What will happen when I apply?
Your local department of social services and Facilitated Enrollers are available to assist you in completing your application for public health insurance. They can help you fill out an application, choose a health plan and answer any questions you may have. You and your family members can apply for several public health insurance programs (Medicaid, Family Health Plus and Child Health Plus) using a single application.
The application will ask for information about the persons living in your household, your household's income, housing expenses, illnesses/injuries, other health insurance as well as 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. If anyone applying is a U.S. citizen and provides a valid Social Security Number, a match with the Social Security Administration (SSA) will verify his/her Social Security Number, identity, U.S. citizenship and date of birth. If verified with SSA, no further proof is needed. The SSA match cannot be used with naturalized citizens. If you require assistance, your local department of social services or Facilitated Enroller 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.
All information is kept confidential and will only be used to verify if you are eligible for public health insurance.
If you meet with a Facilitated Enroller, once your application is complete your Facilitated Enroller will let you know if you and/or your family appear to be eligible for Family Health Plus or another public health insurance program. The facilitator will forward the completed application to your local department of social services where it will be reviewed and final insurance eligibility determinations will be made. The local department of social services 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 department of social services. 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. You will also get a handbook from your health plan that will tell you what services are covered and how you can get health care.
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.
