a required employment program, you could lose Temporary Assistance, Food Stamp Benefits, and other services. Before you lose your Temporary Assistance, Food Stamp Benefits or other services, you may be offered a meeting, called a Conciliation Conference or Agency Conference, to discuss why you failed or refused to participate.
You will not lose your Temporary Assistance, Food Stamp Benefits, or other services if you have good cause for failing or refusing to participate. You may be asked to provide documents to support your claim of good cause for not participating in an employment program as required by the local department of social services. You also have a right to a Fair Hearing. For how to request a Fair Hearing, see Book 1 (LDSS-4148A) "What You Should Know About Your Rights And Responsibilities".
Q. Does Everyone Who Lives With Me Have To Apply For Temporary Assistance?
A. When you apply for Temporary Assistance all of your children who live with you (under the age of 18) must also apply. If anyone else living in your household is a blood related or adoptive parent or blood-related or adoptive brother or sister (under age 18), of your children, they must also apply and have their income and resources applied toward the Temporary Assistance household. This is called the Filing Unit Rule. In addition, a parent cannot apply for Temporary Assistance without also applying for his or her children living with the parent.
Q. What Happens If My Child Gets Social Security Benefits?
A. If any of the children in your household have or must apply for Social Security benefits, and you are applying for Temporary Assistance for these children, you should know the following:
Congress and the Social Security Administration have deemed it legal for you to spend the Social Security benefits of a child in your care on that child's parents and siblings if they want to apply for or are in receipt of Temporary Assistance benefits. This means that the Social Security benefits will be counted as income to the filing unit and can be used for basic household expense items, such as food and shelter, in addition to providing for the child's immediate needs.
Q. If I Am Found Eligible, How Do I Access My Temporary Assistance Benefits?
A. You will receive a brochure entitled "EBT How to use your Benefit Card to get Food Stamp and/or Cash Benefits."
Q. Is There A Limit On How Long I Can Get Temporary Assistance?
A. There are two time limits on Temporary Assistance in New York State.
NOTE: Once you have reached the 24-month time limit you are only eligible for non-cash benefits.
NOTE: TANF assistance received in other states may include time periods before December 1996.
NOTE: If you are HIV positive or have an incapacity that prevents you from working you may be exempt from time limits.
NOTE: Temporary Assistance time limits do not affect your Food Stamp Benefits or Medical Assistance.
Q. I Believe I Am A Victim of Domestic Violence. How Can This Agency Assist Me?
A. You must meet certain requirements to be eligible for Temporary Assistance. However, if you are a victim of domestic violence and you think that meeting one or more of the Temporary Assistance requirements would put you or your children at further risk of harm, you may request a meeting with a domestic violence liaison to address the risk of harm. Some requirements can be waived if necessary. Your Temporary Assistance worker can give you more information during your interview.
Additionally, you can call a 24-hour hotline for information about emergency shelter, support groups, and counseling. These services will help keep you and your children safe.
To get information and referrals to your local domestic violence services provider you may call the following numbers, toll-free, 24 hours a day:
A Services caseworker can also arrange for you to get this information.
Q. As An Alien Lawfully Residing In The United States, How Will My Sponsor's Income And Resources Affect My Eligibility And Grant?
A. The income and resources of the sponsor who signed an affidavit of support after December 1997 will be deemed available to you when determining eligibility for Family Assistance. If you are eligible, only the amount actually contributed by the sponsor is considered income for purposes of calculating your Temporary Assistance benefit. However, under the revised federal sponsorship agreement, the local department of social services will request and pursue reimbursement from the sponsor. This information as to the sponsor's obligation will be shared with the federal government.
Q. What Happens If Someone In My Household Has Resources That Are Not Counted Towards Temporary Assistance Eligibility?
A. Resources include, but are not limited to, real property, personal property, cash, bank accounts, insurance policies, trust funds, automobiles, etc. The resource limit for TA is $2,000.00 for a household. If the household contains a member who is disabled, or age 60 or over, the resource limit is $3,000.00.
Some resources such as Earned Income Tax Credit (EITC) payments, undergraduate educational grants and loans, bank accounts for a first or replacement vehicle to seek, obtain or maintain employment and savings from Supplemental Security Income are exempt resources. These funds should be kept in accounts separate from other funds. If they are not kept separate they could be counted toward the resource limit for your household.
For example, if someone in your household receives Supplemental Security Income (SSI) they should have a separate account for the SSI money to be deposited in. This way, the SSI money will not be counted toward your resource limit.
Q. What Happens If I Have Income That I Receive Regularly But Not Every Month? (For Example, Income That Only Comes In Once A Year)?
A. If you have earned or unearned income that is received on a regular periodic basis you should use the income in equal amounts for each month until the next payment is received.
For example, if you receive an annuity (once a year payment) of $1,200.00, you should use $100.00 every month for 12 months. Your worker would also budget $100.00 every month toward your monthly Temporary Assistance grant.
Q. What Is Medical Assistance (Also Called Medicaid)?
A. Medical Assistance is help for people who cannot pay for all of their medical care.
Q. Who May Get Medicaid?
A. You may get Medical Assistance if you:
Q. How Do I Apply For Medicaid?
A. You must fill out an application and check the Medicaid box.
If you want to apply for Medicaid, you must do one of the following:
There are enrollment facilitators throughout New York State who can assist you with applying for Medicaid. For the name of the organization nearest you, call toll free 1-800-698-4543 or toll free 1-877-934-7587.
Q. How Can Medicaid Help Me?
A. Medicaid may help you pay for:
Medicaid may also help pay for the following, but you or the person/facility providing the service must have the service approved ahead of time (prior approval):
If you are pregnant or have a child, the following programs may be able to help you:
For more information about the WIC Program and where you can apply, call 1-800-522-5006.
All children need a "medical home". A medical home is the doctor, nurse, physician's assistant or healthcare team who takes care of your child's health as he or she grows and develops from an infant to a toddler, to a preschooler, and all throughout childhood and adolescence. A medical home is the place you always bring your child for a check up or when your child is sick. And a medical home is the place where you go with questions and concerns about your child's health and development.
Child/Teen Health Plan—The Child/Teen Health Plan helps you find a "medical home". It is a way for children and teens to receive preventive care (checkups), medical exams and follow-up care they need to make sure they are healthy and growing right.
The Child/Teen Health Plan is for children from birth up to age 21 who have Medical Assistance. It is free of charge.
The Child/Teen Health Plan gives your children:
For more information about this program, or for help finding a doctor for your child, ask the Child/Teen Health Plan Services coordinator at your local department of social services.
Q. If I Move To A New County, Do I Have To Reapply To Get Medical/FHPlus?
A. No. If you move, you must notify your local department of social services of your new address. If there are no other changes in your circumstances that affect your eligibility. Your Medicaid case will be transferred to your new county of residence.
Q. Can Medicaid Help Me Get Family Planning Services?
A. Yes. If you are of childbearing age and are eligible for Medical Assistance or Family Health Plus, family planning services are included. If you were denied or terminated from Medical Assistance and/or Family Health Plus, you may be eligible for the Family Planning Benefit Program because the income level is higher and there is no resource limit. You can also apply for the Family Planning Benefit Program only, without applying for Medical Assistance or Family Health Plus.
The Family Planning Benefit Program (FPBP) provides Medical Assistance coverage for family planning services to eligible persons of childbearing age based on their income. Both the application process and the services provided are confidential.
If you are eligible, you will have access to family planning services from all Medical Assistance enrolled family planning providers. These services include: all FDA approved birth control methods, devices, and supplies, comprehensive reproductive health history and physical/gynecological examination, male and female sterilization, pregnancy testing and counseling, and preconception counseling. If you are eligible, coverage will begin on the first of the month in which you apply.
Most local county health departments, publicly-supported family planning clinics, and Prenatal Care Assistance Program providers (Medicaid enrolled family planning providers) may assist you in completing the application and obtaining required documentation. Eligibility for the Family Planning Benefit Program will continue for 12 months unless eligibility circumstances change. After the 12 months you will receive a renewal form in the mail. For more information about this program, call or visit your local department of social services and ask for an application. You may be able to apply at a family planning provider's office. To find out where a participating family planning provider is in your area, you may call 1-800-541-2831. (See the description of Family Health Plus at end of the Medical Assistance section of this booklet.)
Q. What Is The Medicaid Buy-In Program For Working People With Disabilities?
A. Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD) offers Medical Assistance coverage for working people with disabilities who have net incomes at or below 250% of the Federal Poverty Level (FPL) and non-exempt resources at or below $10,000. The program is designed to help working people with disabilities retain their healthcare coverage. Depending on your income, you may be asked to pay a monthly premium.
Q. What Are The Eligibility Requirements For The MBI-WPD Program?
A. To qualify for the MBI-WPD program, you must:
Q. How Does Medicaid Work?
A. After an application is approved, most persons will get a plastic card called a Common Benefit Identification Card (CBIC). When you get medical care, give this card to the doctor, pharmacist or other person from whom you want help. Your doctor, pharmacist or other person must agree to bill Medicaid and be a Medicaid enrolled provider. Your bills will be sent to the New York State Medical Assistance program to be paid. Persons enrolled in Family Health Plus will receive a card from the health plan that they selected. Eligible persons enrolled in Family Health Plus or a Medicaid managed care health plan must use providers in their health plan for services covered by the Plan.
In most counties in New York, you will have the option to join a managed care health plan. Most counties have mandatory managed care. (See the Question and Answer "What Is A Medicaid Managed Care Health Plan?")
Q. Do I Pay Any Money For My Medical Care?
A. Medical Assistance recipients age 21 or older may be asked to pay part of the costs of some medical care/items. This is called a co-payment or co-pay. Your health care provider is allowed to ask you for the co-payment. For each 12 months beginning April 1, there is a $200 maximum per recipient for all co-payments.
