Medical Assistance

MEDICAID COMMUNITY SECTION
(PUBLIC HEALTH INSURANCE PROGRAMS)

John H . Mulroy Civic Center 5th floor
421 Montgomery Street
Syracuse, NY 13202

Hours: 8:00 AM- 4:30 PM Monday through Friday
Telephone: (315) 435-2928 Fax: (315) 435-3938

The Medicaid Community Unit processes applications for a variety of public health insurance programs including Medicaid, Family Health Plus (FHP), Prenatal care services (Presumptive Eligibility), Family Planning Benefit Program and the Medicare Savings Program.

Financial eligibility is determined based on the income and resource standards governing the Public Health Insurance Programs. A Supplemental Security Income recipient is granted Medicaid based on his/her certification for SSI benefits. A separate application for Medicaid is not needed for SSI recipients.

Persons eligible for Medicaid may be required to enroll in a managed care plan. Persons eligible for Family Health Plus must enroll in a managed care plan. Managed Care information and options will be provided upon application.

You can obtain more information online at www.mybenefits.ny.gov.

HOW TO APPLY
An application for public health insurance can be requested by calling (315) 435-2928. An application packet will be sent to you. Complete the application form and return it to us - a face to face interview is not required and the process can be completed by mail. The application and your documentation will be reviewed. If additional documentation is required you will receive a letter which will list what information is needed in order to complete your application. You will have 10 days to supply this documentation.

Persons under 65 are encouraged to contact a Facilitated Enroller to file an application. The enroller will assist in completing the application form, collecting required documentation and will forward the application packet to the Medicaid office for processing.

Facilitated Enrollers may be contacted at the following locations:
Onondaga County Health Department Lead Agency  (315) 435 6808
Fidelis Health Care   (315) 437-1835
Total Care   1-800-223-7242  (315) 634-5555
United Healthcare Community Plan 1-888-617-8979 (315) 433-5700
Excellus BCBS Health Care 1-800-338-4995

Pregnant women may apply at the following sites:
Onondaga County Health Department (315) 435-6808
Family Planning (315) 435-3295
Planned Parenthood (315) 475-5540
St. Joseph’s Maternal Child Health Center/St. Joseph's Family Medicine (315) 448-6146
Syracuse Community Health Center (315) 476-7921x2327
UHCC/Womens's Health Care Services (315) 464-5210

Applications for the Family Planning Benefit Program are taken at these sites:
Family Planning (315) 435-3295
Planned Parenthood (315) 475-5540

Applications for the Medicare Savings Programs may be obtained by calling 435-2928.

With the application the following documentation must be presented:
Birth Certificates for all persons who are applying
Social Security Card for all who are applying (optional)
Proof of citizenship status
Veteran Discharge papers (if applicable)
Verification of ALL income, including but not limited to: wages, Social Security, pensions, veteran’s benefits and interest or dividends
Depending on your circumstances you may be asked to verify ALL your resources, including but not limited to: bank accounts, trust funds, insurance, CDs, burial accounts, burial spaces, vehicles and property.
Medicare and other health insurance cards and verification of premium cost

RECEIVING A FINAL DECISION
After all the necessary documentation needed to determine eligibility has been received, a decision will be rendered by the Medicaid office and a formal written notice will be mailed to the applicant and to their representative.
If the applicant does not agree with the written decision the notice includes information on how to apply for a Fair Hearing through the New York State Department of Health

RENEWAL OF ELIGIBILITY & REPORTING RESPONSIBILITY
If you are found eligible for ongoing Medicaid or another Public Health Insurance Program you will be required to re-establish your eligibility at regular intervals as determined by the New York State Social Welfare law. This is called a “Renewal”. You will receive notification of your renewal and a renewal form by mail. It must be retuned by the date in the notice for your benefits to continue.
Social Services law requires that you report any changes in your income, resources, third party health insurance, family composition and residence to the Medicaid office. You may also be contacted by the department if a computer income match indicates a change in your circumstances.

If you have any questions, you may contact the Medicaid Community Unit at
(315) 435-2928.

Rev 4/5/11