Unitedhealthcare Connected General Benefit Disclaimer
This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.
You can get this document for free in other formats, such as large print, braille, or audio. Call Member Services, 8 a.m. – 8 p.m., local time, Monday – Friday . The call is free.
You can call Member Services and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.
Language Line is available for all in-network providers.
Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al Servicios para los miembros, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.
Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.
Are You Already Getting Insurance Through Your Employer
If you have health insurance coverage through your employer, you should keep that insurance and reach out to HRA. Medicaid may cover the cost of the premium for that insurance coverage.
The MBI-WPD program does not offer family coverage. Single people and married couples are both covered under this program if both individuals are working and have a disability. Spouses without a disability and children may be covered through other programs such as Medicaid through New York State of Health or Child Health Plus.
View Or Download Our Free Guide
While we are not affiliated with the government in any way, our private company engaged writers to research the Medicaid program and compiled a guide and the following answers to frequently asked questions. Our goal is to help you get the benefits that you need by providing useful information on the process.
Our free Medicaid Guide is filled with helpful information about how to apply, program eligibility and how to get in touch with local offices. You can view or download our free guide here.
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This Plan Is Available In The Following Counties:
Albany,Bronx,Broome,Cayuga,Chautauqua,Chemung,Chenango,Clinton,Columbia,Dutchess,Erie,Essex,Franklin,Fulton,Genesee,Greene,Herkimer,Jefferson,Kings,Lewis,Livingston,Madison,Monroe,Nassau,New York,Niagara,Oneida,Onondaga,Ontario,Orange,Orleans,Oswego,Queens,Rensselaer,Richmond,Rockland,Schenectady,Seneca,St. Lawrence,Suffolk,Tioga,Ulster,Warren,Wayne,Westchester,Wyoming,andYates.
UnitedHealthcare continues to partner with state and local public health departments, following guidance and protocols appropriate to our members that are provided by the U.S. Centers for Disease Control and Prevention , and state and local public health departments that are appropriate for our members. Please review the UnitedHealthcare Coronavirus Information. To learn more, go to CDC.gov.
COVID-19 NY State PPE Fee Guidance
The New York State Department of Financial Services recently issued guidance stating that care providers should not charge members additional fees for items such as personal protective equipment . DFS expects New York care providers to refund any of these charges paid by the member that were more than the members financial responsibility on a claim. If you have questions, you may contact your provider or call the number on the back of your card for assistance with filing a complaint.
How Long Does It Take To Get Approved By Medicaid
There is no easy answer for those wondering how long it takes to get approved by Medicaid as the timeframe varies greatly depending on several factors. Typically, it should take a few weeks to be approved, but every state has its own procedures for checking Medicaid eligibility.
Other factors, like the income verification process, can impact the application approval timeframe because it takes longer to complete. Local office capacity also plays a key role, as offices that are processing many applications will take longer to approve applications. Every situation will be unique. If you feel that you should have heard back about your application, you should contact the office to see if you must fix any part of your application.
Read Also: Medicaid And Other Health Insurance
How Do I Apply
If you apply at one of our Department of Community and Family Services locations, you will need the following documents:
- If you are a U.S. citizen and provide a valid Social Security Number , a match with the Social Security Administration will verify your SSN, date of birth, and U.S. citizenship. If SSA verifies this information, no further proof is needed. The SSA match cannot verify birth information for a naturalized citizen. You will need to submit proof of naturalization or a U.S. passport.
- Proof of citizenship or immigration status.
- Proof of age , like a birth certificate.
- Four weeks of recent paycheck stubs .
- Proof of all your income including sources like Social Security, Veteranâs Benefits , retirement benefits, Unemployment Insurance Benefits , Child Support payments.
- If you are age 65 or older, or certified blind or disabled, and applying for nursing home care waivered services, or other community based long term care services, you need to provide information of all bank accounts, insurance policies and all other resources.
- Proof of where you live, such as a rent receipt, landlord statement, mortgage statement, current utility bill or envelope from mail you received recently.
- Copy of insurance benefit cards .
- Copy of Medicare Benefit Card .
Note: Medicaid coverage is available, regardless of alien status, if you are pregnant or require treatment for an emergency medical condition and you meet all other Medicaid eligibility requirements.
How To Apply For Ny Medicaid
You may apply for Medicaid in the following ways:
- Enrollment Assistors offer free personalized help.