If you are unable to pay the requested co-payment, tell your health care provider when the provider asks you for payment. You can still get the services you need from your provider. The provider cannot refuse to give you services or goods because you tell the provider that you are unable to pay the co-payment. Call 1-800-541-2831 to report any provider who refuses to give you care or services because you are unable to pay the co-payment.
NOTE: Co-payments are not charged by practicing physicians and dentists or for home health and personal care services.
NOTE: If you are getting Family Health Plus, you have different co-payments. ("See the question "How Much Does It Cost?" In the FAMILY HEALTH PLUS subsection in this MEDICAL ASSISTANCE section, several pages after this note.)
Q. How Often And How Much Medical Assistance Help Can I Get?
A. The number of times Medical Assistance will pay for visits to doctors or clinics, labs and drug stores may be limited. This limit is called "Medicaid Utilization Thresholds". Your worker can tell you if Medicaid Utilization Thresholds apply to you.
Q. What Is A Medicaid Managed Care Health Plan?
A. Most counties have a Medicaid Managed Care program through one or more Medicaid Managed Care health plans. When you join a Medicaid Managed Care health plan, you use the providers and hospitals that are in your plan. You choose your own doctor or nurse practitioner who will keep track of all your health care. This person is called Primary Care Provider (PCP). Your Primary Care Provider will send you to a specialist if you need one. Under Family Health Plus, all services are received from managed care plan that you select.
Q. Why Join A Medicaid Managed Care Health Plan?
A. In many counties, you must join a managed care health plan to receive most of your Medicaid health care services. Call your local department of social services to find out if you can join or must join a Medicaid Managed Care health plan. Most Medicaid Managed Care health plans offer more providers to choose from than regular Medical Assistance. You get to choose your own Primary Care Provider (PCP), which means you don't need to use the emergency room for medical care that is not life threatening. Your Primary Care Provider will give you a referral when you need to see a specialist. You can call your Primary Care Provider or a health plan phone number 24 hours a day if you think you need medical care.
If you are pregnant, you will have your own doctor or nurse practitioner who will give you all the medical care and tests that you need. Your newborn baby will get follow-up visits. Your children will also have their very own Primary Care Provider.
There are no co-payments or utilization thresholds except for pharmacy services when you are in a Medicaid Managed Care health plan. You will get your own health plan card that is separate from your Common Benefit Identification Card (CBIC).
More information is available on the New York State Department of Health website at www.nyhealth.gov and click Health Insurance Programs, then click Managed Care.
Q. Can Medicaid Pay For Past Medical Bills?
A. We can pay you for some bills you paid before you asked for Medical Assistance—even if the doctor or other provider that you paid does not take Medical Assistance. The following explains when we will pay you for these bills.
What bills can be paid? You can be paid for bills you paid before you asked for Medical Assistance and for bills you pay until you get your Common Benefit Identification Card (CBIC). Bills you paid before you asked for Medical Assistance must be for services you received on or after the first day of the third month before the month that you asked for Medical Assistance. Example: If you ask for Medical Assistance on March 11, we can pay you for services you received and paid for from December 1 until you get your Common Benefit Identification Card (CBIC).
What if the doctor or other provider that you paid doesn't take Medical Assistance? We can pay you for some bills even if the doctor or other provider you paid does not take Medical Assistance. If you paid the bills before you asked for Medical Assistance, we can pay you even if the doctor or other provider does not take Medical Assistance. After the day you ask for Medical Assistance, we can pay you only if the doctor or other provider takes Medical Assistance.
Like public sponsored health insurance, once your application for Medicaid or Medicaid sponsored insurance with a managed care organization is approved, you must go to Medicaid providers or in network health care organizations to be paid for services rendered.
Always ask the doctor or other provider if he or she takes Medicaid. After you ask for Medical Assistance, we will not pay you if the doctor or other provider does not take Medicaid.
Are there more rules? Yes. You also need to know that:
What if my family or friend paid the bills for me? If your bills were paid by a family member or friend, we may be able to pay them. Ask your worker.
Any questions? Please ask your worker if you have any questions.
Q. Can Medical Assistance Pay For Medical Care I Get Outside Of New York State?
A. Maybe. Medical Assistance will pay for medical care you get out of state if:
If you are a member of a Medicaid Managed Care health plan, call the health plan member services number on the back of your card to find out how to get services if you are going out of state.
Q. What Is Medicare?
A. Medicare is not the same as Medical Assistance (Medicaid). Medicare is a federal insurance program administered by the Social Security Administration that pays for hospital bills (Part A) and doctor bills and some other medical services (Part B), and prescription drugs (Part D). You can apply for Medicare at your local Social Security Office.
Q. Can I Have Both Medicare And Medicaid?
A. Yes. If you are eligible for both programs, Medicare will be billed first and Medicaid will pay for services that Medicare does not cover but that are covered by the Medical Assistance program.
Q. Can Medical Assistance Pay My Medicare Premiums?
A. Yes, under certain conditions, Medical Assistance may pay for Medicare Part A or Part B premiums, coinsurance and deductibles. Medical Assistance does not pay for Part D premiums or co-payments.
Q. If I Have Both Medicare And Medical Assistance, Do I Have To Get My Prescription Drugs Through Medicare Part D?
A. Yes, if you have both Medicare and Medical Assistance, enrollment in Medicare Part D is a condition of eligibility for receiving Medical Assistance. The only exception to this rule is if you or your dependents have other health insurance through a retiree insurance plan, and you have been told that if you enroll in Medicare Part D, you will lose your health insurance coverage. Medical Assistance may sometimes pay for certain prescription drugs that are not available through Medicare Part D.
Q. Should I Cancel Any Other Health Insurance I Already Have?
A. No. Wait and ask this question at your interview.
Q. Can I Still Keep Some of My Income If I Am In A Nursing Home Or Other Medical Facility?
A. Yes. You can keep a small amount for your own personal use. You can also keep some of your income and resources for your family if they are dependent on you.
Q. Are There Higher Income And Resource Limits For Pregnant Women And Children?
A. Yes, if you are pregnant or want help for a child younger than age 19, you can have higher income and your family's resources are generally not considered.
If you have children and your income is too high for Medical Assistance, you may want to apply for Child Health Plus for your children. You can apply for Child Health Plus by calling toll free 1-800-698-4543.
NOTE: If you are pregnant or want help for a baby under the age of one, there is no limit to the amount of resources the family can have.
Q. What Are Home And Community Based Services (HCBS) Waiver Programs?
A. Home and Community Based Services (HCBS) Waiver, programs permit a state to furnish an array of home and community based services that assist Medicaid-eligible individuals to live in the community and avoid medical institutionalization. These are Medical Assistance programs which may provide special services that are not typically paid for by Medical Assistance. The programs may also have different financial eligibility rules.
New York has HCBS Waiver programs for:
In 2007 a new HCBS Waiver, "Bridges to Health" (B2H) was approved. The B2H Waiver allows for services to be provided to children who are in foster care and who have serious emotional disturbance, are medically fragile, or have developmental disability.
Q. What If I Have Emergency Medical Needs?
A. New York State law requires hospitals to give you emergency care, even if you cannot pay for it. If you have a medical emergency, like a heart attack or other life-threatening illness, go to a hospital right away, before you find out if you are able to get Medical Assistance or before you have applied for Medical Assistance. If you are sick and need medical care right away, and you have applied for but have not gotten your Common Benefit Identification Card, your worker may be able to help you get a temporary card for the medical help you need. You must show the card when you get medical treatment and the doctor or other person providing medical care must agree to bill Medical Assistance.
Medical Assistance may be able to pay medical bills for care you were given during the three months before you applied for help. Remember to tell your worker if you have any paid or unpaid medical bills.
Q. What Is Prospective Drug Utilization Review?
A. The Prospective Drug Utilization Review Program lets a pharmacist check a computer before you get your prescription filled to see if you recently received any other medicines that should not be taken with your new prescription. If the pharmacist sees a problem, the pharmacist may check with your doctor to find out if you should be given the new medicine. This is done to make sure you get the right medicine. By checking with the computer, your pharmacist will also be better able to answer any questions you may have about your medicines.
Q. If I Sell, Give Away Or Transfer Any Money Or Property, Can I Still Get Medical Assistance?
A. This section explains what may happen if you are institutionalized and you or your spouse transfer any property or money and apply for Medical Assistance. A transfer is when you give away money or property or sell property for less than it is worth. You can keep certain money or property for you and your family and still get Medical Assistance. If you or your spouse transferred other money or property, Medical Assistance might not pay for the following medical care for a period of time, depending on how much money or property you transferred:
However, Medical Assistance will pay for other medical care if you are eligible.
In most cases if you want full Medical Assistance coverage, you cannot transfer money or property. Sometimes, you can transfer money or property and still get full Medical Assistance coverage if:
When the local department of social services decides that you have transferred any property or money and you think that they have made a mistake, you have a right to prove that you did not transfer the property or money by:
Q. Will A Claim Be Made Against My Estate When I Die?
A. If you receive medical services paid for by Medical Assistance on or after your fifty-fifth birthday, or when permanently residing in a medical institution, Medical Assistance may recover the amount of the cost of these services from the assets in your estate upon your death.
