Medicaid renewal letters in New York: what they mean if you have Medicare too

Sorting the pile takes one question: does this letter ask me to do something, or does it tell me a number?

• Status letters decide whether you keep Medicaid, an MSP, or Extra Help. Examples: a Medicaid renewal packet, a Social Security "review of your eligibility for Extra Help," a grey "loss of deemed status" notice, or a Notice of Action from the Medicaid office. These carry deadlines.
• Cost letters report what you will pay. Examples: the orange copay-change notice, your drug plan's Annual Notice of Change, the plan's Extra Help rider, and the December Social Security letter showing your 2027 payment and Medicare deductions. Keep these; act only if a number looks wrong.

Two letters straddle both: the blue reassignment notice (your drug plan is changing unless you choose one) and an EPIC letter telling you to apply for the MSP. Both are covered below.

The Centers for Medicare & Medicaid Services (CMS) publishes a yearly guide to the letters it, Social Security, and the plans send. The dates below come from that guide and repeat each fall. New York's Medicaid renewal letters are not on this calendar because they follow your own renewal date, which can fall in any month.

Open Enrollment for Medicare plans runs October 15 to December 7. Most cost letters are timed so you have the numbers before then.

New York is moving Medicaid cases between systems, so the return address on your renewal changed for many people in the past year. The state's Medicaid modernization page says that since late 2025, people who have both Medicare and Medicaid, most people over 65 who are not seeking long-term care, and people applying for the Medicare Savings Program apply and renew through NY State of Health. People who get Supplemental Security Income (SSI), people in the Medicaid excess income ("spend-down") program, and people getting community long-term care stay with their county Department of Social Services (LDSS) or, in the five boroughs, HRA.

So your renewal can arrive one of two ways:

• A letter from NY State of Health. Their renewal page says notices go out 30 days or more before your renewal date, with email or text reminders about 45 days ahead if they have your contact details. You renew in your online account, by phone at 1-855-355-5777 (TTY 1-800-662-1220), or with an enrollment assistor. You can find your renewal date under the Plans tab in your account.
• A renewal packet from HRA or your county. New York City's renewal FAQ says HRA mails packets about three months before the renewal date. You return the packet in the envelope provided, upload it through ACCESS HRA, or bring it to an HRA office. Outside the city, the county's packet tells you where to send it.

The same city FAQ says renewals completed within 30 days after the due date, in either system, avoid a gap in coverage. Treat that as a safety net, not a plan.

Two lines from the state's own MSP instruction sheet are worth taping to the fridge. First: "You will need to renew (recertify) your MSP every year." Second: if you do not receive a renewal notice in the mail, contact your local Medicaid office or HRA and ask what you need to do. Silence is not approval.

If a renewal asks for documents, our MSP documents checklist lists what counts as proof and how recent it must be.

Medicaid or MSP renewal packet

Who sends it: NY State of Health, HRA, or your county. What it means: your coverage period is ending and the office needs current income and household information. If the state can verify everything electronically, some people are renewed without doing anything and get a letter saying so. What to do: answer every question, sign, attach the proofs asked for, keep a copy, and send it before the date on the letter. An MSP-only renewal does not ask for bank statements, because New York has no savings test for QMB or QI. A full Medicaid renewal can, because full Medicaid does have a resource limit.

Request for documents

Who sends it: the same office, after you return a renewal or application. What it means: something was missing or unclear. This is not a denial. What to do: send exactly what is asked, by the date given, and write your case number on every page.

Notice of Action or Notice of Decision

Who sends it: HRA, the county, or NY State of Health. What it means: a decision. It says whether Medicaid or the MSP is approved, continued, changed, or ending, and from what date. The state's MSP instruction sheet says a Notice of Action comes within 45 days of filing an application. What to do: read the effective date and the appeal section. If the notice ends or reduces coverage and you disagree, you can ask for a fair hearing, and asking before the effective date can keep coverage in place while the hearing is pending. The notice states the deadline and the ways to ask. A HIICAP counselor or a legal services office can help you file quickly.

