We know that finding a therapist near you in or near Garden City NY of Long Island who takes your Managed Medicaid plan with Fidelis Healthfirst or Community Plan is important in your care and we are happy to be able to provide services under these plans.
Managed Medicaid Plans Accepted: Fidelis, HealthFirst, UHC Community Plan
The following is general information to best of our knowledge about obtaining Managed Medicaid plans but please be to sure to take into account all your benefits and circumstances and consult with others to see if this is best for you.
Navigating Managed Medicaid
Have you had a significant life change that has or may impact your insurance? If so one of these may apply to you:
Scenario 1:
At times when you apply through the state or another entity for other types of benefits, the office of Medicaid or another entity may by default change your insurance back to straight Medicaid. This can happen during renewals, when states try to streamline services, or when your other benefits or income changes. This can happen because Medicaid programs must coordinate benefits with other entities and also because the choice of a more specific plan is yours to make. The challenge is that this default change to straight Medicaid can limit your provider network and access to specialized care, which are typically managed through a Managed Medicaid plan. In order to see a provider here see help getting Managed Medicaid.
Scenario 2:
If you have had a recent change of income, may no longer be eligible to be on another's insurance plan, or have another qualifying life event, you may be eligible for a Medicaid managed care or essential insurance plan. If so, you could receive full or significant coverage for therapy visits here if selecting a plan we are in network with. In order to see a provider here see help getting Managed Medicaid.
Scenario 3:
You never had Managed Medicaid and were automatically assigned NY Medicaid or Straight Medicaid. This may not be an error, but as mental health providers under our provider type we are only able to accept Managed Medicaid Plans which in the simplest of terms means that a specific insurance company would be managing a portion of you Medicaid benefits and access to certain care and providers such as us. Read on for help with getting a Managed Medicaid Plan we accept.
Help obtaining Managed Medicaid
It is best to call the number through the NYS health exchange (1.855.355.5777) and let them know you believe you may qualify for a Medicaid level or Essential plan or already have Medicaid but want to choose a managed Medicaid plan. These plans are not always viewable on the main website.
The Medicaid plans we accept are Healthfirst, UHC Community, and Fidelis.
Here is the link to the New State of Health website to look into enrolling and questions you might have: https://info.nystateofhealth.ny.gov
You may want to consider the following when changing your insurance:
-Make sure any necessary medical treatment you need such as providers, medications would be covered under the new plan. Our clients thus far have not had issues when switching but every situation is unique.
-Discuss any impact on co-insured family members if applicable
-Ask if there would be any deductible or copay for 'routine professional individual mental health visits'. Medicaid and Essential plans usually are $0 to $15 but higher level essential plans may be more or have a deductible.
-If you have insurance through your job and are considering opting out of that and getting a plan through the exchange, make sure to examine compare the effects of this.
-The NYS of health assigns insurance agents to help clients navigate benefits and you can view full benefit descriptions online before choosing.
Thank you and we hope this is of help.