Is Neighborhood Health Plan Medicaid

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Health Care And Group Hugs: Keeping Barbara Well

Neighborhood Health Plan of Rhode Island Celebrating 25 Years of Service

Barbara chooses Neighborhood Health Plan of Rhode Island. That means when she interacts with her health insurance company, its typically with welcoming hugs at the front door of her Warwick apartment. People in say, Youve got to be the luckiest person in here! Barbara says. Every six weeks, the Two Tracys from Neighborhood pay

Neighborhood Health Plan Of Ri Secures 3

Monday, November 09, 2020

Peter Marino, CEO

It is good news for the 550 employees who work for Neighborhood in Rhode Island.

The contract extension “ensures that the more than 13,000 members on Neighborhoods INTEGRITY plan will have uninterrupted access to integrated managed care services through 2023,” said Neighborhood.

According to Neighborood, the renewal follows Neighborhoods naming by CMS as a top scoring Medicare-Medicaid Plan for Overall Rating of Health Plan as a result of the 2019 Consumer Assessment of Healthcare Providers and Systems survey. It also comes on the heels of a strong performance by Neighborhood on key outcome measures established prior to the 2016 launch of INTEGRITY.

When Neighborhood began working with the state to integrate Medicaid and Medicare benefits, we knew we had an opportunity to help some of Rhode Islands most vulnerable residents by streamlining their access to high-quality health care and creating long-term stability for them, said Peter Marino, president and CEO of Neighborhood. We are proud of the work we have done with EOHHS, CMS and terrific providers in the community to build a nationally-recognized Medicare-Medicaid program that provides first-class care coordination for eligible members and are honored to continue such important work.

$1.4 billion in revenue serves one out of every five Rhode Islanders.

Accessis Neighborhoods Rite Care Plan For Families Children Pregnant Women And Children With Special Health Care Needs

The Benefits of Neighborhood ACCESS

ACCESS offers a range of benefits to keep you healthy:

  • Check-ups and routine immunizations, doctor visits, prescription drugs, hospital care, behavioral health services, emergency services and more.
  • Neighborhood REWARDS, including gift cards for healthy choices like getting your annual check-up and joining a gym.
  • Special wellness programs to help you manage your health.
  • A friendly and helpful customer service team to ready to assist you.

Learn more

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Warren Quits Smoking With Help From Neighborhood

Step into Warrens Providence apartment, and the first thing you see is a wall full of his most precious memories. About half of them are family photos. The other half are notes hes received from Neighborhood Health Plan of Rhode Island. They come from Rosemary, the Health and Wellness Specialist who heads up Neighborhoods Quit

Your Care Manager Will Also:

NCMS Partners to Create Medicaid Managed Care Health Plan ...
  • Provide you with education about conditions, medications, treatment and resources in your community.
  • Provide you with education on available benefits and services, help address any medication issues, create self-management plans and goal setting.
  • Help you coordinate and facilitate your medical services and provide assistance in adhering to your plan of care with your provider.
  • Provide assistance to help you find specialists and get any durable medical equipment you may qualify for.
  • Enhance communication between multiple providers that may be involved in your care.

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Neighborhood Helps Keep Andrew At Home

Visit Andrews Warwick home and you will find him surrounded by technology. Much of it is educational some is for entertainment. But the bulk of the electronics surrounding the nine-year-old boy has a much more important purpose: keeping him alive. He doesnt really have a true diagnosis he is undiagnosed, explains Andrews mother, Tara. But he has

Neighborhood Health Plan For The Self

Neighborhood Health Plan has been providing more affordable health care and health care benefits to our members since 1997. NHP embodies the egalitarian and non-profit spirit that NASRO closely identifies with. NHP is now the third largest HMO in Massachusetts, with over 260,000 members providing health care through a network of 70 hospitals, 4,300 primary care providers and 13,000 specialists throughout all of the eastern and central counties of the state and part of western Massachusetts. Now part of Partners HealthCare, NHP maintains a solid balance sheet and may become an even more important part of Massachusetts health care in the years ahead, without losing its unique management style.

NASRO rates the Neighborhood Health Plan as our best buy because of the lower premium costs it brings our individual and small business members, while having a wide choice of benefit plans, and a rapidly expanding number of doctors from internal medicine, family practice and pediatrics. All with no deductible for most plans, low administrative costs, access to many times the same doctors and hospitals as the more well known plans and the most affordable monthly prices in the state year after year.

