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Medicaid
provides assistance to people who do not have the means to pay for medical
care. People who are eligible include people in receipt of SSI (Supplemental
Security Income), Public
Assistance and those that meet the eligibility criteria.
Medicaid Pays for the Following:
In-patient care in hospitals
Out-patient care at hospitals
Physician services Clinic services Pharmacy Skilled nursing home care Long Term Home Health Care Personal Care Aides Child Teen Health Program Mental Health Family planning Medical and health insurance Premium Non-emergency medical transportation Supplemental Security Income (SSI)All
SSI recipients are eligible for Medicaid automatically. The district
they reside in will be the district of financial responsibility.
Supplemental
Security Income (SSI) is a federal assistance program for the aged (65
and over), blind and disabled which is administered through local Social
Security Offices. SSI beneficiaries
are automatically eligible for Medicaid and may be eligible for Food
Stamps and Emergency
Assistance to Adults (EAA) as well
as other services through the local district offices. A small number of
SSI recipients, whose available income is less than the applicable public
assistance standard, may be eligible for Safety
Net Assistance. Any Public
Assistance applicant who reasonably
appears to qualify for SSI, must apply for SSI and appeal any negative
determination made by the Social
Security Administration.
Questions about individual SSI claims should be addressed to the Social Security Administration at 1-800-772-1213 or you can view the Social Security web site for additional information. Child Health PlusNew
York State has a health insurance plan for children under 19 years of age.
The Medicaid program must evaluate every child's eligibility for Medicaid
(Child
Health Plus A), and those not eligible will be evaluated by
the provider for Child Health Plus B. The toll free number for information
on the program is 1-800-698-4543. This health insurance plan is available
throughout the state and covers the following services:
 well-child
care
Basically, most of your child's health needs will be covered. Family Health PlusIn
December 1999, Governor George E. Pataki signed into law the most comprehensive
health care legislation in the nation. The Health Care Reform Act of 2000
marks an extraordinary achievement in New York State's commitment to expanding
quality health care coverage to nearly one million uninsured New Yorkers
under a bold new initiative, Family
Health Plus.
What is Family Health Plus?Family
Health Plus is a new program signed into law by Governor George E. Pataki,
which provides health coverage to adults who do not have insurance through
their employers, but have income too high for Medicaid.
When will Family Health Plus be av ailable?Applications
will be available September 1, 2001 and coverage will be available October
1, 2001.
Who can join?Parents and childless adults aged 19 through
64 are eligible if they live in New York State, have no health insurance
coverage and have income at or below the eligibility levels established
by the New York State Department
of Health.
How
much does it cost to join?
There is no cost to participate in Family Health Plus. What services are covered?
How is care provided? Once applications are available, health care will be provided through managed care plans. Family Health Plus will do its best to help participants continue to see their current doctor. How does a person enroll in Family Health Plus? Enrollment facilitators and local social services district offices will help people enroll, answer their questions, and also help people choose a health plan. How does a person know when to apply? This website will be updated to let people know when they can apply for Family Health Plus. In addition, there will also be an advertising campaign. Can a person drop health insurance to join this program? No. Family Health Plus is a health care program for persons who do not already have health insurance. If my children are in Child Health Plus, does that mean I'm eligible for Family Health Plus? Not necessarily. Family Health Plus has maximum income levels depending on household size. Child Health Plus does not. Will children who are in Child Health Plus have to transfer to Family Health Plus ? No. Children will still be covered under the Child Health Plus program. Child Health Plus is a program for children, and Family Health Plus is a program for adults. Family Health Plus will do its best to help parents enroll in the same plan as their children. What if an individual's income is too high for Family Health Plus? You may be eligible for the Healthy NY program. Please contact Healthy NY at 1-866-HEALTHYNY (1-866-432-5849) or at their website: http://www.ins.state.ny.us/healthny.htm More Questions? If you have any questions, please call 1-877-9-FHPLUS (1-877-934-7587). Medical TransportationMedicaid
can pay for transportation to and from emergency medical care and services.
Medicaid can also pay for transportation to and from non-emergency medical
care or services for a Medicaid eligible individual, or reimburse that
individual for the expense.
In non-emergency
situations, prior approval of the Department is required to ensure that:
- the mode of transportation, (i.e. private vehicle, public transit,
taxi,ambulette,
ambulance), is appropriate to the medical needs of the client.
- the least costly appropriate transportation is arranged.
If you
are traveling by private vehicle or public transit, you must contact the
Department's Medical Services Unit at 516-227-8070. If your medical
condition requires you to travel by taxi, ambulette or ambulance, you must
contact GlobeGround Corporation, the Department's transportation coordinator,
at 516-433-1660.
Home CareMedicaid
can pay for approved licensed personal care and home health care services
for people financially eligible for Medicaid. To have this service
approved requires a nursing assessment.
Skilled Nursing FacilityMedicaid
can pay for eligible individuals in a licensed skilled nursing facility.
Transitional Medical AssistanceTransitional
Medical Assistance provides continued medical assistance coverage to people
who become ineligible for Family
Assistance or medical assistance with
budgeting and who have a dependent child under the age of 21 living with
them. Transitional MA benefits are available for six months
to those who lose family assistance due to:
new
employment
An additional six months of medical assistance may be possible if the person remains employed; has earned income below certain levels; and has a dependent child under the age of 21 living with them. |
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| What
does Medicaid pay for?
Supplemental Security Income (SSI) Catastrophic Health Care Expense Program Transitional Medical Assistance RELATED LINKS New York State DOH Consumer Page New York State DOH Child Health Plus |
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