Medicaid Albany Ny Phone Number


American Disabilities Act Notice

Medicaid in New York State and Prescription Medication Coverage – Seth Ginsberg

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 , UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Great News For Dental Health

Healthy Capital District’s Seal a Smile Serviceshave resumed! Seal a Smile provides school-based preventive dental services such as screenings, cleanings, fluoride, and sealants. The team is so happy to be able to provide your child safe and effective dental care again!

Your health plan may now include dental and vision. Thanks to the American Rescue Plan , starting June 1, 2021 individuals insured under NY State of Health’s Essential Plans 1 and 2 are now covered for dental and vision at no extra cost! Have questions about these changes or want to update a plan to take advantage of changes?

Am I Eligible For Cdpap

There are three important criteria that must be met to be eligible:

1. You must have Medicaid.

2. You must require home care.

3. You must be self-directing, or you must have a representative that can direct your care.

There are other factors that can potentially affect your eligibility, but if you meet the above criteria, we recommend you give us a call to see if you can enroll.

Please Note: Edison Home Health Care is a Fiscal Intermediary for CDPAP. We do not administer the program. We can help you navigate, but application and enrollment for CDPAP must go through your Local Department of Social Services or Medicaid plan.

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Do You Need Someone To Guide You Through Your Health Insurance Options

NYS Certified Navigators: We meet with you to provide free information and assistance to applicants without pressure or obligation. HCDI staff work directly with individuals to complete applications through the NY State of Health Marketplace and apply for Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans. Insurance subsidies are available for people who make up to 400% above the poverty line.

What Forms Do I Need To Apply For The Cdpap Program

Dentists Who Accept Medicaid In Albany Ny  Find Local ...

It really depends on your situation. However, you will certainly need something. We recommend you give us a call so we can give you a clear picture of what you will need. We will even help you with gathering the necessary forms from your doctor and other providers. For a complete list of the forms, see our dedicated CDPAP Forms page.

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Unitedhealthcare Connected For Mycare Ohio

UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.

Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .

Hiring A Family Member As A Paid Family Caregiver

One of the most appealing aspects of the CDPAP program is the ability to hire a family member as your paid caregiver. This can relieve much of the stress and anxiety that often accompanies receiving care from an agency provided home health aide or personal care aide . Many people are uncomfortable having strangers coming to their home, especially when they find themselves in need of assistance. Do you want to hire a paid family caregiver? The following are answers to some common questions that come up regarding what family members can be hired as paid family caregivers under the CDPAP:

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New York Medicaid Office

Below is the contact information for the Medicaid office in New York. They can assist you with questions or concerns about the New York Medicaid program, including the eligibility requirements and Medicaid enrollment in New York. You can view their site online at To find out if you are eligible for this program, New York Medicaid eligibility.

The Medicaid program in New York covers basic medical care. This may include doctor services, inpatient hospital care, laboratory and x-ray services, inpatient short-term skilled nursing or rehabilitation-facility care, outpatient hospital or clinic care, short-term home healthcare, ambulance service and prescription drugs for people not covered by Medicare. We suggest contacting the Medicaid office to find out specifically what coverage is provided as it can be different in each state.

Ready To Enroll In Cdpap Home Care

New Provider/New Biller — Medicaid Partners

What are you waiting for! Call us now at 718-831-2900. A specialist will guide you through the entire enrollment process.

Please Note: Edison Home Health Care is a Fiscal Intermediary for CDPAP. We do not administer the program. We can help you navigate, but application and enrollment for CDPAP must go through your Local Department of Social Services or Medicaid plan.

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Requesting The Release Of Information To A Third Party

Any request to release Medicaid payment records to another party must consist of both a letter of request, either from the third party or from the Medicaid Member and an original authorization .

The letter requesting Medicaid payment records must include:

  • the Medicaid Member’s name AND date of birth,
  • the Medicaid Member Client Identification Number or Social Security Number, preferably both, and
  • the dates of service the report will cover.

A copy of the authorization form and the guidelines for submitting it can be found here: . Copies of this document may also be obtained by contacting the New York State Department of Health Public Web Site Administration at .

The following are requirements for an authorization to be considered valid:

  • The authorization must give the name and address of the party that the records are to be sent to.
  • The authorization must be signed by the Medicaid Member or by a person having legal authority to sign for the Member. Except for the parent and natural guardian of a Medicaid Member who is a minor, persons signing on behalf of a Member must supply documentation proving their authority to act for the Medicaid Member.
  • The authorizations must have original, “wet ink” signatures. Copied signatures are unacceptable.