NASRO is also now able to offer group dental plans with Delta Dental to accompany our group health plans with Neighborhood Health Plan.

. If you are ready to enroll it can be done quickly and easily on line. Go to our Neighborhood Health Plan Member Enrollment Application to get started.

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Getting Healthy Thanks To The Affordable Care Act

There are times in Maries life, like when shes sitting with her nurse case manager and reviewing strategies to improve her health, when Marie has to pause to realize how lucky she is. Im grateful, Marie says. I dont take things for granted. I appreciate even the smallest thing because I know what its like

About Neighborhood Health Plan Of Rhode Island

Jen – Member Story – Neighborhood Health Plan of Rhode Island

Neighborhood Health Plan of Rhode Island is a not-for-profit health plan founded in December 1993 in partnership with Rhode Islands Community Health Centers to ensure everyone in the state has access to high-quality, cost-effective health care. Neighborhood serves over 205,000 members in the state, with 82 percent of its membership Medicaid eligible through its ACCESS and TRUST plans and 6 percent of its membership utilizing Neighborhoods INTEGRITY Medicare-Medicaid Plan . About 12 percent of Neighborhoods members are individuals, families and small businesses who select one of eight Neighborhood commercial plans available through the health exchange, HealthSource RI. Of these members, about 85 percent qualify for federal subsidies to cover a portion of their costs. Today, Neighborhoodwith over 500 employees and $1.4 billion in revenueserves one out of every five Rhode Islanders. Learn more at nhpri.org.

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How To Choose Neighborhood As Your Plan

When you apply for Rhode Island Medicaid, you can select Neighborhood as your plan.

  • Apply online through HealthSource RI, over the phone by calling the 1-855-840-4774, or in-person at your local Department of Human Services office. For more information, visit.
  • Contact our Sales Team for assistance or a referral to a navigator in your community. Call today at 1-800-459-6019 or fill out this form to request a call back.
  • If you were assigned to another Medicaid plan and want to enroll in Neighborhood, you can complete a Change Request Form within 90 days of your initial enrollment. If you have been enrolled in your plan for more than 90 days, you can switch to Neighborhood during the next Medicaid open enrollment period. Contact our Sales Team with questions.
  • Trust Is Neighborhoods Rhody Health Partners Plan For Adults With Disabilities Trust Also Covers Adults Without Dependent Children This Is Called The Rhody Health Partners Expansion Plan

    The Benefits of Neighborhood TRUST

    TRUST offers a range of benefits to keep you healthy:

    • Check-ups and routine immunizations, doctor visits, prescription drugs, hospital care, behavioral health services, emergency services and more.
    • Neighborhood REWARDS, including gift cards for healthy choices like getting your annual check-up and joining a gym.
    • Special wellness programs to help you manage your health.
    • A friendly and helpful customer service team to ready to assist you.

    Learn more

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    Prior Authorization Reference Guide Exchange

    • The purpose of these guides is to inform you of services that require prior authorization.
    • If you do not find a specific service listed on these guides, it may be that the service is a non-covered benefit. If you need information related to covered services, please refer to our Billing Guidelines and Coverage Summaries or call Neighborhood Member Services at 1-800-459-6019.
    • All Acute and Post-Acute admissions require authorization.
    • Neighborhood Health Plan of RI utilizes the following criteria to make medical review decisions:
    • InterQual
    • Clinical Medical Policies
  • Access Prior Authorization Forms here. Forms can be completed online or submitted to the 24/7 fax line at 401-459-6023.If you have any questions about the authorization process, please call Utilization Management at 401-459-6060.
  • For the following areas: Radiology, Oncology and Durable Medical Equipment please see our partnered vendor information below regarding authorization requirements
  • With Neighborhood Integrity You Get:

    Provider Portal
    • All of your benefits you are receiving from Medicare, Medicare Part D and Medicaid with just one card.*
    • All of the benefits you receive today with Medicare and Medicaid with no plan premiums, deductibles, co-insurance or co-pays.**
    • Coordinated care for you that meets your needs.