- To speak with the Marketplace Customer Service Center call 355-5777
- Through a Managed Care Organization
- Call the Medicaid Helpline 541-2831
- Through your Local Department of Social Services Office
Where you apply for Medicaid will depend on your category of eligibility. Certain applicants may apply through NY State of Health while others may need to apply through their Local Department of Social Service . No matter where you start, representatives will help make sure you are able to apply in the correct location. For more information on determining your category of eligibility and where you should apply read on.
NY State of Health determines eligibility using Modified Adjusted Gross Income Rules. In general, income is counted with the same rules as the Internal Revenue Service with minor variations. Individuals who are part of the MAGI eligibility groups listed below should apply with NY State of Health.
- Adults 19-64 years of age who are not eligible for Medicare,
- Children 1 – 18 years of age
- Pregnant Individuals,
- Parents and Caretaker Relatives of any age, who may have Medicare.
Individuals who are part of the non-MAGI eligibility groups listed below should apply with their Local Department of Social Services .
Other factors that may affect your eligibility include:
- State Residency
- Family or Household size
Medicaid Application for Non-MAGI Eligibility Group
Supplement A
Recommended Reading: Medicaid Change Plan Phone Number
Can I Print A Replacement Medicare Card In New York
Though some states allow Medicaid recipients to print a replacement card if one is lost, damaged, or stolen, in New York, you must request a replacement card using one of the methods described above. You cannot print a replacement card in New York, but will have to apply and then wait to receive your new Medicaid card in the mail.
Applying For A Replacement Medicaid Card In
If you go to Health and Human Services in-person to replace a stolen or lost Medicaid card, find a member of the staff and ask them for assistance with your lost, damaged, or stolen Medicaid card. Be prepared to provide a photo ID to verify that you are who you say you are. An appropriate form of identification includes the following:
Read Also: Phone Number To Change Medicaid Plan
Take Control Of Your Health Insurance Status
It is simple to begin the process of enrolling in Medicaid or verifying your enrollment from home or at your local benefits office so you can have the peace of mind that you or your family are covered. Online and local resources are available to anyone who wants to enroll in the Medicaid program or check their Medicaid status. Full Medicaid eligibility requirements can be found through your state Medicaid agency website.
If you are not eligible for Medicaid but are still in need of affordable health insurance, FirstQuote Health can help you find and compare affordable plans. Get a quote on health insurance plans near you today!
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Medicaid Buy In Program For Working People With Disabilities And Medicare Savings Programs
The Medicaid Buy-In Program for Working People with Disabilities provides Medicaid coverage for people ages 16-64 who have a disability and are engaged in a work activity for which they are paid. In order to be considered for this program, the individual must be determined disabled as defined by the Social Security Administration. The persons net income must be at or below 250% of the federal poverty level.
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Medicaid Enrollment Requirements And Compliance Deadlines For Managed Care Providers
Federal and state laws require all Medicaid Managed Care network furnishing , ordering, prescribing, referring and/or attending providers to be enrolled with the New York State Medicaid program. For more information, see the January 2018 issue of the Medicaid Update article titled Medicaid Managed Care and Children’s Health Insurance Program Network Providers Must Enroll in the New York State Medicaid Program.
Beginning, , EmblemHealth will deny claims from non-enrolled providers. You must be enrolled either as a fee-for-service billing provider or as an OPRA provider to continue receiving payment for services provided to EmblemHealth Medicaid members.
Enrollment of Physicians, Nurse Practitioners, Physician Assistants, Podiatrists, Dentists, Optometrists, Audiologists, and Certified Nurse Midwives
Pharmacy Enrollment
Beginning , EmblemHealth will deny payment to pharmacies that are not enrolled as an FFS billing provider. Pharmacies are furnishing providers that must enroll in the NYS Medicaid program to continue receiving payment. Information on how to enroll is available on the eMedNY Pharmacy Provider Enrollment web page.
Criteria for NYS Medicaid Enrollment
How to Check Provider Enrollment Status
| Provider Type |
|---|
| Enroll with Medicaid as billing provider** or if eligible as an OPRA provider |
Questions and Additional Information
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Talk to a doctor any timefor a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.
*Telemedicine isnt a replacement for your Primary Care Provider . Your PCP should always be your first choice for care .
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Renew Your Medicaid Or Chip Coverage
As COVID-19 becomes less of a threat, states will restart yearly Medicaid and CHIP eligibility reviews. This means your state will use the information they have to decide if you or your family member still qualify for Medicaid or CHIP coverage. If your state needs more information from you to make a coverage decision, theyll send you a renewal letter in the mail. Go to Medicaid.gov/renewals, find a link to your state Medicaid office and confirm your contact information is up-to-date.
