How to apply for a Medicare Savings Program in New York

Before you start: one form, one door

New York’s Medicare Savings Program application is state form DOH-4328. It is published on health.ny.gov in English, Spanish, Russian, Chinese, Bengali, Haitian Creole, Korean, Arabic, Polish, and Italian. The state page says paper applications must be mailed to the local district where you live. Inside the five boroughs that district is the NYC Human Resources Administration (HRA). In the other 57 counties it is your county Department of Social Services (DSS).

People who are 65 or older, people with a disability, and people who already have Medicare apply this way, not through the NY State of Health marketplace. HRA’s Health Assistance page says it accepts applications from residents who are 65 or over, people of any age living with a disability or blindness, and people who receive Medicare and are not a parent or caretaker of minor children.

Step 1: Check the numbers with a counselor

Call HIICAP and say your county. A counselor will tell you whether your household looks closer to QMB, QI, or full Medicaid, and what each would mean for the Part B premium and your prescriptions. Have your Social Security benefit letter or a recent statement nearby. This takes minutes and costs nothing. The figures are on the cost-program overview.

Step 2: Gather the documents

HRA’s page says applicants must show proof of residency, identity, income, and immigration status, and that proof of Medicare is now required as well. For a Medicare Savings Program application that typically means:

• Your Medicare card, or the Social Security letter showing your Medicare start date.
• Photo ID, or the state’s alternative documents for identity and date of birth.
• Proof of income: the Social Security benefit letter, pension statements, pay stubs if working, and any other monthly income.
• Proof of your address, such as a lease, utility bill, or a letter mailed to you.
• Proof of citizenship or immigration status when it cannot be verified electronically.

New York has no resource test for the Medicare Savings Programs, so bank statements are generally not needed for an MSP-only application. They are needed if you are applying for full Medicaid at the same time. Send copies, never originals.

Step 3: File it (New York City)

1. Phone. Call the HRA Medicaid Helpline at 1-888-692-6116. Ask for the Medicare Savings Program and how to submit the application.
2. Online. HRA’s page says you can apply through ACCESS HRA, the city’s online benefits portal.
3. Mail or in person. Mail the DOH-4328 to HRA, or bring it to an HRA Medicaid office. Office locations are listed on nyc.gov/hra and they change, so check the site rather than an old flyer.

There is no Bronx, Brooklyn, Manhattan, Queens, or Staten Island Medicaid phone line. Every borough uses the same HRA helpline. Our borough and neighborhood pages cover the local layer: which county name goes on the form, and where the nearest free in-person counselor is.

Step 3, outside New York City

Mail the same DOH-4328 form to the county Department of Social Services where you live. County DSS numbers are on each county’s official website. HIICAP at 1-800-701-0501 can help you fill out the form wherever you live.

Step 4: What happens after approval

Once an MSP is approved, the state notifies Medicare and the Part B premium stops being deducted from your Social Security payment. That change often takes a month or two to show up, and it often comes with a lump-sum refund of premiums deducted for months the MSP already covered. If your check has not changed after a couple of months, call HRA or your county to confirm the approval went through, and ask a HIICAP counselor what to expect.

Extra Help follows automatically: your drug plan is told you have it and pharmacy copays drop. If you were denied because a document was missing, HRA generally defers the application and gives you time to send it rather than denying outright; read the notice for the deadline.

Step 5: Renewals

Medicare Savings Programs are renewed, usually once a year. Watch for the renewal notice and return it on time. If your address changes, tell HRA or your county right away so the notice reaches you. The HRA Medicaid Helpline handles address changes for city residents. Our renewal-season letters decoder explains which office sends the renewal and what the grey, orange, and blue Medicare notices mean.

Extra Help and EPIC on their own

• Extra Help without an MSP: apply through Social Security at 1-800-772-1213 or online. Applying for Extra Help also starts a Medicare Savings Program application with the state unless you opt out.
• EPIC (65 and older, not on full Medicaid): apply through the state EPIC program. The EPIC Helpline is 1-800-332-3742 (TTY 1-800-290-9138), weekdays 8 a.m. to 5 p.m.

Common mistakes

• Skipping the application because you own a home, a co-op, or have savings. New York does not count resources for QMB or QI.
• Counting a working adult child’s salary as household income. The MSP household is the applicant, or the couple if married and living together.
• Writing the borough name instead of the county name: Brooklyn is Kings, Manhattan is New York, Staten Island is Richmond.
• Sending original documents. Send copies.
• Letting the renewal notice sit. QI in particular is funded by a yearly allotment; do not leave an application or renewal in a drawer.

Free help

Sources

New York State Department of Health, Medicare Savings Program 2026 (application form, languages, mailing instructions) and MSP overview; NYC Human Resources Administration, Health Assistance (who applies through HRA, required proofs, ACCESS HRA); Medicare.gov, Medicare Savings Programs and help with drug costs; NYS DOH EPIC application and contact pages. Checked September 10, 2026. Confirm on nyc.gov/hra and health.ny.gov.