Q. Can I Get Medical Assistance If I Am Not A Citizen Of The United States?
A. For the Medical Assistance Program, identity, citizenship and/or satisfactory immigration status must be documented. If you are pregnant, you do not have to tell us about your citizenship or alien status. If you do not have satisfactory immigration status you may be eligible for Medicaid for the treatment of a medical emergency. For the purposes of qualifying as a United States citizen, the United States includes the 50 states, the District of Columbia, Puerto Rico, Guam, U.S. Virgin Islands and the Northern Mariana Islands. Nationals from American Samoa or Swain's Island are also regarded as United States citizens for the purpose of Medical Assistance. Additionally, if you are a Native American born in Canada, with at least 50% Native American blood or a Native American who was born outside the United States and belong to a federally recognized tribe, you are also regarded as a United States citizen for the purpose of Medical Assistance.
Otherwise, if you are not a citizen of the United States, in order to be eligible for Medical Assistance you must provide documents that show you are an alien in one of the following immigration categories:
If you are an alien who is not in any of the immigration categories listed above, you may be able to get help with your medical care if you are pregnant or you need medical care because of an emergency medical condition.
Q. Are There Limits On The Number Of Times I Can Receive Certain Medical Services Through The Medical Assistance Program?
A. Yes. There are limits on the following types of services:
There are no limits on the following services:
Service limits are for a 12-month period called a benefit year, which begins the month you become eligible for Medical Assistance. You will have these same limits even if you go on and off Medical Assistance during this benefit year. After the benefit year is over, a new 12-month benefit year will begin with the full number of service limits (for example: 18 laboratory tests). Services not used from the last benefit year will not be carried over to the new benefit year.
During each benefit year we will keep track of the number of services you are using and will let you know by mail if you are using services quickly and are in danger of reaching your limit. We will also let you know by mail if you have reached your service limit.
When you go for a medical service, your doctor, clinic or pharmacy must first check with Medical Assistance to see whether you have reached the limit for medical services. It is important that you show your "Common Benefit Identification Card" (CBIC) each time you go for medical services. Each case member will receive a CBIC for Medical Assistance purposes.
If you are enrolled in a managed care plan, you will also get a health plan card that is separate from your CBIC. (See the Question and Answer "What is a Medicaid Managed Care Plan?")
Your doctor can fill out a special form called a "Threshold Override Application" to ask Medical Assistance to increase the number of services you can receive or to give you an exemption from service limits.
You should ask your doctor to fill out the Threshold Override Application to get more services when:
If you need services above your limit make sure that you ask your doctor to fill out the Threshold Override Application. Remember, if you do not ask for more services and you reach your limit. Medical Assistance will not pay for additional services, except for emergency medical care, until your new benefit year begins.
If you enroll in a Medicaid Managed Care Program you will not be subject to the Utilization Threshold Program except for pharmacy. To find out if there is a Medicaid Managed Care Program available to you, please call your local department of social services. If you are enrolled in Family Health Plus, you are not subject to Utilization Thresholds, but there may be limits on some services.
Call your local department of social services and ask for the Medicaid Managed Care Coordinator (upstate New York). In NYC, call toll free 1-800-505-5678.
You have a right to a Fair Hearing when your application for an exemption or an increase in service limits is denied and you have reached your service limits. At this hearing you can raise the issue of whether we correctly figured the number of services you used.
Your eligibility for Medical Assistance will be determined by your local department of social services. Generally, you should contact your local department of social services with any questions concerning your application for Medical Assistance. If you have general questions concerning Medical Assistance in New York State, you may call toll free 1-800-541-2831.
Q. Are There Any Program Requirements That May Limit What Drugs I May Get?
A. Medical Assistance law requires that New York State Medical Assistance recipients receive generic drugs in place of brand name drugs. The law requires doctors to prescribe the generic version of a drug, unless they get special approval for a brand name drug.
Q. What Is FHPlus?
A. FHPlus is a public health insurance program for adults age 19 through 64 who have incomes too high to qualify for Medical Assistance. FHPlus is available to single adults, couples without children, and parents with limited income who are not eligible for employer-sponsored health coverage through Federal, State, county, municipal or school-district benefits plans. Family Health Plus premium assistance is available to individuals who are covered by health insurance through other employers. To be eligible for FHPlus, you must be a resident of New York State, and be a United States citizen, or an alien who falls into one of the immigration categories listed earlier. There are also income and resource guidelines that must be met. Health care is provided through a participating managed care plan that you select, in your area.
Q. How Do I Qualify for FHPlus Premium Assistance?
A. If you have insurance through your employer you may be eligible for help in paying for your share of the insurance premiums.
Q. How Can I Apply?
A. When you apply for Medical Assistance, either at a local department of social services or with a facilitated enroller, eligibility determination for Medicaid or FHPlus is made automatically. If eligible, you will be given the appropriate coverage for which you are eligible.
Q. What Benefits Can I Get?
A. FHPlus provides comprehensive coverage, including: prevention, primary care, hospitalization, prescription and other services. Some services have limits. A co-payment may be required for some services. FHPlus does not cover: nursing home care, long term home health care, personal care and non-emergency transportation. Some FHPlus plans offer dental services; others do not.
Q. If I Move To A New County Do I Have To Re-Apply To Get Medicaid/FHPlus?
A. No. If you move, you must notify your local department of social services of your new address. If there are no other changes in your circumstances that effect your eligibility. Your Medicaid case will be transferred to your new county of residence.
Q. How Is Health Care Provided?
A. Health care in the FHPlus program is provided through managed care plans. You must select a participating health plan when you apply. When you choose a health plan, you use the providers and hospitals that are in that plan. You will get your own health plan card so you can get services from the plan. You will also receive a Common Benefit Identification Card (CBIC) to use for covered pharmacy benefits. If you received benefits in the past and were sent a card, a new card will not automatically be mailed to you. If possible, you should use the same card you received before. Please keep your card in a safe place and let you worker know immediately if your card does not work, is lost or stolen. Keep this card even if you stop receiving benefits. The same card will be used again if you become eligible again in the future.
Q. How Do I Choose A Health Plan?
A. In choosing a health plan, you should think about the doctors you want, the services you and your family need, and the health plans available to you. Make sure the doctor you want to see is in the health plan you choose. After you join a plan, you must use the hospital, clinics and doctors that work with that plan.
Q. How Much Does It Cost?
A. There is no cost to join FHPlus, and no yearly fee or deductibles. Once enrolled you may be asked to pay part of the costs of some medical care/services. This is called a co-payment or co-pay.
The co-payment amounts for FHPlus are as follows:
Pregnant women or individuals under the age of 21 will not have to pay the co-payment. In addition, enrollees do not have to pay co-payments for family planning services, including birth control, or if they are a permanent resident of a nursing home, a resident of an Intermediate Care Facility for the Developmentally Disabled, or an Office of Mental Health or Office of Mental Retardation and Developmental Disabilities Certified Community Residence. If you are a resident of an adult care facility licensed by the State Department of Health, you do not have to pay co-payments for prescription drugs.
If you cannot afford the co-payment at the time of services, tell your provider. The provider must still provide services but can bill you later.
Q. Can FHPlus Help With Past Medical Bills?
A. No. Unlike Medicaid, FHPlus cannot pay for any care you receive before your enrollment in your FHPlus plan.
Q. Where Can I Get Additional Information On FHPlus?
A. To obtain additional information on the FHPlus program, you can call at the toll free hot line at 1-877-9FHPlus (1-877-934-7587) or log onto the FHPlus website at http:/www.health.state.ny.us/nysdoh/whatisfhp.htm.
Q. If You Have A Disability And Are Working And Have More Income And Resources Than Is Allowed For Medicaid, Is There Any Way To Get Or Keep Medicaid Health Care Coverage?
A. Yes, if you are between 16 and 64 years old, have a disability as defined by the Social Security Administration, and are working, you can have income up to 250% of the Federal Poverty Level (FPL) and resources as high as $10,000 by participating in the Medicaid Buy-In program for Working People with Disabilities (MBI-WPD). A monthly premium may be charged for participants in this program who have countable income between 150% and 250% of the FPL.
Q. What If You Do Not Qualify For Medicaid Or FHPlus? Is There Any Other Help?
A. The New York State Department of Health Cancer Services Program provides breast, cervical, and colorectal screening at no cost to eligible individuals who are uninsured. If breast, cervical or colorectal cancer is found, you may be able to get Medicaid coverage. Also, if prostate cancer is found by a doctor in this program, you may be able to get Medicaid coverage for treatment. For more information call toll free 1-800-422-2262.
Q. What Are Child Support Enforcement Services?
A. Child support enforcement services are those services provided by the Child Support Enforcement Unit (CSEU) within each social services district. The CSEU will do the following for you, as appropriate:
If the noncustodial parent lives in another state, either your local CSEU or the child support agency in the other state can provide you with assistance in establishing paternity, and establishing, modifying and/or enforcing a support order as necessary and appropriate.
Q. Who May Get Child Support Enforcement Services?
A. Any custodial or noncustodial parent, or non-parent caregiver acting as a guardian of a child for whom support is needed, may obtain child support enforcement services.
These services are available to the general public, as well as to applicants/recipients of Temporary Assistance, Safety Net Assistance, Medical Assistance, Title IV-E or non-Title IV-E Foster Care, Food Stamp Benefits and Child Care.
Q. How Do I Apply?
A. You may apply by contacting the CSEU located in your local department of social services or, if you live in New York City, by contacting the Human Resources Administration Office of Child Support Enforcement (HRA OCSE) to obtain and complete a child support services application. If you are applying for Temporary Assistance for a child for whom legal fatherhood needs to be established or where there is a noncustodial parent, you will be automatically referred to the CSEU.
Q. What Happens When I Apply For Or I Am Referred For Child Support Enforcement?
A. You will have an interview with the CSEU to determine what services are necessary to secure support for your child(ren). During the interview you will be asked to provide information and documentation, such as:
This information is critical to the ability of the child support enforcement program to expedite getting child support for you. Your child support worker will assist you with the next steps in the process.