Purple notice: deemed status

Who sends it: Medicare. What it means: you get Extra Help automatically because you have Medicaid, an MSP, or SSI. Medicare.gov calls this being "deemed." What to do: keep it. If you do not have a drug plan, get one; Medicare may enroll you in one and send a yellow or green letter about it.

Grey notice: loss of deemed status

Who sends it: Medicare, in September. What it means: Social Security's records show you no longer have the Medicaid, MSP, or SSI that gave you automatic Extra Help, so the automatic Extra Help stops on January 1. Usually this means a Medicaid or MSP case closed during the year, often because a renewal was not returned. What to do: two paths, and you can take both. The notice includes an Extra Help application and a postage-paid envelope for Social Security. Separately, find out why the Medicaid or MSP ended and whether you can get it back. In New York, an approved MSP brings Extra Help with it and has no savings test, so for many people the MSP door is the wider one. Our post on Extra Help and the MSP together explains the connection.

Social Security review of your eligibility for Extra Help

Who sends it: Social Security, early September, to people who applied for Extra Help directly rather than getting it through Medicaid or an MSP. What it means: Social Security is checking that your income, savings, and household are still within the Extra Help limits. The letter includes an Income and Resources Summary sheet. What to do: medicare.gov's wording is blunt: return the enclosed form within 30 days "or your Extra Help may end." Fill it out from the summary sheet, in black ink, and mail it back. Social Security's decision arrives in November, and any change takes effect in January.

Orange notice: change in Extra Help copayment

Who sends it: Medicare, in October. What it means: you keep Extra Help, but your copay level is changing on January 1, usually because your Medicaid or MSP category changed during the year. What to do: keep it. No action unless you think the new level is a mistake. For reference, the 2026 Extra Help copays on medicare.gov are up to $5.10 for a generic and $12.65 for a brand-name drug.

Blue notices: reassignment

Who sends it: Medicare, in November. What it means: your drug plan is leaving Medicare, or its premium is rising above the amount Extra Help covers, so Medicare will move you to a different plan on January 1 unless you choose one yourself by December 31. A second blue letter lists the drugs you took this year and says which ones the new plan covers. What to do: compare the assigned plan with others on medicare.gov or with a HIICAP counselor. Any plan at or below the Extra Help premium benchmark costs you $0 in premium.

Tan notice: you chose a plan and its premium is changing

Who sends it: Medicare, early November, to people with Extra Help who picked their own plan. What it means: next year your plan's premium will be above what Extra Help pays, so you will owe the difference unless you switch. The letter lists local plans with no premium. What to do: switch by December 7 if you want a $0 premium, or stay and pay the difference.

Annual Notice of Change and Extra Help rider

Who sends it: your health or drug plan, by September 30. What it means: the plan's 2027 premium, drug list, and benefit changes, plus a rider that says how much Extra Help will cover next year. What to do: check that your drugs are still covered and keep the rider with your plan documents.

December Social Security letter

Who sends it: Social Security, in December. What it means: your new monthly benefit for next year, after the cost-of-living increase, and the Medicare premiums being deducted. The state's MSP overview says that once an MSP is approved, "you will no longer have this premium amount deducted from your Social Security benefit." What to do: if you have QMB or QI and the letter still shows a Part B deduction, call HRA or your county to confirm the MSP is active, then Social Security. The standard Part B premium is $202.90 a month in 2026, so this is a line worth checking.

EPIC letter about the Medicare Savings Program

Who sends it: the state EPIC program, to members 65 and older whose income looks low enough for an MSP. What it means: the state's EPIC FAQ says members must apply for the MSP within 30 days, get a reminder at 45 days, and lose EPIC coverage if no application is filed by 75 days. If the MSP is denied, EPIC is not affected. What to do: apply. EPIC's FAQ points members to NY State of Health for the application. Our EPIC vs Extra Help post explains why this letter is good news rather than a threat.

It happens: the packet went to an old address, or a document was late. The status letters above then start arriving in a chain, because the grey notice, the orange notice, and the loss of premium help all trace back to the closed Medicaid or MSP case. The fix is upstream.

