Where to mail the Medicare Savings Program application in New York

1. Get the right form. For MSP-only, use DOH-4328. The state posts it in English and many other languages. If you also want full Medicaid, use the longer Medicaid application instead.
2. Fill in every question and sign the back. The state's MSP page warns that the signature block is on the back and that an unsigned form is not complete. If you are married and live with your spouse, fill in the spouse part too, even if your spouse is not applying.
3. Make copies of your proofs. You need your Medicare card (front and back), proof of birth date, proof of address from the last six months, and proof of all income. See our MSP documents checklist.
4. Make a copy of the whole packet for yourself. The state instructions tell you to do this.
5. Mail it to the right address below. Legal Services NYC suggests certified mail with a return receipt so you can prove the date.
6. Mark your calendar for 45 days. The state says you will get a Notice of Action within 45 days of filing. If you hear nothing, see our guide on what to do after a denial or no answer.

Bronx, Brooklyn (Kings), Manhattan (New York County), Queens, and Staten Island (Richmond) all use HRA. HRA's brochure gives two addresses, depending on what you are applying for:

• MSP-only (the short DOH-4328 form): HRA/Medical Assistance Program, Initial Eligibility Unit, 5th Fl., PO Box 24390, Brooklyn, NY 11202-9814.
• MSP and Medicaid together (the longer form): HRA/Medical Assistance Program, MSP-CREP, 5th Fl., PO Box 24330, Brooklyn, NY 11202-9801.

You can also apply online with ACCESS HRA or hand it in at an HRA office. See our list of NYC Medicaid offices by borough. Questions: HRA Medicaid Helpline, 1-888-692-6116.

The state's MSP page says all paper MSP applications must be mailed to the local Department of Social Services where you live. Here is the state's list. The addresses are the ones the state posts for each county office. If your county has a separate Medicaid mailing address, the office will tell you when you call.

Live in a town or village and not sure of your county? Use the county, not the town. For example, Plattekill is in Ulster County, so it goes to Ulster DSS in Kingston.

The state instructions for DOH-4328 only describe mailing it or bringing it in. Some offices accept fax or upload, but we could not confirm a public fax number for MSP applications from an official page for every county, so we do not list them. Call your county DSS and ask. In NYC, ACCESS HRA lets you apply online and upload proofs.

• Sending the MSP-only form to the MSP-and-Medicaid P.O. box in NYC, or the other way around.
• Mailing to a borough office street address instead of the P.O. box HRA lists for mail applications.
• Writing your town instead of your county. Brooklyn is Kings County; Staten Island is Richmond County.
• Forgetting to sign the back of the form.
• Not keeping a copy or proof of the mailing date.