Transitional Medicaid

What is Transitional Medicaid?

If your public assistance case was closed, you may get Medicaid for at least six months after your case was closed.

Who is eligible for TMA?

To be eligible for TMA, you must:

(1) have been discontinued from public assistance because you were earning too much money or because an increase in child or spousal support, and

(2) have a child under 21 in your home, and

(3) have received public assistance for three out of the six months immediately before your welfare case was closed.

If your increased income is from child support, you will get four months TMA. If your income is from work, you will get six months.

If your public assistance case was closed for any reason other than increased child support or work income, you will not receive TMA. Your children might still be able to get “non-public assistance Medicaid.”

What do I have to do to get TMA?

Nothing. The notice you get from Social Services telling you that your welfare is discontinued should say that your Medicaid is being continued, and how long it will last. If the notice says your Medicaid is discontinued, you should request a Fair Hearing.

What happens after my TMA runs out?

Before the end of your certification, DSS will send you a form to report your wages. If you return that form, DSS will see whether you are eligible for another six months of TMA. If you had four months TMA because of increased child support, you cannot get this extra six months.

What do I do when my TMA runs out?

When you cannot get anymore TMA, you and your children may still be eligible for Medicaid. You should fill out an application asking only for Medicaid.

If you reside in Nassau County, you should go to the Nassau County Department of Social Services building, 60 Charles Lindbergh Blvd., Uniondale, NY 11553-3656 and request an application for Medicaid.

If you are a Suffolk County resident, there are two offices that process Medicaid only applications. The Riverhead Center covers eastern Suffolk County and they can be reached at (631) 852-3710 to request an application. The Smithtown Center covers western Suffolk County and they can be reached at (631) 853-8730.

If you are pregnant, you will be eligible.

Can I get a Fair Hearing if DSS does not give me TMA?

Yes. DSS cannot reduce or stop your Medicaid without a 10-day notice. If you call for a hearing before the effective date of the notice, you will continue receiving your Medicaid until after your hearing. To ask for a hearing, you should call 800 342-3334.