Answers to common questions

Medicaid is a program that provides health care coverage for millions of Americans. In New York, it’s called New York State Medicaid. Those who qualify for New York State Medicaid can get Managed Long-Term Care (MLTC) services if they’re eligible. MLTC services are for adults (age 21 and up) who need a nursing home level of care and meet other eligibility requirements. If you qualify, you can get coverage for things like:
 

• Vision care 

• Dental care

• Social day care

• Home health services

• Durable medical equipment 
   

Learn more about what’s covered

Find out if you qualify

Yes. To keep receiving MLTC services, you must renew your Medicaid coverage every year.

Learn how to renew

We want you to be happy with the care you get. So if you’re ever unhappy with your health plan or a provider, you can file a complaint. Or you can file an appeal if we deny, delay or change a service. If you don’t agree with the decision on your appeal, you can ask for a state fair hearing.
 

Complaints and appeals

Tell us. You have the right to report anyone you believe is committing fraud or abuse.

Fraud and abuse

You’ll find your health plan summary and benefits info in your member handbook or on your Member Portal.

Learn more about your Member Portal

We’re here for you 24 hours a day, 7 days a week. Just call us at 1-855-456-9126 (TTY: 711).

You can also use the contact us page to get in touch. Or log in to your Member Portal.

Learn more about your Member Portal

You have some options if you lose your member ID card. First, log in to your Member Portal. There, you can:

• Ask us to mail you a new ID card
• Find the electronic version of your ID card — as long as you have your smartphone, you’ll always have your ID card with you for health care visits

Or call us at 1-855-456-9126 (TTY: 711).

Learn more about your Member Portal

Your PCP is a medical provider who will manage your health care. They’re the doctor, nurse, physician assistant or clinic that provides your main health care. They’ll help you get all the covered services you need.

Specialists are providers who treat specific conditions. Your PCP might refer you to a specialist in our network. Or they may recommend you see one. Need help finding a specialist? Just call us at 1-855-456-9126 (TTY: 711). Then ask to speak to your care manager. They can help you set up appointments and rides.

You can find providers for the health care services you need.

Find a provider

Whether it’s day or night, your PCP or on-call provider can tell you what to do. If they’re not in the office, leave a message. They’ll return your call. Your provider must see you within 24 hours if you need urgent care. 

If you’re having an emergency, call 911 or go to the nearest emergency room (ER).

If you're having an emergency, call 911 or go to the closest hospital.

You’ll only need emergency care if you think your health is in serious danger. Emergencies may include:

• Severe pain
• Serious injury
• Sudden illness
• Illness that is quickly getting much worse
• Heavy bleeding that doesn’t stop

Check out some of these articles to learn more about getting the right care at the right time:

• Is it an emergency?

• Where to go for quick medical care

You can get help with rides to medical services. We cover rides for your nonemergency medical needs. You can get a ride for visits to your:

• Health care provider 
• Dental or vision provider
• Mental or behavioral health care provider 
• Pharmacy
• Social day care
• Dialysis

Rides

If you’re away from home and have an emergency, go to the closest hospital or call 911.

When you have a condition, you’ll work with your health care provider to set up a treatment plan. The plan will likely include certain steps, like:
 

• Taking medication
• Making lifestyle changes, like eating and exercise
• Finding emotional support

Some conditions can benefit from disease management, like:
 

• Chronic obstructive pulmonary disease (COPD)
• Diabetes
• Heart failure
• Sepsis
• Urinary tract infections (UTIs)

Do you have one of these conditions? If yes, you may be able to get help from a care manager. You can learn more on our page about disease management. Or call us at 1-855-456-9126 (TTY: 711).

Disease management

Dental and vision benefits
 

You can learn more about dental and vision benefits.

What’s covered

Dental and vision care

Staying active is one of the best things you can do for your health. It can:

• Give you more energy
• Help you feel better 
• Prevent some health problems that go along with aging

Some physical activity is better than none at all. But check with your doctor before you start — just to be sure it’s safe. Want to learn more about staying active? 

Learn more about exercise 

You’re not alone. With everything that’s been going on, many people have felt more stress and anxiety than ever. They need more help than usual coping with everyday pressures. 

Did you know that stress can affect your health? It’s common during times of stress to pick up some unhealthy habits. Don’t be too hard on yourself. It’s not always easy, but you can learn ways to:

• Eat healthy
• Exercise regularly
• Start other healthy habits 

Learn more about healthy habits:

• Healthy living resources
• Ways to manage stress
• Staying mentally healthy in tough times

It may not be easy, but you can stop using nicotine — whether it’s smoking, vaping, chewing or another form. Let’s quit together.

Find more support

You can also learn more about quitting from the:

• American Cancer Society’s guide to quitting smoking
• Great American Smokeout® event
• Centers for Disease Control and Prevention at 1-800-QUIT-NOW (1-800-784-8669)

Your PCP can give you more personal help and treatment. Be sure you know who your PCP is and make an appointment today.