An official website of the United States governmentHeres how you know
Official websites use .gov
When Do You Have To Present Your Card
You will need to present your Medicaid Benefit Identification Card after any health-related appointment or when you go to pick up a prescription medication. There are certain restrictions around what is covered by Medicaid and what is not, however, because many healthcare costs are covered by Medicaid, recipients will be asked to present their card at most healthcare institutions. Although sometimes coverage may not be provided, Medicaid cards should be presented any time you use any medical service in New York.
Your Medicaid coverage and card entitles you to receive coverage for a wide array of medical services, including :
Doctors visits
Emergency room visits and emergency transport costs
Hospital services
Prenatal and postnatal care for pregnant women
Some medical equipment costs
Therapy, counseling, and psychiatric care
Nursing home care for the elderly
Dental care
Home health care and personal care
And more
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Check Your Medicaid Application Status Online
Its quick and convenient to check Medicaid status in the comfort of your own home, and many states offer an online option for checking your Medicaid status. The first step is to log in to your account. If you dont have an account, you can create one by providing your email address and verifying your information.
Once you have created your online account, find and then click on the My application and coverage link from the sites drop-down menu. Here youll discover whether or not you have Medicaid coverage and the date your Medicaid coverage starts if youve recently enrolled.
What Does A Medicaid Card Look Like
In the state of New York, Medicaid recipients receive a Common Benefit Identification Card that is currently blue and gray with a yellow stripe dividing the top of the card from the bottom. This card can be used by recipients of various New York government benefit programs including the Temporary Assistance to Needy Families , the Supplemental Nutrition Assistance Program , the Healthcare Exchange program, and Medicaid .
The CBIC card contains basic information including the following:
This card should be presented at healthcare appointments.
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Do I Have To Reapply For Medicaid Every Year
Yes, you will have to reapply for Medicaid every year. However, unless your financial or life situation has changed, the renewal application process is usually significantly simpler and takes less time than the initial Medicaid application. Because Medicaid is a government funded health insurance program with strict rules regarding who is eligible and who is not, its important that all recipients reapply on a yearly basis to alert authorities to changes in their financial situation. Thus, each year, you will have to review whether or not you are eligible and, if you are eligible, youll have to provide all the necessary documentation to reapply for Medicaid.
Most Medicaid recipients receive a packet in the mail each year with all the information they need to be able to re-enroll in the Medicaid program and obtain a new CBIC card. If you no longer qualify for Medicaid, you will receive a rejection letter in the mail informing you that you are no longer eligible and will not be receiving a new Medicaid card and coverage for the coming year. Always remember to keep your current address updated with the Medicaid office because Medicaid will only send mail to the address on file. Medicaid documents cannot be forwarded to a new address. So, if you move to a new house or apartment, make sure to update your address so that you will receive the documents you need to reapply in the coming year.
Applying For A Replacement Medicaid Card Via Email Mail Or Fax
It is also possible to contact the New York State Department of Health and Human Services by email, snail mail, or fax to inquire about a new Medicaid card. But if you submit an application this way, only include the last 4 digits of your Social Security number to avoid having your identity stolen.
Also Check: Income Limit For Medicaid Wv
General Instructions For Checking Application
Since Medicaid is jointly funded by federal and state governments, there is always going to be variation in the process of one state vs. another. For specific information regarding checking the status of your Medicaid application in your state of residence, scroll below.
In all states, three are three avenues to checking up on the status of a submitted application: phone, in person, and online. The online method for applying and checking status is almost always online since this is the quickest and easiest.
However, do know that there are these other ways of accessing your application online makes you uncomfortable. Find your state below to find the way that works best for you!
Regardless of how you are checking the status of your application, make sure to gather any relevant materials or information beforehand.
Once the person or computer finds your application, you should be able to hear more about the status of your application!
How Do I Find Out My Medicaid Application Status
Medicaid is a federally-funded health insurance program for low-income families that is administered by each state. The income requirements and types of coverage you get depend on state laws, but there are federal minimums that every state has to meet to qualify for funding. Each year, low-income families apply for Medicaid services that will allow them to get the health care they need. The application process can sometimes take a while, but there are ways to check the progress of your application.
Wait For The Letter
When your state Medicaid office receives your application, it will send out a letter that will give you a date you can expect coverage to start. At some point before that date, you should get insurance cards in the mail and a confirmation of the effective date. If you dont mind waiting, then you will get your application status mailed to you.
Look Online
These days, most states have an online application process set up for Medicaid that makes the process much easier. When you submit your application online, the website will create an account for you. If you ever want to check the status of your application, then you can just log into your online account and check.
Go To Your Medicaid Office
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