Family Health Plus
What will happen when I apply?
You will need to meet for an hour or so with an enrollment facilitator at a location near your home or at your local social services district. This person will help you fill out an application for public health insurance, choose a health plan and answer all of your questions. You and your family members can apply for several public health insurance programs (Medicaid, Family Health Plus, Child Health Plus and WIC) using a single application.
You will be asked for information about the persons living in your household, your household's income, resources, housing expenses, illnesses/injuries, other health insurance as well as your New York State residency, United States citizen or immigration status, and social security numbers of the persons applying for Family Health Plus. You will need to provide proof of the identity, date of birth, residence, current income, dependent care costs, health insurance, citizenship and immigration status for the members of your family applying for insurance. Some adults may need to provide proof of their resources. Your enrollment facilitator will help you identify and gather this documentation. All information is kept confidential and will only be used to verify if you are eligible for public health insurance.
Once your application is complete your enrollment facilitator will let you know if you and/or your family appear to be eligible for Family Health Plus or another public health insurance program. (An application is "complete" when it is filled out, all of the required documentation is submitted, a health plan is chosen and it is signed.) The facilitator will forward the completed application to your local social services district where it will be reviewed and final insurance eligibility determinations will be made. The local social services district will let you know which health insurance program you qualify for and verify which health plan you chose.
You will get a letter to confirm your eligibility and the plan you chose from your local services district. Your health plan will send you a welcome letter that includes the date you can start using the plan's services and a member ID card. If you need care before your plan-issued ID card arrives, use the plan's welcome letter to show your provider (such as your doctor, clinic, hospital) that you are a member. Your will also get a handbook from your health plan that will tell you what services are covered and how you can get health care. A New York State Common Benefit Identification Card (Benefit Identification Card) will also be sent to you separately. This card will allow you to access your prescription drug benefit on or after October 1, 2008 at a Medicaid enrolled pharmacy. Until October 1, 2008, your Family Health Plus plan card must be used to obtain pharmacy benefits.
It could take two months or more from the time you sign the application to when you can start getting services from the managed care health plan you chose.
There is no retroactive coverage in the Family Health Plus Program; your coverage begins once you are enrolled in the health plan you chose. If you are determined eligible for FHPlus, your enrollment should be effective no later than 90 days from the date of submission of your completed application. In the event of an error or delay in your enrollment, Medicaid may be able to pay for reasonable medical expenses you pay for services covered under FHPlus. Medicaid may also pay for any unpaid medical expenses, but only if the provider is an enrolled Medicaid provider.