1. Call the office named on the closing notice and ask two questions: why the case closed, and whether a late renewal can reopen it. New York City's renewal FAQ describes a 30-day window after the due date with no gap; ask about anything later.
2. If the deadline has passed, apply again. For the MSP that is the two-page DOH-4328 form, or the NY State of Health application. Our how to apply walkthrough covers both doors.
3. Mail the Extra Help application from the grey notice to Social Security at the same time. It does not hurt to have both in motion.
4. Tell your pharmacy and your drug plan once the MSP is back so copays are corrected.

One reassurance from the HIICAP training materials: if an MSP ends and later restarts, you do not owe a Part B late enrollment penalty for the gap.

NY State of Health published a page on federal changes to Medicaid on September 8, 2026. Two items matter for this audience, mostly because of who they leave out:

• Starting January 1, 2027, some adults ages 19 to 64 will have to show work, school, training, or volunteer hours to keep Medicaid, and some will renew every six months instead of yearly. The state's list of people who do not have to meet the work rule includes anyone 65 or older, anyone on Medicaid because of a disability, and anyone entitled to Medicare Part A or enrolled in Part B. If you have Medicare, that is you.
• The state says it will notify affected people by September 30, 2026, and that nothing changes at the moment the notice arrives.

The practical point is to keep your address current with whichever office renews you, so the letter that explains your own case reaches you.

• Assuming a letter with a color is junk. The grey, orange, blue, and tan notices are real Medicare mail.
• Answering the Social Security Extra Help review with a form printed from the internet. The letter says to use the enclosed form.
• Mailing the Medicaid renewal to a walk-in office address instead of the return envelope's address.
• Moving without telling NY State of Health, HRA, or the county. Most closed cases start there.
• Treating a Notice of Action as final without reading the appeal section and the effective date.
• Ignoring the EPIC letter about the MSP because "I already have EPIC."

I got a grey notice but I still have Medicaid. What happened?

The grey notice is built from Social Security's records of who had Medicaid, an MSP, or SSI during the year. If your case closed and reopened, or the state's file had a gap, the notice can still go out. Medicare.gov says you can reapply for Extra Help through Social Security or a state Medicaid office. Call HRA or your county first to confirm your Medicaid or MSP is active, and ask them to make sure the state has reported it. Then send the enclosed Extra Help application anyway as a backstop.

Do I have to renew the Medicare Savings Program every year in New York?

Yes. The state's DOH-4328 instruction sheet says you will need to renew, or recertify, your MSP every year, and that if no renewal notice arrives you should contact your local Medicaid office or HRA and ask what to do. QI in particular is described on the state's page as funded by a yearly allotment, so a missed renewal can mean reapplying from scratch.

My renewal came from NY State of Health but I always dealt with HRA. Is that right?

It can be. The state's Medicaid modernization page says that starting in late 2025, people with both Medicare and Medicaid, most people over 65 who are not seeking long-term care, and MSP applicants apply and renew through NY State of Health. People with SSI, a spend-down, or community long-term care stay with HRA or the county. If you are unsure which office has your case, call the number on the letter you received; it is the office that currently holds it.

What is the deadline on the Social Security Extra Help review letter?

Thirty days from the letter, using the postage-paid envelope. Medicare.gov's description of the notice says that if you do not return it, your Extra Help may end. Social Security mails its decision in November and changes take effect in January.

Which letters show whether my Part B premium is being paid?

The December Social Security letter shows what is being deducted from your monthly payment for next year. If you have QMB or QI, the Part B premium, $202.90 a month in 2026, should not be on that line. The state's MSP page says the premium stops being deducted once the MSP is in place. If it still appears, confirm the MSP with HRA or your county before calling Social Security.

Can someone help me read these letters for free?

Yes. HIICAP counselors at 1-800-701-0501 read Medicare and Medicaid letters with people every day and can help you fill out the renewal or the Extra Help form. Our post on preparing for a HIICAP appointment says what to have in front of you when you call.