Q. If I Apply For Temporary Assistance Am I Required To Cooperate With The Child Support Enforcement Program?
A. Yes, as a condition of eligibility you must:
Q. What Happens If I Do Not Cooperate With The Child Support Enforcement Program?
A. When an individual, without good cause, fails to cooperate with the child support enforcement program, the Temporary Assistance benefit available to the household is reduced by 25 percent.
Q. What If I Do Not Want To Cooperate Because I Have Safety Concerns For My Child Or Myself?
A. You need to indicate what your concerns are to your worker. The worker will guide you through appropriate steps to determine if you have good cause or if you need a domestic violence waiver from child support requirements.
Q. When I Apply For Temporary Assistance, Do I Have To Assign My Rights To Receive Child Support Payments?
A. Yes. Beginning October 1, 2009, new Temporary Assistance applicants/receipts are required to assign any rights to support which accrue during the period of assistance that the applicant/recipient may have in his or her own right or on behalf of any other family member for whom the applicant/recipient is applying for or receiving assistance. Individuals who are Temporary Assistance applicants/recipients prior to October 1, 2009 continue to assign all rights to support held on their own behalf or on behalf of any other family member for whom the applicant/recipient is applying for or receiving assistance, whether or not those rights accrue during the period of assistance.
Support rights which were assigned to the State by applicants/recipients for Temporary Assistance prior to October 1, 2009 will continue to be assigned if such individuals re-apply for Temporary Assistance on or after October 1, 2009. However, for new applicants/recipients only the rights to support which accrue while they are in receipt of assistance will be subject to the new assignment made on or after October 1, 2009.
Q. If I Am Receiving Temporary Assistance Will I Also Get Child Support Payments?
A. When you assign your rights to support, the child support payments collected while you are receiving Temporary Assistance are first distributed to the agency to reimburse the benefits provided to you and other family members on your Temporary Assistance case. However, for each month in which current support is collected, you will receive on your EBT card a "pass-through payment" taken out of the funds distributed to the agency. Once all benefits paid to you have been reimbursed to the extent allowed by any existing assignment of support rights, any excess amount of support that is collected will paid be to you on your EBT card as an "excess support payment."
Q. What Is A "Pass-Through Payment?
A. A pass-through payment is a portion of the assigned current support collections which, when paid timely, the state passes through to families who are currently on Temporary Assistance. The pass-through payment is the lesser of an amount of up to the first $100 of current support collected each month or the current support obligation amount. Effective January 1, 2010, the $100 pass-through payment will continue where there is one individual under the age of 21 active in the Temporary Assistance case. Where there are two or more individuals under the age of 21 active in the same Temporary Assistance case, the pass-through payment will increase to the lesser of an amount up to the first $200 of current support collected each month or the current support obligation amount collected for the month. The pass-through payment is disregarded from budgeting when determining the amount of Temporary Assistance that the family will receive but may reduce your Food Stamp Benefits.
Q. What Happens To My Child Support Arrears When Support Collected Pays Back All Of My Temporary Assistance Benefits?
A. While you are on Temporary Assistance, if all of the benefits provided to you that were subjected to a child support assignment have been paid back, you are entitled to receive the support payments collected for any arrears/past-due support owed to you. Beginning October 1, 2009 these arrears will be paid directly to you by the Support Collection Unit as "family arrears." Additionally, the household may receive a "pass-through payment" if there is a current support collection.
Q. How Will The Family Arrears Payment Affect My Benefits?
A. The amount of family arrears payment will be reported to your local department of social services and reviewed to determine whether it affects your eligibility for Temporary Assistance, Food Stamp and/or Medicaid benefits.
Q. When I No Longer Receive Temporary Assistance, Will Child Support Services And Collections Continue?
A. Child Support Enforcement Services automatically continue after your Temporary Assistance case closes unless you request the CSEU to close your case. If you continue Child Support Enforcement Services, you will receive all the child support collected except any collections made for past-due support/arrears owed to the Agency under an assignment of rights made when you applied for Temporary Assistance.
Q. How Long Does A Parent Have To Pay Child Support?
A. A parent has an obligation to pay child support for a child until (s)he is 21 years of age. After the child reaches 21 years of age, the parent remains obligated to pay only past-due support/arrears.
Q. What Are Food Stamp Benefits?
A. Food Stamp Benefits are used to purchase food items and are redeemed when you use your Common Benefit Identification Card (CBIC). Most food stores accept the CBIC/EBT card. Look for the Quest sign on the door or window of the store.
Q. Who May Get Food Stamp Benefits?
A. You may be able to get Food Stamp Benefits if you:
NOTE: Even if you own a home and a car you may still be able to get Food Stamp Benefits.
Q. Can I Apply For Food Stamp Benefits If I Have Reached The Temporary Assistance Time Limits?
A. Yes. Limits for cash assistance programs do not apply to the Food Stamp Benefits Program.
Q. How Do I Apply For Food Stamp Benefits?
A. In order to apply you must fill out a Food Stamp Benefits application. An application may be requested from your local department of social services. Additionally, you may download and print a food stamp application at http://www.otda.state.ny.us/main/apps/4826.pdf. A Food Stamp Benefits application must be accepted at your local department of social services, or in NYC your local food stamp center, if you have filled in at least your name, address (if you have one) and signature. This is important because the amount of your Food Stamp Benefits is figured from the day you turn in (file) your Food Stamp Benefits application. You could get more Food Stamp Benefits if you turn in your application the same day you get it. Please note, however, that you will have to fill out the rest of the application to see if you can get Food Stamp Benefits.
NOTE: If everyone in your household has applied for Temporary Assistance, usually you do not have to apply separately for Food Stamp Benefits. Also, you do not have to apply for Temporary Assistance to get Food Stamp Benefits.
Q. Where Do I Apply?
A. You may apply in person, by mail, or fax at your local department of social services. If you live outside New York City, call toll free 1-800-342-3009 for the address and phone number of the local department of social services nearest you. If you live in New York City, you can get the address and phone number of the center nearest you by calling toll free 1-877-472-8411 or toll free 1-800-342-3009 or 311. If you have access to the internet, the following website will provide information of the agency or center nearest you: http://www.otda.state.ny.us/main/workingfamilies/dss.asp.
Q. Can Someone Apply For Food Stamp Benefits For Me?
A. You can choose a relative or friend to apply for your household. This person would be called an "Authorized Representative". You must print their name, address, and phone number on the application where indicated in the instruction booklet. The space is usually at the back, or end, of the application. Both you and the authorized representative must sign the application unless you reside in an institution. If you want, this person or someone else may also be authorized to access your Food Stamp Benefits and use them to shop for your food. To do this an Authorized Representative can get his or her own EBT card (CBIC).
Q. Do I Have To Apply For Food Stamp Benefits in Person?
A. No. You can also apply by mail or another person can apply for you.
NOTE: If you have access to the Internet, find out if you may be eligible for Food Stamp Benefits and other work supports by visiting www.myBenefits.ny.gov. If everyone in your household is applying for or getting Supplemental Security Income (SSI,) you can also apply at your local Social Security Administration Office.
Q. What Happens When I Turn In My Application?
A. After you turn in your application, you will have a confidential interview with a worker. Usually, you must appear in person for this interview unless:
Unless the local department of social services determines that you are exempt from Food Stamp Benefits work requirements, you may also be required to participate in Food Stamp Benefits work activities.
NOTE: If you cannot go to the interview and you do not have anyone to go for you, you may be interviewed over the phone or a worker may ask to come to your home.
Q. How Long Will It Take To Get Food Stamp Benefits?
A. It may take up to 30 days from the date you first apply.
Q. Can I Get My Food Stamp Benefits Right Away?
A. Yes, you may be able to get your Food Stamp Benefits within five calendar days. This is called Expedited Processing.
Usually, you may be able to get Expedited Processing if you are eligible for Food Stamp Benefits and:
NOTE: You do not need to be out of food to get Expedited Processing of Food Stamp Benefits.
Q. If I Am Found Eligible, How Do I Access My Food Stamp Benefits?
A. Please refer to Section K: "Getting Benefits With Electronic Benefit Transfer (EBT)", in this Book.
Q. When Do I Access My Food Stamp Benefits?
A. If you live outside of New York City:
The last number of your case, 1 through 9, will tell the earliest date of the month that you can access your Food Stamp Benefits. For example, if your case ends in 2, you can access your Food Stamp Benefits beginning on the 2nd day of the month. If your case ends in 0, you can access your Food Stamp Benefits beginning on the 1st of the month.
If you live in New York City:
You will get a form from your Food Stamp Benefits Office that will tell you the earliest date of the month that you can access your Food Stamp Benefits. For example, if the form tells you the first day you can access your Food Stamp Benefits is the 3rd, you can use your Common Benefit Identification Card (CBIC) on the 3rd and thereafter.
NOTE: If your Food Stamp Benefits account goes unaccessed for a 365 consecutive day period, any Food Stamp Benefits in the account that are at least 365 days old will be removed (expunged) and not replaced.
Q. Can Food Stamp Benefits Be Used At Senior Citizen Sites And For Home Delivered Meals?
A. You may be able to sign a voucher form for these services to charge your Food Stamp Benefits account.
Q. What Happens If A Person In My Household Does Not Follow A Food Stamp Program Work Requirement Or Quits A Job?
A. A person who does not comply with Food Stamp Benefits work requirements, or voluntarily quits or reduces work hours, without a good reason will be sanctioned (no Food Stamp Benefits for that person), usually for a certain amount of time.
