Not a U.S. citizen and need Medicaid home care or nursing home care in New York? What the October 2026 change means

Federal Medicaid money now goes only to U.S. citizens and nationals, green-card holders who have finished or are exempt from the 5-year wait, Cuban-Haitian entrants, and COFA migrants. Other lawfully present non-citizens, such as refugees, asylees, parolees, and people with temporary protected status, no longer bring in federal money.

The state notice says lawfully residing children and pregnant people keep federally funded coverage under a separate rule.

• Coverage continues with state money. GIS 26 MA/14 says people who do not move to the Essential Plan stay in the state's Medicaid system and keep Medicaid with state-only funding, if otherwise eligible.
• Long-term care is named. The notice says the people who stay on state-only Medicaid may include lawfully present non-citizens under 65 who need long-term services and supports, such as nursing home care, or who qualify through a spend-down or pooled trust.
• People 65 and older cannot get the Essential Plan, so under the notice they stay on Medicaid with state funding if otherwise eligible.
• Some adults 21 to 64 move to the Essential Plan if they qualify for it.
• Most of the change is behind the scenes. The state is changing funding codes in its system in October 2026. It does not describe a change to the home care services themselves.

• The Medicare Savings Program has no state backup. New York ended MSP on September 30, 2026, for people outside the federal groups. If MSP paid the Part B premium, Social Security will take it from the check again.
• Medicare itself may change in 2027. A federal law limits Medicare to the same groups. New York's notice says affected people may keep Medicare until January 4, 2027. A CMS rule that is still proposed would end it February 1, 2027, after notices from Social Security.
• If Medicare ends, the plan may change. Some long-term care plans require Medicare. Watch for letters from New York Medicaid Choice (1-888-401-6582), your plan, and HRA or your county.

1. Answer every request for immigration documents by the deadline. The state notice says that if no response comes, the Medicaid application must be denied or coverage stopped.
2. Send copies, not originals. Keep a copy of every page and the date you sent it.
3. Keep the renewal on time. A missed renewal is a bigger risk than the funding change.
4. Do not cancel home care or Medicaid out of fear. If you are worried about how Medicaid affects an immigration case, ask the New York State New Americans Hotline (1-800-566-7636) or an immigration lawyer first.
5. Call for help with long-term care questions. NY Connects (1-800-342-9871) is free and explains long-term care options.