An authorization is not valid and will not be honored by the Office of Health Insurance Programs if any of the following apply:

Send the request to:

What Types Of Home Care Services Can Personal Assistants Provide

The types of care that personal assistants can provide are much broader than those that traditional agency provided home health aides and personal care aides are allowed to administer. Unlike home health aides and personal care aides that are only allowed to provide custodial care such as dressing, bathing, and meal preparation, Personal Assistants are also allowed to provide skilled care such as wound care, giving insulin shots, and suctioning tracheostomies. Please see here and here. This is potentially a very significant benefit for home care consumers that require ongoing skilled care.

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Medicaid Chronic Care Nursing Home Placement

  • Placement of Albany County residents in Nursing Homes
  • Pickup of Albany County residents already in Nursing Homes
  • Long Term Home Health Care cases Married couples where one is looking for a waiver program:
  • Nursing Home Transition Diversion or Traumatic Brain Injury or to enroll in a Managed Long Term Care Plan . This allows a spouse to receive care at home and still qualify for Medicaid.

Please call the above number for further information.

Managed Long Term Care In Albany Ny

Time Union " A Bailout for Medicaid?"

Are you looking for long-term health care services in your Albany, NY home? If you are Medicaid eligible, you qualify for managed long-term care, or MLTC, from Nascentia Health Options. Our managed long term care plans offer a wide array of services, including both medical and non-medical care, for people living in Albany, NY. These services are paid for through Medicaid. In order to qualify for a MLTC plan, patients must be eligible for nursing home.When you choose Nascentia Health Options to help meet your managed long-term care needs, youre choosing a healthcare team comprised of caring, qualified and professional staff who have been specially trained to offer comprehensive care in a wide range of areas.

Below is a quick reference guide for you, so that you can easily click on any of the services you might need. We created this page because we want to make it as simple as possible for you to learn about the services that Nascentia Health Options offers residents living in Albany, NY. Your health is important to us.

Nascentia Health Options provides the following services to Medicaid eligible patients in Albany, NY:

  • Providing a Bridge Between Family, Physician and Hospital
  • Working to Reduce Readmission to Hospital
  • Supervision of Others Providing Care
  • Visiting Nurses
  • Care for Open Surgical Sites
  • Care for Pressure Sores & Bedsores
  • Care for Tube Sites
  • Care for Tumor Erosion Sites
  • Care for Ulcers

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Do I Need To Be In A Medicaid Managed Care Plan To Enroll In The Cdpap Program

Most consumers must be enrolled in some form of Medicaid Managed Care to enroll. The good news is, you may have a choice as to what type of plan you enroll in. If you will be enrolling in Managed Long-Term Care , as many consumers must, there are a few different types of MLTC plans to choose from, each offering the consumer their own unique set of benefits. To learn more about the different types of plans, see Managed Long-Term Care Plans.

How Can Medicaid Planning Help You

Medicaid Planning can be extremely important in helping you to protect your hard earned assets.

Nursing home care is often a tremendous expense. Despite what many people think, your regular health insurance does not pay for long term nursing home care. In New York, there are three primary ways to pay for the enormous cost of long term care: Private Pay, Long Term Care Insurance, or Medicaid.

For many, privately paying for long term care is unrealistic. Long term care insurance is a wonderful option, but it is typically very expensive and many individuals dont qualify due to age or medical reasons.

Medicaid is a joint federal, state, and county program that covers the cost of long term care for individuals who meet certain income and asset levels. Any amount in excess of the asset limitations must be used to pay for your care prior to being eligible for Medicaid assistance.

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You Have Chosen To Enroll In

  • What is DSNP?

    A Dual Special Needs Plan is a type of health insurance plan for people who have both Medicaid and Medicare. It works together with your Medicaid health plan. You’ll keep all your Medicaid benefits. Most dual plans also give you more benefits and features than you get with Original Medicare. All for a $0 plan premium.

  • Who is eligible?

    You might qualify for Dual Eligibility Plans if

  • You are under age 65, eligible for state Medicaid benefits, and qualify on the basis of disability or other special situation.
  • You are at least 65 years old and receive Extra Help or assistance from your state.
  • The Medicare Annual Enrollment Period happens once a year in the fall. If you qualify for a Dual Special Needs Plan, you may not have to wait.