Q. Can I Get Food Stamp Benefits If I Am Not A Citizen Of The United States?
A. Many non-citizens are qualified aliens who are eligible for Food Stamp Benefits. Even if you are not eligible for Food Stamp Benefits, you may receive Food Stamp Benefits for your children if they are eligible. Food Stamp Benefits should not affect your immigration status with respect to any United States Citizenship and Immigration Services' (USCIS) decision regarding your immigration matter.
You may be eligible for Food Stamp Benefits if you are a United States (U.S.) citizen, a non-citizen U.S. national (people born in American Samoa or Swain Island), or a qualified alien. A qualified alien for the purpose of Food Stamp Benefits eligibility is:
You have a right to a Fair Hearing if you have been denied Food Stamp Benefits, if your benefits have been discontinued, suspended or reduced, or if you disagree with the decision of the local department of social services. For more information about your Fair Hearing Rights, please refer to Book 1 (LDSS-4148A) "What You Should Know About Your Rights And Responsibilities".
For further information about Food Stamp Benefits, you may also go to the following internet website: http://www.otda.state.ny.us/main/foodstamps/.
Q. Can I Still Get Child Care Assistance When My Temporary Assistance Stops?
A. Recipients who voluntarily close their assistance case, or who are otherwise ineligible for assistance, may be eligible for a child care subsidy. If you need child care because you are working, and your household income falls within the allowable limits, your worker should determine your eligibility for this child care assistance before your Temporary Assistance stops. You will have to pay a share of the cost of child care. This child care is called transitional child care and is available for up to 12 months after you are no longer eligible for Temporary Assistance.
Q. What If My Medical Assistance Case Closes?
A. Transitional Medical Assistance—If your Low Income Family Medical Assistance case closes because you have increased earned income, or the combination of your earned and unearned income increase to make you ineligible, you may still be able to get Transitional Medical Assistance. Low Income Family Medical Assistance is the Medical Assistance program for families who are eligible for Temporary Assistance, but you do not have to be getting Temporary Assistance to get Low Income Family Medical Assistance.
You may be able to get this extra help for up to 6 months if:
After the 6 months are up, you may be able to get 6 more months of Transitional Medical Assistance if:
A woman eligible for Medical Assistance during any month of her pregnancy remains eligible for Medical Assistance until 60 days after the end of her pregnancy. To receive the 60-day postpartum extension, the woman must have applied for Medical Assistance prior to the end of her pregnancy.
An infant, born to a woman eligible for and receiving Medical Assistance during her pregnancy, is eligible for Medical Assistance until the end of the month in which the child turns age one. Medical Assistance includes Medicaid, Family Health Plus, the Family Planning Benefit Program and women presumptively eligible within 3 months of the birth. If a woman applies for Medicaid within 3 months of giving birth and is eligible for the retroactive period when she gave birth, the child is eligible for one year of coverage.
Children up to the age of 19 who are fully eligible for Medical Assistance are given Medical Assistance from 12 months from the date that they were determined or redetermined eligible or until their 19th birthday, whichever is sooner, regardless of any changes in income or circumstances.
An individual enrolled in a Managed Care Organization (MCO) is guaranteed six months of Medical Assistance coverage for the capitated benefits offered through the MCO even if he or she loses Medical Assistance eligibility.
Q. Can I Still Get Help With Collecting Child Support After My Temporary Assistance Stops?
A. Yes, as a former recipient of Temporary Assistance child support services continue for you automatically unless you request in writing that such services stop. You should have received notice of the continuation of services at the time your case closed.
Q. Can I Still Get Food Stamp Benefits After My Temporary Assistance Stops?
A. If you work and get low wages, have other low income, or are unable to work, you still may be able to get Food Stamp Benefits (see "Food Stamp Benefits", Section D of this Book).
Q. What Is Child Care Assistance?
A. Child care assistance helps a parent(s)/caretaker(s) who needs care and supervision for his or her child(ren) when the parent(s)/caretaker(s) is not available to care for his or her child(ren). Child care assistance helps a parent(s)/caretaker(s) to pay some or all of the cost of child care services.
Q. Who May Get Child Care Assistance?
A. There are certain families that are guaranteed child care, some families that are eligible if the local department of social services has funds available, and other families that are eligible if the district has funds available and has decided to pay for child care for those categories of families.
The following families are guaranteed child care, when such services are needed for a child under the age of 13:
The following families are eligible for child care assistance when the local department of social services has funds available and the family has applied for or is receiving Temporary Assistance for an eligible child 13 or older, who either has special needs or is under court supervision, and child care is needed. So that a parent/caretaker/relative can participate in activities required by the local department of social services including orientation, assessment, or work activities.
The following families are eligible for child care assistance when the local department of social services has funds available and, if the family is on Temporary Assistance and child care is needed:
The following families are eligible for child care assistance when the local department of social services has funds available:
Child care is available for families in the following circumstances if the local department of social services has decided to serve these families, the family is on Temporary Assistance, and the local department of social services has funds available. Ask your worker whether your local department of social services pays for child care assistance for one or more of these categories:
Child care is available for families in the following circumstances if the local department of social services has decided to serve these families, the family has income within the allowable limits, the local department of social services has funds available, and the activity has been determined to be a necessary part of a plan for family's self-support. Ask your worker if your local department of social services pays for child care assistance for this category:
Child care is available for families in the following circumstances if the local department of social services has decided to serve these families, the family is either on Temporary Assistance or has income within the allowable limits, and the local department of social services has funds available. Ask your worker if your local department of social services pays for child care assistance for one or more of these circumstances:
Child care is available for families in the following circumstance if the local department of social services has decided to serve these families, the family has income within the allowable limits and the activity has been determined to be a necessary part of a plan for family's self support. Ask your worker if the local department of social services pays for child care assistance for the following circumstance:
Q. What Does Child Care Guarantee Mean?
A. A child care guarantee means that if you meet the eligibility requirements, the local department of social services will provide a child care subsidy to an eligible child care provider for your child care. You will be required to pay for part of the child care cost if you are not receiving Temporary Assistance. Also, if your child care provider charges more than the local department of social services is allowed to pay, you will have to pay the difference between the amount the local department of social services is allowed to pay and the amount your provider charges.
Q. Is There A Time Limit To The Child Care Guarantee?
A. Families on Temporary Assistance that are eligible for a child care guarantee will receive child care assistance for as long as they are on Temporary Assistance and are participating in an activity required by the local department of social services. Families that fall under transitional child care guarantee are limited to twelve months of transitional child care assistance. There is no time limit for Child Care In Lieu of Temporary Assistance as long as your income is at or below the amount that would allow you to remain eligible for Temporary Assistance.
Q. What Is The Age Range Allowed For A Child To Receive Child Care Assistance?
A. In general, a child is eligible for child care if they are under 13 years of age. However, exceptions are made for children under 18 years of age who are either under court supervision or who have special needs. Children who have special needs or who are under court supervision and are under 19 years of age are eligible so long as the student is a full-time student in an approved educational or vocational program.
Q. How Do I Apply For Child Care Assistance?
A. If you live outside of New York City, call or visit your local department of social services and ask for an application package. If you live in New York City and you are on Temporary Assistance or applying for Temporary Assistance, call or visit your local
Job Center. If you are applying only for child care assistance, call the New York City information helpline at 311 and they will direct you where to call. You must complete the application package and turn it in either in person or by mail. Remember, you may turn in the application the same day you get it.
Q. What Happens When I Apply For Child Care Assistance?
A. You will be asked to prove certain things within 30 days of the date the local department of social services receives your application. See Book 1 (LDSS-4148A) "What You Should Know About Your Rights and Responsibilities". The local department of social services will, within 30 days of receiving your application, determine if you are eligible for child care assistance, and will notify you in writing of their eligibility decision within 15 days of the date they make it.
Q. Can I Get Child Care Assistance If I Am Not A Citizen Of The United States?
A. Yes, however, the child who needs child care services must be legally in the United States.
Q. If I Apply For Child Care Assistance Am I Required To Pursue Child Support From An Absent Parent?
A. No, it is not a requirement to pursue child support in order to receive child care assistance. However, establishing paternity and placing responsibility for supporting children on those parents that have the financial resources provides a step toward family self-sufficiency and economic security. Child support is a vital source of income for New York State's single parent households. Next to the custodial parent's earnings, child support is the second largest source of income for low income families. Obtaining child support income and any health care insurance benefits for your child from the absent parent is important for the well being of your family.
Each local social services district has a Child Support Enforcement Unit (CSEU) that will help to establish paternity of your child. The CSEU will help you file a petition with family court to get a support order that is based on the child support guidelines. Child support may cover some of your child care costs. Also, the CSEU will make sure you get the child support you are entitled to and will help you file a petition with family court to collect unpaid support. Upon your request the CSEU will review your support order and if eligible apply a cost of living adjustment to the child support amount.
Your child is legally entitled to health insurance, if it is available from you or the noncustodial parent. The CSEU will help you file a petition with family court to get this coverage if it is available through the noncustodial parent's employer.
These services are available to you whether the noncustodial parent lives in or outside of New York State. A $25 dollar annual services fee will be charged when you receive child support services in any year if you have never been in receipt of Temporary Assistance for Needy Families and child support collects at least $500 for you during a 12-month period beginning October 1st each year.
Q. How Much Help Can I Get Paying For Child Care?
A. If you are on Temporary Assistance you are not required to pay a family share of the cost for child care assistance. If you are not on Temporary Assistance you have to pay a share of the cost of child care. The amount depends on the size of your family and your income. If your provider charges more than the local department of social services is allowed to pay you will also have to pay the difference between what your provider charges and the amount the local department of social services is allowed to pay.