    *Certain Medicaid benefits will still be covered through Rhode Island Medicaid, such as your dental and transportation services. We can help you access those services.

    **If you get long-term services and supports , you may have to pay part of the cost of the services. This amount is determined by Rhode Island Medicaid.

    About This Plan

    Medicare and Rhode Island must approve Neighborhood INTEGRITY each year. You can get Medicare and Medicaid services through our plan as long as:

    • we choose to offer the plan, and
    • Medicare and the State approve the plan.

    Even if our service area is reduced or our plan stops operating in the future, your eligibility for Medicare and Medicaid services would not be affected.

    If Medicare and/or Rhode Island disapprove Neighborhood INTEGRITY you will automatically be disenrolled from Neighborhood INTEGRITY when your new coverage begins. In these instances you would be enrolled in Original Medicare, your previous Part D plan and Rhode Island Medicaid.

    Neighborhood Health Plan of Rhode Island is not responsible for content on social media accounts.

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    Rewards For Healthy Behaviors

    • Gift cards to Walmart.
    • Up to $50 in a gift card when you submit your receipt for a 3-month enrollment in a gym or a facility that provides healthy physical activity such as a yoga or kickboxing studio. Up to $40 in Visa gift cards for getting certain visits during pregnancy and after giving birth. To learn more, call Neighborhood Member Services at 1-800-459-6019 .
    • And more
  • Select the form above based on your age / your childs age.
  • Print and fax your completed form to: 1-401-709-7090, or
  • Print and mail your completed form to:Neighborhood Health Plan of Rhode IslandAttn: Member Services
  • Print and fax your completed form to: 1-401-709-7090, or
  • Print and mail your completed form to:Neighborhood Health Plan of Rhode IslandAttn: Member Services
  • Claims And Eligibility Information

    Neighborhood is contracted with NaviNet to provide online member benefit, eligibility, and claims status lookup. Both contracted and non-contracted providers can use NaviNet. to access the NaviNet website. For additional help or information, contact Neighborhood Provider Services at 1-800-963-1001.

    for a guide to assist NaviNet users to cross-reference Neighborhood Plan ID numbers with NaviNet Group ID Numbers.

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    How We Make A Difference

    My provider is an excellent doctor. I could not find a better doctor to care for me than her, nor could I find someone that could care for my wellbeing like she does. I like everything about the clinic from the attention they give me to the follow up about my health. I love how kind the doctor is. Even though she has many patients, she knows all the patients and their medical histories. She is attentive to her patients health.

    PATIENT

    The staff was great. I needed an emergency appointment for my child and it was given right at the time that I wanted, the next day. The doctor explained everything well.

    PATIENT

    Neighborhood Health is filling an absolute critical need for health care in our community. There are thousands of patients that would not be receiving essential primary care, essential dental care, and essential behavioral health care if it was not for Neighborhood Health.

    COMMUNITY PARTNER

    We are all like a big family. We all have one mission which is to take care of patients even if they cannot afford insurance and we treat everyone with dignity and respect.

    PHYSICIAN

    My provider is extremely competent, knowledgeable, caring, relatable, and professional. I also like the support staff. They are always very helpful, very calm, and make me feel like it is a safe, non-judgmental environment.

    PATIENT
    PATIENT
    PATIENT
    PATIENT
    PATIENT

    I always say I couldnt work anywhere else because our patients are so wonderful to work with and deliver care to.

    PHYSICIAN

    Neighborhood Is A Safety Net Health Plan

    Small Business – Member Story – Neighborhood Health Plan of Rhode Island

    We insure about 60 percent of the vulnerable populationswith low income, disabilities or other special needsin Rhode Island. We are committed to a culture of caring and ensuring our members have access to the medical treatment and community services necessary within a culturally and linguistically appropriate setting to achieve health and wellbeing.