    You may be able to enroll right away if you

  • Are 65 and newly eligible for Medicare or have a qualifying disability
  • Are retiring and losing your current coverage
  • Have moved out of your current Medicare plan’s service area
  • Have a chronic condition like diabetes or chronic heart failures
  • Receive Medicaid benefits
  • Looking for the federal governments Medicaid website? Look here at

    We Will Assist Your Medicaid Planning By:

    Do You Qualify for Medicaid in New York State? – Medicaid Eligibility & Income Requirements
    • Protecting your home and your family savings from the expense of long term care
    • Preparing and filing a Community Medicaid application for home care
    • Preparing and filing an Institutional Medicaid application in the event
    • Nursing Home Care is Needed
    • Assist with Medicaid Renewals and Recertification
    • Creating & Funding your Medicaid Trust
    • Assisting with the Pooled Trust

    Albany, NY Office

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    Prior Authorization For Non

    18 NYCRR §505.10 is the regulation governing transportation for medical care and services. Generally, payment will be made only upon prior authorization for transportation services provided to an eligible medical assistance recipient. Prior authorization will be granted by the prior authorization official only when payment for transportation expenses is essential in order for an eligible MA recipient to obtain necessary medical care and services which may be paid for under the medical assistance program. 18 NYCRR §505.10.

    Prior authorization generally must be obtained by the medical assistance recipient, his representative, or an ordering practitioner before the transportation expenses are incurred, but such authorization is not required for emergency ambulance transportation or Medicare approved transportation by an ambulance service under certain circumstances. 18 NYCRR §505.10 18 NYCRR §505.10.

    The request must be made in the manner required by the prior authorization official. 18 NYCRR §505.10. A request for prior authorization for nonemergency ambulance transportation must be supported by the order of an ordering practitioner who is the medical assistance recipients attending physician, physicians assistant, or nurse practitioner. 18 NYCRR §505.10. The prior authorization official may approve or deny the request, or require additional information before doing so. 18 NYCRR §505.10.

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    Medical Answering Services Procedures


    Unitedhealthcare Connected 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 , TTY 711, 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 , TTY 711, 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.

    Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

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    Can A Caregiver Live At The Same Address As The Consumer

    Great question. The short answer is, it depends. The governments policy states as follows: a consumer directed personal assistant may include any other adult relative of the consumer who does not reside with the consumer or any other adult relative who resides with the consumer because the amount of care the consumer requires makes such relatives presence necessary.

    Consider The Following Scenario:

    Medicaid Transportation Phone Number Albany Ny

    Sally Bronson was a dedicated mother who had worked hard her whole life to provide for her family. Now in her late-70s, she suffered from a number of health complications that caused her to require help with activities of daily living. She also required daily insulin shots for her diabetes. Her daughter, Michelle, was there as often as possible, but she herself had to work to support her own family.

    Michelle wanted to get her mother a home attendant, but she knew that her mother would be reluctant to let a stranger into her home. Additionally, even if she could get her mother to accept a home attendant, the home attendant would not be allowed to administer the daily insulin shots that her mother required. Then Michelle discovered the Consumer Directed Personal Assistance Program .

    Under the CDPAP program, Michelle was able to get paid to take care of her mother. Since personal assistants are allowed to administer skilled services, Michelle was able to give her mother the daily insulin shots. This allowed Michelle to give her mother the kind of care that only a daughter can provide, without compromising on her responsibilities to her own family.

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    Are You A Senior Disabled Or Blind

    Facilitated Enrollment: Insurance coverage for individuals with specialized needs can be more complex to coordinate. HCDI staff assists in the application process for seniors, disabled and blind individuals for Medicaid, Medicaid Buy-in Programs for working Disabled, Medicaid Spend down Programs, Medicare Savings Program, and help with Medicaid for Nursing Homes. This program is for residents of Albany, Saratoga, Schenectady and Schoharie County.

    Medicaid Enrollment Levels Could Pose Budget Risks

    This screen grab from the website shows the extended deadline for signing up for health care coverage for 2020. The Trump administration says people will get more time to sign up for Obamacare health insurance following a spate of computer glitches over the weekend. The Centers for Medicare and Medicaid Services says the new deadline is 3 a.m. Eastern time on Wednesday, Dec. 18.

    NEW YORK According to a new report by New York State Comptroller Thomas DiNapoli, an increased record number of New Yorkers relied on Medicaid for health care coverage in 2021, with monthly enrollment exceeding seven million for the first time. DiNapoli says, however, if current enrollment trends continue, the state could face billions of dollars in unbudgeted costs.

    The share costs of New Yorkers without health care coverage have fallen from 11.4% in 2008 to 5.2% in 2019 per the report. As a result of the pandemic and resulting economic recession Medicaid enrollment has swelled in New York to record levels in 2021.

    Enrollment trends accounted for two-thirds growth of adults rising by 356,677 to a monthly average of more than three million enrollees for the first three months of 2021. The mid-year update to the SFY 2021-22 Enacted Budget Financial Plan, expects monthly enrollment to remain above seven million at least through March 2022.

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