Q. How Do I Get Help In Finding A Child Care Provider?
A. The Child Care Resource Referral Agency in your area can help you locate a child care provider. If you live outside of New York City you can contact the New York State Child Care Coordinating Council at (518) 690-4217 to find a Child Care Resource and Referral Agency that serves your area. If you live in New York City you can call toll free 888-469-5999 for help in locating a child care provider. Or you can visit the New York State Office of Children and Family Services website at http://www.ocfs.state.ny.us, then go to "Programs and Services", then go to "child day care", and then go to "child care" for help in choosing the right child care setting for your family. You can search all the programs in your area and get information on their record of compliance with New York State standards for child day care providers.
Q. Who Can Care For My Child?
A. You have the right to choose any legally-permissible child care. This includes:
Q. What Is Transitional Child Care?
A. Transitional child care is for families who were receiving Temporary Assistance, but became ineligible when their income increased due to employment or child support. You may be eligible to receive transitional child care assistance for up to 12 months after you become ineligible for Temporary Assistance.
Your worker should determine your eligibility for transitional child care before your Temporary Assistance or guaranteed child care case is closed. As long as you inform your worker before or soon after your Temporary Assistance case is closed, the worker cannot require you to complete a new application. However, they may need some additional information from you in order to find out if you are eligible. Ask your worker if you are eligible for transitional child care.
Requirements for transitional child care are:
You will be responsible to pay a portion of the child care cost each month. The amount you pay depends on the size of your family and your income. If your provider charges above the amount, the local department of social services is allowed to pay, you will also have to pay the difference between what your provider charges and the amount the local department of social services is allowed to pay.
Your transitional child care assistance will be stopped if:
Q. What Is Child Care In Lieu Of Temporary Assistance?
A. Child Care In Lieu of Temporary Assistance is for families who are applying for or are receiving Temporary Assistance and need child care in order to work; and who choose child care instead of Temporary Assistance.
Requirements for Child Care In Lieu of Temporary Assistance are:
If you are eligible for Temporary Assistance and decide that all you really need is child care, your worker can tell you how to apply. If you are already receiving Temporary Assistance and are otherwise eligible for Child Care In Lieu of Temporary Assistance, you will need to close your Temporary Assistance case in order to get Child Care in Lieu of Temporary Assistance. If you change your mind and decide that you need Temporary Assistance, as well as child care, you can still apply for Temporary Assistance at any time. If you are found eligible for Temporary Assistance you may still be eligible for child care.
If you choose to receive child care assistance instead of receiving Temporary Assistance and child care, you will have to pay part of your child care costs. This is called your family share. If you live outside of New York City, the minimum amount that you will pay will be $1 per week. If you live in New York City, the minimum family share for full time care is $3 per week, and the minimum family share for part time care is $2 per week. Additionally, if your provider charges more than the amount the local department of social services can pay, you will need to pay the amount that your child care provider charges above the amount the local department of social services can pay.
You have a right to a Fair Hearing if you have been denied child care benefits, if your benefits have been discontinued, suspended or reduced, or if you disagree with the local department of social services decision. For more information about your Fair Hearing Rights please refer to Book 1 (LDSS-4148A) "What You Should Know About Your Rights And Responsibilities".
Q. How Can Services Help Me?
A. Services programs may be able to help you and/or your family with:
Besides these, there are other ways that Services may be able to help you and/or your family. They are described in the rest of this Services section.
Q. How Do I Apply For Services?
A. If you live outside of New York City, call or visit your local department of social services and ask for an application package.
If you live in New York City, call or visit your local Income Support/Job Center or look for the Human Resources Administration (HRA), Administration for Children's Services (ACS), in the Government pages of the telephone book for your borough. Call the number listed for the type of help you need.
Q. What Services Can I Get?
A. You can get or apply for the following services:
1. Child Care—Services to help families who need care and supervision for their children. Children may get child care if the parent in a single parent household or both parents in a two parent household are:
Children may also get child care in conjunction with protective services to keep them safe, or as part of child preventive services to keep them from entering foster care.
For a more detailed description of child care services and requirements, see Section F CHILD CARE, in this book.
2. Preventive Services To Children and Families—Services given to children and families to safely keep the family together and to prevent foster care placement, or to safely return the children from foster care as soon as possible. These services may include:
Other services may also be available.
There is no income limit to get these services. It is possible that fees could be charged for certain of these services, although that is usually not done.
3. Foster Care
Voluntary Placement—Voluntary placement of a child into foster care is available to provide out-of-home care and services when circumstances or conditions exist that affect the health and safety of the child, to help meet certain parent and child services needs, or if the parent(s) has surrendered the child for adoption.
Birth Families/Legal Guardians—Services given to birth parents or legal guardians of a child who is placed in foster care may include:
Foster Parents—Families who want to provide foster care for a child must apply and be certified (non-relative of a child) or approved (child's relative). Foster parents must undergo a New York State and national criminal background check and meet a number of other licensing requirements, and are required to attend training prior to certification or approval. Once certified or approved, upon placement of a child in their care foster parents will receive:
Foster parents may receive, as appropriate:
4. Adoption—
A. Services given to the birth parent(s) or legal guardian(s) of a child who is being adopted may include:
B. Services given to families who want to adopt a child may include:
Families who want to adopt a child must apply, and will be accepted, for an adoption study. The priority given to the family's application for an adoption study will be based on the characteristics of the children awaiting adoption and the interest that the prospective adoptive parent(s) expresses in adopting children with these characteristics.
In addition, once a child is placed with you for adoption, adoption assistance in the form of extra money (adoption subsides) and medical assistance may be provided to support children who are handicapped or considered "hard-to-place". There may also be one-time payments for non-recurring costs of adoption.
5. Teenage Pregnancy Programs and Unmarried Parent Services—Social Services to help pregnant teens and unmarried parents may include:
6. Domestic Violence (Physical or Emotional Abuse or Threat of Abuse)—Services given to family or household members, with or without children, to help them with physical or emotional abuse, or threats of physical abuse or emotional abuse. You may be able to get help with:
There is no income limit to get these services.
7. Preventive Services for Adults—Services given to single adults 18 years of age and older or to families without children under age 18. These services may include:
8. Protective Services For Adults—Services given to individuals 18 years of age or older who are physically or mentally impaired, have been harmed or are at risk of harm, cannot protect themselves, and have no one able and willing to responsibly help them. These services may include:
There is no income limit to get these services.
9. Residential Placement Services For Adults—Services given to individuals 18 years of age and older who are mentally or physically impaired and need supervised living outside their own homes.
These services include:
10. Housing Improvement Services—Services to help with:
11. Home Management Services—Services to help with learning about budgets, fixing good meals, caring for children, health care, and home care.
12. Housekeeper/Chore Services—Services to help with chores such as shopping, light housework, simple repairs and errands when you, or a child or adult's caretaker, is ill, disabled or absent.
13. Homemaker Services—Services to help with personal care, home management and household tasks from a trained homemaker when you, or a child or adult's caretaker is ill, disabled or absent.
14. Kinship Caregiver and Kinship Navigator Programs—There is a statewide network of community-based supportive programs, and a telephone hotline, that provide services for kinship caregivers and their kin, whether or not the children are in foster care. See the Question and Answer "If I Am The Caregiver Of A Child Who Lives With Me And Who Is Not My Biological Or Adopted Child, And I Need Additional Help Or Resources To Care For The Child, Can You Tell Me Where To Find Them?" in the middle of Section A, TEMPORARY ASSISTANCE, in this book.
15. Other Services you may be able to get:
Q. What If I Emergency Services Are Needed To Protect Adults, Children or Other Family Members?
A. The following are some services you can get to help you with an emergency.
If you live outside of New York City, your local department of social services may be able to help you, in addition to the help that you can get by calling the phone numbers listed below.
If you live in New York City, call or visit your local Job Center or look for the Human Resources Administration (HRA) or Administration for Children's Services (ACS) listings in the Government pages of the telephone book for your borough. Call the number listed for the type of help you need. You can also get help by calling the phone numbers listed below. There is no income limit to get these services.
To get information and referrals to your local domestic violence services provider you may call the following numbers, toll-free, 24 hours a day:
A Services caseworker can also arrange for you to get this information.
1. Supplemental Security Income (SSI) If you are certified blind, certified disabled or age 65 or older and your income and resources are below certain limits, you may be able to get money from the Supplemental Security Income Program. You can apply for Supplemental Security Income at your nearest Social Security Office. Most people who get Supplemental Security Income also get Medical Assistance.
2. Interim Assistance—You may be able to get money called Interim Assistance through the Safety Net Assistance Programs if:
This Interim Assistance will stop once you start getting your SSI, or when your SSI is reinstated. The Social Security Administration (SSA) will reimburse some or all of the interim assistance owed directly to the local department of social services from any retroactive SSI benefits you are eligible to receive. To get interim assistance you must sign an Interim Assistance Reimbursement (IAR) authorization. You must sign a new authorization consistent with NYS rules if you reapply for SSI after this authorization terminates, or if you file a new SSI claim while you have an SSI application or appeal pending. This authorization gives the SSA permission to repay the agency for interim assistance paid to you. If you live outside of New York City, you may apply for Interim Assistance at your local department of social services. If you live in New York City, call or visit your local Income Support Center.
Q. What Is Interim Assistance?
A. Interim assistance is payments you receive from Safety Net Assistance (SNA) funds for basic expenses such as shelter utilities and fuel when:
Q. Do I Have To Repay Interim Assistance?
A. Yes, you must repay interim assistance. The law requires repayment to prevent people from receiving both Temporary Assistance (TA) benefits and SSI benefits for the same period.
Q. For What Months Must I Pay Back The Interim Assistance I Received?
A. If you receive SNA benefits while your SSI application was pending, you must repay for the months beginning with the first month you were eligible to receive an SSI payment and ending in the month your SSI payments actually began, or the following month if the local department of social services cannot stop your last TA payment.
