Medical Assistance, Medical Services and Managed Care/SSI

 

Medical Assistance

Transitional MA

Child Health Plus

Family Health Plus

Supplemental Security Income

Medicaid Buy-in Program for Working People with Disabilities

SSI Disability Review

Medical Services:
Home Care Services
Nursing Home Care 
Medical Transportation

Managed Care

Adult Protective Services

Related Links

WCDSS Home

What is Medical Assistance (MA/Medicaid)?

Medical Assistance is help for people who cannot afford to pay for all of their medical care. Most MA in Westchester County is provided through Medicaid Managed Care.  For more information on Managed Care, click on link at left.  
Privacy Notice:  This notice from the State of New York Department of Health describes how medical information about you may be used and disclosed and how you can get access to this information.  Please review it carefully.  

Privacy Notice-English

Notificación de Privacidad:  Esta carta del Estado de Nueva York Departamento de Salud describe cómo se puede usar y divulgar su información médica confidencial, y también cómo puede usted obtener acceso a esa información.  Por favor lea con cuidado.

Privacy Notice-Spanish

Who is eligible for MA or Child Health Plus A?
You may be eligible for Medical Assistance  if you receive Public Assistance, Supplemental Security Income (SSI), or if you meet  income, resource, age or disability criteria. There are  special programs to help if you are pregnant or have a child. If you are pregnant, a worker at the clinic or hospital you are using for prenatal care can assist you to apply for Medicaid.  If you have a child, he/she may be eligible for Child Health Plus A (Children's Medicaid) which provides the same benefits as Medicaid.

What Medical Services are paid for by Medicaid in New York State?

  • inpatient care in hospitals

  • outpatient care at hospitals

  • physician services

  • clinic services

  • dental care

  • drugs, prescription and non-prescription (some co-pays apply)

  • eyeglasses

  • nursing home care

  • personal care/long term home health care

  • domiciliary care facilities

  • child teen/health program

  • managed care

  • prenatal care

  • family planning

  • laboratory and X-ray services

  • mental health services

  • health insurance and Medicare premium payments

How can I apply for Medical Assistance or for Child Health Plus A?

Applications for Medical Assistance can be filed at any of the four social service district offices:  Mt. Vernon (914-813-6000), Peekskill (914-862-5000), White Plains (914-995-4681) and Yonkers
(914-231-2000).

Applications for Child Health Plus can be filed at a social services district office, through a facilitated enroller at one of several community based organizations.  For information, call the Westchester County Department of Health: 
(914) 813-5629 (English)/(914) 813-5631 (Spanish) or with a facilitated enroller at one of the following health plan sites throughout Westchester:

  • Hudson Health Plan (1-800-339-4557)

  • Fidelis Care (1-888-343-3547)

  • Community Choice (1-800-619-2247)

  • Affinity Health Plan (1-800-553-8247)

  • HIP Health Plan (1-800-447-8255)

Westchester County Department of Social Services has a deputized worker program for hospitals and most nursing homes in Westchester. This program allows people who are hospitalized or admitted to a nursing home to apply for Medicaid at that facility instead of applying at one of the four Social Services Centers or at the Institutional Assistance Office in New Rochelle, (914) 813-5560.  If you have any questions regarding the Medicaid program, please call  (914) 995-5468. 

What is Transitional Medical Assistance?

Transitional Medical Assistance is a program that provides continued medical assistance coverage to people who become ineligible for family assistance and who have a dependent child under the age of 21 living with them.   Transitional MA benefits are available for six months to those who lose family assistance due to:

  • new employment

  • increased earned income

  • loss of earned income disregards

An additional six months, up to a total year, may be possible if the person remains employed; has earned income  below certain levels; and has a dependent child under the age of 21 living with them.

What if I don't qualify for Medical Assistance but I have no health insurance?

New York State has health insurance programs for all uninsured children up to 19 years of age and some uninsured adults.  Children ineligible for Medicaid may receive health services under Child Health Plus B available through providers throughout Westchester.

What services are covered by Child Health Plus B?

  • well-child care
  • physical examinations
  • immunizations
  • diagnosis and treatment of illness and injury
  • X-rays and lab tests
  • outpatient surgery
  • emergency care
  • prescription drugs
  • inpatient hospital medical or surgical care
  • short-term therapeutic outpatient services (chemotherapy, hemodialysis)
  • limited outpatient treatment for alcoholism, substance abuse, and mental health

How can I apply for my child?

Call 1-800-698-KIDS (1-800-698-4543), the Westchester County Department of Health:  (914) 813-5629 (English)/
(914) 813-5631 (Spanish) or you can obtain information from the Child Health Plus website. 

What is Family Health Plus?

Family Health Plus provides coverage to adults who do not have health insurance but have income too high for Medicaid.  Parents and childless adults aged 19 through 64 are eligible if they live in New York State, have no health insurance and meet income and resource guidelines.  There is no cost to apply for Family Health Plus and no deductibles once you are enrolled.  Once enrolled you may be asked to co-pay part of the costs of some medical care/services.  Health care is provided through managed care plans.  Family Health Plus will do its best to help participants continue to see their current doctor.

What services are covered by Family Health Plus?

  • physician services
  • inpatient and outpatient hospital care
  • prescription drugs and smoking cessation products
  • X-rays and lab tests
  • vision, speech, and hearing services
  • rehabilitative services (some limits apply)
  • durable medical equipment
  • inpatient hospital medical or surgical care
  • emergency room and emergency ambulance
  • drug, alcohol, and mental health treatment (some limits apply)
  • diabetic supplies and equipment
  • radiation therapy, chemotherapy and hemodialysis 
  • dental services (if offered by the plan)
  • family planning and reproductive health services

How can I enroll in Family Health Plus?

Enrollment facilitators and social service district offices  answer questions and help you choose a health plan. Call 1-877-9FHPLUS (1-877-934-7587), call the Westchester County Department of Health: (914) 813-5629 (English)/(914) 813-5631 (Spanish) or visit the Family Health Plus website.

What is Supplemental Security Income (SSI)?

Supplemental Security Income (SSI) is a federal assistance program for the aged (65 and over), blind and disabled which is administered through local Social Security Offices. SSI beneficiaries are automatically eligible for Medicaid and may be eligible for Food Stamps and Emergency Assistance to Adults (EAA), as well as other services, through the local district offices. A small number of SSI recipients, whose available income is less than the applicable public assistance standard, may be eligible for Safety Net Assistance.  Any public assistance applicant who reasonably appears to qualify for SSI, must apply for SSI and appeal any negative determination made by the Social Security Administration.

What is SSI Disability Review?

SSI Disability Review seeks to assist disabled individuals to secure Federal SSI benefits.  Retro Review seeks to evaluate Medicaid cases with high expenditures against Federal disability criteria to secure Federal participation and reimbursement.

Address questions about individual SSI claims to the Social Security Administration at 1-800-772-1213;  visit the Social Security web site for information.