Medicaid and Managed Care
Breast Cancer Surgery
Enrolling in a Medicaid Managed Care Plan
Medicaid Managed Care offers many New Yorkers a chance to choose a Medicaid health plan. Managed Care plans focus on preventive health care and provide enrollees with a medical home for themselves and their families. In many counties, once you are eligible for Medicaid, you can join a plan if there is one available and you want to join. However, there are some counties where families will have to join a plan. In these counties there are some individuals who don't have to join. Enrollment in Medicaid managed care is available at any local Department of Social Services.
To find out more about Medicaid managed care where you live, choose a county from the map or list below.
An HIV SNP is a health plan that covers special services for people living with HIV/AIDS. If you live in Metropolitan New York there is a choice of HIV SNPs available.
Medicaid managed care provides comprehensive health care services to enrollees. Find out if you can apply by contacting your local Department of Social Services.
Medicaid managed care enrollees may obtain family planning and reproductive health services in or out of network from any Medicaid provider who offers these services without prior approval from the health plan or primary care provider. Enrollees will need to present their Medicaid benefit card to receive services outside their plan.
Information in the model contracts is presented here to provide general guidance on the benefits provided in New York's Medicaid managed care program.
- Primary Care Partial Capitation Provider (PCPCP) Model Contract (PDF, 667KB, 203pg.)
- Medicaid Managed Care/Family Health Plus/HIV Special Needs Plan Model Contract (PDF, 4,455KB, 365pg.)
- Medicaid Advantage Model Contract (PDF, 1.57MB, 223pg.)