If you received post eligibility interim assistance, you must repay beginning with the first day of the month for which retroactive SSI payments are paid and ending in the month your SSI payments actually began, or the following month if the local department of social services cannot stop your last TA payment.
Q. How Is Interim Assistance Repaid To The Local Department Of Social Services?
A. The Social Security Administration (SSA) will pay the interim assistance directly to the local department of social services from any retroactive SSI benefits you are eligible to receive.
Q. How Does The SSA Get My Permission To Reimburse The Local Department Of Social Services For Interim Assistance?
A. You give the SSA permission when you sign the Temporary Assistance application or recertification form, or the Mail-in Recertification/Eligibility Questionnaire.
Q. How Does SSA Determine How Much Of My SSI Money To Pay The Local Department Of Social Services District.
A. SSA looks at the amount of money the state claims and also looks at the amount of your retroactive SSI money that can be used to repay the state. SSA matches the months you received interim assistance and the months you received SSI payments. After this matching, SSA pays the amount for each month claimed by the local department of social services district.
Q. How Will I Receive Any Balance From My Retroactive SSI Payment?
A. After the SSA reimburses the local department of social services for interim assistance owed, SSA will send you a notice explaining how they will pay you any remaining SSI money. If you have questions about your SSI payments, or any other questions, you can contact your local SSA office or call 1-800-772-1213.
Q. What Happens If The Amount Of My First Retroactive SSI Payment Is Not Enough To Pay Back All The Interim Assistance Received?
A. The local department of social services will not collect any more money from your SSI Payments. The local department of social services can only be repaid interim assistance by the SSA from your retroactive SSI Payment. They cannot collect from any other SSI Payments.
Q. How Long Does The Interim Assistance Reimbursement Authorization Last?
A. The authorization is in effect for any SSI application or appeal you have pending at the time you apply for TA. The authorization is in effect for 12 months beginning with the date the local department of social services correctly notifies SSA through an electronic system that they receive the authorization. However, if you file for an SSI appeal within the time permitted under SSA's regulations, the authorization will remain in effect, even beyond the 12 month period. The authorization ends when your SSI claim is completely decided; SSA first pays you; or you and the state agree to terminate the authorization. You must sign a new authorization consistent with NYS rules if you reapply for SSI after this authorization terminates, or if you file a new SSI claim while you have an SSI Application or appeal pending.
Q. How Long Is The Interim Assistance Reimbursement Authorization In Effect For A Post-Eligibility Retroactive Payment?
A. The authorization is in effect for 12 months beginning with the date the local department of social services notifies SSA through an electronic system that the local department of social services has received the authorization. However, if you file for an SSI administrative or judicial review within the time permitted under SSA's regulations, the authorization will remain in effect, even beyond the 12 month period unit. SSA makes the initial SSI post-eligibility payment following a suspension or termination of your SSI benefits; or SSA makes a final determination on your appeal; or you and the local department of social services both agree to terminate the authorization. You must sign a new authorization consistent with NYS rules if you reapply for SSI after this authorization terminates, or if you file a new SSI claim while you have an SSI application or appeal pending.
Q. Where Do I Get Interim Assistance Reimbursement Authorization?
A. At your local department of social services.
Q. What Can I Do If I Think The Local Department Of Social Services Made A Mistake In The Amount Of Interim Assistance I Received, Or Made A Mistake About The Amount Of Interim Assistance I Got Back?
A. You can request a fair hearing. You must follow the fair hearing instructions listed in Book 1 "What You Should Know About Your Rights and Responsibilities" (LDSS-4148A).
Q. What Is A Protective Filing Date For SSI Benefits?
A. Temporary Assistance (TA) applicants and recipients who apply for SSI within sixty days of signing a TA application or recertification form may be entitled to a "protective filing date" given by the SSA. The SSA may treat the TA application or recertification date as the SSI application date under the "protective filing date" rule. If the SSA establishes a protective filing date, this may give an SSI applicant up to two extra months of SSI.
3. Work Supports—The programs and benefits described in sections A (Temporary Assistance), B (Medical Assistance), C (Child Support), D (Food Stamps Benefits), E (Transitional Help), F (Child Care), and this section H (Other Benefits) can be very helpful if you are struggling to make ends meet, particularly if you are working. Also, if your earnings are less than $41,646 per year, (the new EITC threshold for two children, married filing jointly) you may be able to bring home more money to support yourself/ your family by filing your tax returns and getting the tax credits you are eligible for.
Anyone in New York can visit a new website, www.myBenefits.ny.gov, to find out if they might qualify for Food Stamp Benefits, Earned Income Tax Credits, Child and Dependent Care credits, and other programs designed to help low-income working households make ends meet. It will also provide information on where and how to apply. The site will be expanded regularly to allow screening for other programs.
4. Home Energy Assistance Program (HEAP)—The Home Energy Assistance Program can help you with heating and utility costs and certain essential heating equipment repairs. You may be able to get Home Energy Assistance if:
YOU DO NOT NEED TO HAVE A HEATING OR UTILITY EMERGENCY IN ORDER TO GET HEAP.
5. Grants of Assistance to Guide Dogs—If you are able to get (SSI) and use a guide dog, you may be able to get money to buy food for your dog. If you live outside of New York City, you can apply for this money at your local department of social services. If you live in New York City, call or visit your local Job Center.
6. LifeLine—If your income is low, you may be able to get a telephone discount service called LifeLine for a little more than $1.00 a month. You may be able to get LifeLine if you get:
For information on LifeLine, call your telephone services provider.
7. WIC (The Special Supplemental Program For Women, Infants and Children)—If you have little or no income, are pregnant, breastfeeding or have children up to age 5, and are at nutritional risk, the WIC Program may be able to help you. The WIC Program provides helpful information about nutrition and the importance of eating healthy foods. The WIC Program provides checks which can be exchanged in participating stores for infant formula, milk, juice, eggs, cheese, cereal, peanut butter, dry peas and beans.
For more information about the WIC Program and where you can apply, call 1-800-522-5006.
8. Burial—The local department of social services provides for burial when a Temporary Assistance recipient or other person dies leaving no funds or insurance sufficient to pay the burial cost, and there are no relatives, friends or other persons liable or willing to take responsibility for the burial expense. This is true only if the local department of social services limit for the cost of the burial is not exceeded.
Sometimes relatives and friends make burial arrangements for a person. They might be eligible for some reimbursement, provided that no more has been spent on the burial than the local department of social services allows.
Application may be made for burial or for limited burial reimbursement at the burial unit or resource unit of your local department of social services. Contact that agency to find out where you should apply and what the limit is on the length of time you have to apply.
Do not make arrangements with a funeral director until you find out the county limit on how much may be spent on an indigent burial.
9. Voter Registration—You have a right to obtain an application for voter registration, to receive assistance in filling out that application, and to file that application for forwarding to the appropriate local board of elections at any government office accepting applications for benefits described in this book. For further information call the State Board of Elections toll free 1-800-367-8683 or 1-800-533-8683 (TDD) for the hearing impaired.
10. Veteran Benefits—If you ever served in the United States Military (including National Guard or Reserves if ever ordered to active duty by the President), and were discharged under other than dishonorable conditions, there are an array of social, economic, and vocational benefits and services you may be entitled to receive through the US Department of Veterans' Affairs. These include, but are not limited to, the following:
If you are a "low-income" veteran in receipt of SSI, or have otherwise been determined to be permanently and totally disabled, and served a minimum of 90 days with at least one day during a period of war, you may be eligible to receive a monthly benefit from the VA that is significantly more than SSI—even if your disability is not the result of military service. If you are age 65 or over and meet the above service requirements, you could also qualify even if you are not disabled.
Veterans suffering from an illness, disease, or injury they feel was incurred or aggravated as the result of military service should pursue eligibility for Service-Connected Compensation benefits—even if the condition was not diagnosed until years later—such as those who served in Vietnam and have since been diagnosed with Type II Diabetes, prostate cancer, respiratory cancers, or Hodgkin's disease, to name just a few.
For more information about the above or other available benefits and services, contact a federal, state, or county veteran benefits counselor today. Counselors are available to assist you at no cost. To locate one nearest you, call 1-888-VETS-NYS (1-888-838-7697).
Q. Can I Get Help From The Local Department Of Social Services Office. If I Am Disabled And Cannot Go To The Local Department Of Social Services Office, Or Do Other Things The Local Department Of Social Services May Want Me To Do?
A. If you have a physical or mental condition that substantially limits what you are able to do, you may have rights under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act. Some examples of physical or mental conditions include, but are not limited to:
Q. If I Am Disabled And Cannot Go To The Social Services Office, Or Do What The Local Department Of Social Services Asks Me To, What Should I Do?
A. If you cannot do something we ask you to do, we may help you do it or find a different way for you to meet the rules or we may change what you have to do. This is called reasonable accommodations. If you have a disability and you need reasonable accommodations you can let us know. Here are some of the ways we can help a person with a disability:
Q. Can I Just Tell The Local Department Of Social Services That I Need Help To Find A Different Way To Meet The Rules To Get The Benefits I Need?
A. Yes. You can tell the local department of social services that you need help. But, the help to find a different way to meet the rules (reasonable accommodation) is for individuals who meet the necessary eligibility requirements for receiving services or participation in the program or activity and who qualify for protection under the ADA. Those are people who have a physical or mental limitation that prevents them from doing certain activities. The local department of social services may ask a person who requests a reasonable accommodation under the ADA to provide documentation or to take part in initial screening and further assessment processes to identify possible disabilities and limitations to ensure that appropriate reasonable accommodations and other services are provided.
Q. What If The Local Department Of Social Services Finds A Different Way For Me To Meet The Program Rules But I Don't Like That Way?
