N.Y. Comp. Codes R. & Regs. tit. 9, § 9610.3 – Eligibility for coverage.

(a) Residents of the State who are at least 65 years of age, who have incomes within the limitations prescribed by statute and who are not in receipt of medical assistance shall be eligible for coverage upon meeting the required registration fee, premium or deductible requirements of the program.
(b) Each applicant and participant shall furnish evidence, and when requested provide verification of, those factors which affect eligibilty and the amount of registration fee, premium or deductible, including:
1. (1) Age. The applicant or participant shall furnish evidence that he/she is at least 65 years of age.
2. (2) Receiving medical assistance. The applicant or participant shall furnish current and accurate information concerning the availability of his/her receipt of medical assistance.
3. (3) Residence. Information shall be provided sufficient to establish that the applicant or participant is residing within the State.
4. (4) Spouse. For each married applicant the following information shall be furnished concerning his/her spouse: full name and date of birth.
5. (5) [Reserved]
6. (6) Income. The applicant or participant shall furnish sufficient information in order to permit calculation of his/her income.
7. (7) Insurance coverage. The applicant or participant shall furnish current and accurate information concerning the availability of coverage of prescription drug expenses under a third-party assistance or insurance plan.
(c) An applicant or participant is not eligible to receive coverage if he/she has equivalent or better coverage from any other public or private third-party payment source or plan or program of insurance.