    Through our ACCESS Medicaid Plan, we insure*:

    • Children up to 19 years old with low to moderate income, lawfully present in Rhode Island less than 5 years
    • Parents with low to moderate income and lawfully present in Rhode Island at least 5 years
    • Pregnant women with low to moderate income
    • Children up to 21 years of age with special health care needs
    • All children up to age 18 years old in the Rhode Island foster care system

    Through our TRUST Medicaid Plan, we insure*:

    • Adults 21 years or older, receiving supplemental security income or low income, and not enrolled in Medicare or receiving long-term services and supports
    • Adults 19 to 64 years old, with no dependents or pregnant at time of enrollment, low income and not eligible for Medicaid or Medicare Part A and Part B must be have lawfully resided in Rhode Island for at least 5 years

    Through our INTEGRITY Medicare-Medicaid Plan *, we insure dually eligible beneficiaries:

    • Adults 21 years or older, permanent Rhode Island resident, entitled to Medicare Part A, enrolled in Medicare Part B, and eligible to enroll in Medicare Part D and are receiving full Medicaid benefits

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    Continues Integrated Benefits For Rhode Islands Most Medically

    Neighborhood Health Plan of Rhode Island today announced it signed a three-year extension with the federal Centers for Medicare & Medicaid Services and the Rhode Island Executive Office of Health and Human Services to continue its Medicare-Medicaid Duals Program. The contract extension ensures that the more than 13,000 members on Neighborhoods INTEGRITY plan will have uninterrupted access to integrated managed care services through 2023. The renewal follows Neighborhoods naming by CMS as a top scoring Medicare-Medicaid Plan for Overall Rating of Health Plan as a result of the 2019 Consumer Assessment of Healthcare Providers and Systems survey. It also comes on the heels of a strong performance by Neighborhood on key outcome measures established prior to the 2016 launch of INTEGRITY.

    When Neighborhood began working with the state to integrate Medicaid and Medicare benefits, we knew we had an opportunity to help some of Rhode Islands most vulnerable residents by streamlining their access to high-quality health care and creating long-term stability for them, said Peter Marino, president and CEO of Neighborhood. We are proud of the work we have done with EOHHS, CMS and terrific providers in the community to build a nationally-recognized Medicare-Medicaid program that provides first-class care coordination for eligible members and are honored to continue such important work.

    Eloise: A Foster Mom Who Keeps Going

    When we first met Eloise three years ago, we were impressed. At the time, she explained that during the 16 years she and her husband were foster parents they had welcomed 55 children into their Lincoln home. Some stayed, she said, smiling. Five stayed. Thats five adopted foster children, in addition to the

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    We Respect Your Privacy

    We promise to never send you spam or to sell your information.

    Disclaimer: Your State Department of Insurance regulates the insurance products that we offer in your state and corresponding premium rates. The premiums charged by a carrier for a particular insurance product must be consistent regardless of whether you buy it from HealthMarkets Insurance Agency, from a competing agency, or directly from the insurance company.

    HealthMarkets Insurance Agency is the d/b/a or assumed name of Insphere Insurance Solutions, Inc. which is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumers enrollment in a health plan. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled.

    This site is not the Health Insurance Marketplace website, and the link to the FFM website is www.healthcare.gov.

    UnitedHealthOnesm is a brand representing the portfolio of insurance products offered to individuals and families through the UnitedHealthcare family of companies. Golden Rule Insurance Company or UnitedHealthcare Life Insurance Company is the underwriter and administrator of these plans.

    New For 2022 Extra Benefits And Services

    10 Things to Know about Medicaid: Setting the Facts ...

    In-Home Support Services Coverage includes up to 120 hours per year of companion care to assist with everyday tasks.

    Healthy Food and Nutrition Benefit Coverage includes a healthy food and savings card with a $25 monthly allowance that can be used to purchase healthy and nutritious groceries.

    Fitness benefit Coverage includes access to a contracted fitness facility. Fitness benefit includes a health and gym membership with an activity tracker.

    Home Delivered Mealsafter inpatient hospitalization or surgery Coverage includes home-delivered meals after discharge from an inpatient hospitalization or surgery. This benefit covers fourteen meals for two weeks and limited to twice per year for a total of twenty-eight meals is covered.

    No Authorization is required for supplemental benefits.

    Please refer to Member Handbook for a complete listing of services.

    ***Note: Members receiving Long Term Services and Supports may have a patient share responsibility. Please contact the Department of Human Services Long Term Care Office for more information on whether patient share applies to you.

    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.

    Questions?

    Neighborhood INTEGRITY is a health plan that contracts with both Medicare and Rhode Island Medicaid to provide the benefits of both programs to enrollees.

    H9576_WebBenefits22 Approved, 11/22/2021

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