A. If the local department of social services finds a way for you to meet the rules and get the benefits that you need (reasonable accommodation), but you refuse that way, you may be found ineligible for the program and benefits you need, or you may get less of the benefit you need. For example, although drug addiction is a disability under the
Q. Will I Automatically Be Eligible For The Programs Of The Local Department Of Social Service If I Am Disabled?
A. You cannot be denied benefits only because you are disabled. But you may be ineligible for a benefit that you want for the same reasons that a non-disabled person is ineligible. For example, if your income is above the limit for the program(s) and benefits you want, you will not be eligible.
Q. What If I Disagree With The Decision Of The Local Department Of Social Services?
A. You can request a fair hearing if you do not agree with the decision of the local department of social services. To request a fair hearing follow the instructions listed in the "YOUR RIGHTS" section of Book 1 (LDSS-4148A), ("What You Should Know About Your Rights and Responsibilities"), which you received at the same time that you received this book.
Q. What Can I Do If I Think I Have Been Discriminated Against?
A. Discrimination by the New York State Office of Temporary and Disability Assistance (OTDA), by the New York State Department of Health (DOH), by the New York State Office of Children and Family Services (OCFS), by the New York State Department of Labor (DOL), or by your local department of social services based on race, religion, ethnic background, marital status, disability, sex, national origin, political belief or age is illegal.
If you think you have been discriminated against you should follow the instructions listed in the "YOUR RIGHTS" section of Book 1, (LDSS-4148A) "What You Should Know About Your Rights and Responsibilities", which you received at the same time that you received this book.
Immunizations have reduced, and in some cases, eliminated, many diseases that routinely killed or harmed many infants, children, and adults. However, the viruses and bacteria that cause preventable disease and death still exist and can be passed on to people who are not protected by immunizations. Immunizations are the single most important way parents can protect their children against the following childhood diseases:
Q. What Is EBT?
A. EBT is Electronic Benefit Transfer. This refers to the method by which your Temporary Assistance and/or Food Stamp Benefits are issued to you. With Electronic Benefit Transfer (EBT) recipients will have accounts set up for Food Stamp Benefits and/or Temporary Assistance benefits. These benefits are electronically transferred into your account(s) on your benefit availability dates.
Q. How Do I Access My Benefits?
A. You will receive a Common Benefit Identification Card (CBIC) that you will use to access your Temporary Assistance, Food Stamp Benefits and Medical Assistance benefits. The Common Benefit Identification Card (CBIC) may be used:
You will receive receipts for all of your Cash and Food Stamp Benefits transactions. These receipts will show the amount of the transaction and the balance remaining in your Cash account or Food Stamp Benefits account. Keep your receipt to make sure it matches the transaction you authorized, and to help you keep track of your account balances.
Q. What Is A PIN?
A. PIN stands for Personal Identification Number (PIN). Your PIN is a 4-digit number that was either assigned to you or that you chose. Your PIN is equal to your electronic signature and should always be kept a secret. Remember—if someone has your Common Benefit Identification Card (CBIC) and knows your PIN they can access ALL of your benefits. These benefits will NOT be replaced. It is YOUR responsibility to keep your card safe and your PIN secret. You may change your PIN at any time.
NOTE: If your Common Benefit Identification Card (CBIC) needs to be replaced you can continue to use the same Personal Identification Number (PIN).
Q. How Can I Change My Personal Identification Number (PIN)?
A. You have three options:
Q. My CBIC Card—How Does It Work And What Kind Of Information Does It Contain?
A. The back of your CBIC has a black magnetic stripe. When the card is inserted or swiped through the card opening at the ATM or retailer Point of Sale (POS) device the machine "reads" information coded into the stripe on your card, which in turn initiates a transaction with your Food Stamp Benefits or Cash account. In order for a transaction to be completed, your PIN must be entered. The back of your card also contains the toll free EBT Customer Service number (1-888-328-6399).
The front of your card contains your name, your 19 digit card number, your date of birth, your Client Identification Number (CIN) and may contain your photo.
Q. When Should I Contact My Worker About My Benefits?
A. You should contact your local department of social services worker regarding the following questions or problems:
Q. Do I Have To Use My Benefits All At Once?
A. No, the benefits in your Cash account and Food Stamp Benefit account can carry over from month to month. However, if you do not use your Cash account for a period of 90 consecutive days, any cash benefit in your account that is 90 days old or older will be expunged (removed) and returned to the agency. You may ask your worker to reissue expunged cash benefits for which you are eligible. If your Food Stamp Benefit account goes unused for a period of 365 consecutive days, any benefit in that account which is 365 days old or older will be expunged (removed) and will not be reissued.
Q. Are There Charges For Using My Common Benefit Identification Card (CBIC)?
A. You may use your card at a Point of Sale (POS) device in a QUEST participating store to make purchases from your Cash and Food Stamp accounts at no charge. Some EBT participating stores and retailers will allow customers to get cash back from their Cash account. Ask the store about its policy on cash back. If you are getting cash from an ATM machine, you may withdraw money 2 times during each month without having to pay a transaction fee. After the 2 free uses, there will be a 50 cent transaction fee taken from your Cash account every time you use an ATM to withdraw cash for the rest of that month. In addition, some ATMs impose a surcharge per transaction to withdraw cash. The cost to use the ATM should be clearly posted. To find locations of ATMs that do not surcharge in your area, you may call the EBT Locator Service toll free 1-800-289-6739.
There Is Never A Charge To Access Your Food Stamp Benefits Or Medical Benefits With Your Common Benefit Identification Card (CBIC).
Q. Will I Be Able To Get Any Change Back From My Food Stamp Account?
A. No, your Food Stamp Benefits account may only be used to purchase eligible food items at participating stores. No cash will be issued as a result of a Food Stamp account transaction.
Q. What Is Electronic Benefit Transfer (EBT) Customer Service? And What Information Can They Help Me With?
A. You may call Customer Service toll free 1-888-328-6399, 24 hours a day/7 days a week, or contact Customer Services—online via the internet at www.ebtaccount.jpmorgan.com if you have a concern about your benefits with EBT. Effective August 15, 2007 the EBT Customer Service number (1-888-328-6399) will no longer accept calls from public payphones. People with disabilities may use the following relay center numbers: TTY users 1-800-662-1220; Non TTY users 1-800-421-1220; and VCO users 1-877-826-6977. Most of the questions and answers that follow are examples of how Customer Service can help you.
Q. What Should I Do If My Common Benefit Identification Card (CBIC) Is Lost, Stolen Or Does Not Work?
A. Immediately call EBT Customer Service toll free 1-888-328-6399 and they will cancel your lost or stolen card. This will avoid the possibility of someone else being able to use this card. To replace your card you need to contact your local department of social Services. EBT Customer Service cannot replace the card for you.
Q. How Can I Find Out How Much Cash Or Food Stamp Benefits I Have In My Accounts? How Can I Find Out Where And When I Spent My Benefits?
A. Call Customer Service toll free 1-888-328-6399 and the Automated Response Unit (ARU) will provide answers to your questions regarding account transactions and balances.
When using the Automated Response Unit (ARU), be prepared to provide your 19-digit card number found on the front of your Common Benefit Identification Card (CBIC). You may also access this information online, via the internet at www.ebtaccount.jpmorgan.com.
Q. What Should Be Done If I Think The Account Balance On The Last Receipt Is Wrong?
A. Contact Customer Service and compare your last several receipts to the information provided regarding your past account record.
Any differences between the account record and your receipts should be reported to a Customer Service representative toll free 1-888-328-6399 so that a claim may be investigated. With regard to Food Stamp Benefits account claims, your claim will be investigated and resolved within 10 business days from the date you filed the claim with Customer Service.
A claim number will be given to you. Remember to write this claim number down because it will be needed when you telephone Customer Service to check on the progress of the claim.
NOTE: A Cash account claim investigation can take up to 30 days from the date you report it to EBT Customer Service to resolve. For both your Cash account and Food Stamp Benefits account, a claim can be taken by EBT Customer Service only if you report it within 90 days of the date of the account transaction that you want investigated.
Q. Can I Get A Written Record Of My Account?
A. Yes, Customer Service will provide the last ten transactions from either your Cash account and Food Stamp Benefits account or you may also request that a Customer Service Representative mail a report of the last two months of transactions to your home. You can also access this information online via the internet at www.ebtaccount.jpmorgan.com.
Q. How Can I find The Location Of ATMs And Retailer Point Of Sale (POS) Devices That Do Not Surcharge To Withdraw Cash?
A. You may call the EBT Locator Service toll-free 1-800-289-6739. This information is also available from your local department of social services office, or via the Internet at http://www.otda.state.ny.us/ebt/zips.
Q. What Is A "Retailer Adjustment"?
A. When you buy food with your Food Stamp Benefits account, but a computer error happens and your account is not charged, the store can ask Customer Service to investigate their claim. If the investigation shows that the store did not get paid from your account, your account will be charged to pay the store for the food you bought. When a retailer adjustment is requested, you will receive a notice about the request.
Q. Can The State Make An Adjustment To My Cash And/Or Food Stamp Benefits Accounts?
A. If, as a result of an error in the benefits issuance process your account is unjustly enriched with a benefit to which you are not entitled, the State may adjust your account to correct the situation.
Q. Can I Continue To Access My Account(s) After My Case Is Closed?
A. Yes, your card will remain active and you will be able to access your account(s) as long as there are benefits remaining in the account(s).
Q. If I Still Have Paper Food Stamp Coupons To Use, Will Stores Still Redeem Them?
A. After June 17, 2009, stores will no longer accept paper Food Stamp coupons. If you have any paper coupons in your possession, you should redeem them at a participating Food Stamp retailer before that date.