Open enrollment for 2017 for the New York State of Health Exchange is November 1, 2016, through January 31, 2017. If you do not enroll in a 2017 plan by January 31, 2017, you cannot enroll in a health insurance plan for 2017 unless you qualify for Special Enrollment Period. Special Enrollment Period includes 60 days to report a move into New York State, job loss, marriage, divorce, birth of a child, etc. (You can apply for Medicaid or Child Health Plus at any time.)
There are significant changes to the way individuals and families apply for and receive health insurance in New York State. A number of key provisions of the Affordable Care Act (ACT) became effective in 2014.
How to Apply
Most families and individuals must apply for health insurance (including Medicaid) through the New York State of Health program (also called the Health Exchange) either by online, by telephone, or in person through a Navigator or Certified Application Counselor. You can apply in the following ways:
- Apply online
- By telephone at 855-355-5777 (Monday through Friday, 8 a.m. to 8 p.m.; Saturday, 9 a.m. to 1 p.m.)
- In person through one of the Navigator agencies:
- Mohawk Valley Perinatal Network 315-732-4657
- Access Care and Resources for Health 800-475-2430
- In person at Madison County Department of Social Services where Certified Application Counselors are available to assist consumers:
133 North Court Street
Building Number 1
P.O. Box 637
Wampsville, New York 13163
Persons applying for Medicaid who are 65 years of age or older, disabled, or blind must complete an application and mail or bring it to the Madison County Department of Social Services. A Medical Assistance Examiner can help you determine where to apply.
A personal interview is no longer required when you apply for Medicaid. You can request a conference to discuss your application when you drop it off at the Department of Social Services or by calling 315-366-2211 and asking to speak to a Medicaid Examiner. Persons requiring care in a skilled nursing facility may call 315-366-2211 or come to the Madison County Department of Social Services to request an application or to speak to a Chronic Care Examiner.
- Medicaid Managed Care
- Public Health Insurance Programs
- Program Eligibility
- Other NYS Programs
- For More Information
Medicaid Managed Care
Managed Care enrollment is mandatory in Madison County. There are two plans available: Fidelis Care and United Health Care. Please call the New York Medicaid Choice Customer Service Representative for plan choice information either by phone at 315-366-2211 or at the Madison County Department of Social Services.
Centene, a large national health insurer, will purchase the assets of Fidelis Care, the New York State Catholic Health Plan. The plan, New York Quality Healthcare Corp., a Centene company, will continue to operate under the Fidelis Care name. There are no changes for Fidelis customers.
Managed Long Term Care enrollment is mandatory for individuals who are Medicaid eligible and require community-based long-term care services for more than 120 days and are able to stay in the home/community without jeopardy to health and safety. Questions or referrals may be directed to New York Medicaid Choice Conflict-free Evaluation and Enrollment Center at 855-222-8350. There are four plans available in Madison County: VNA Homecare Options, VNSNY Choice, iCircle Care, and Fidelis Care At Home.
Public Health Insurance Programs
The Medical Assistance unit is here to serve the health insurance needs of the residents of Madison County. The Medical Assistance unit processes applications for a variety of public health insurance programs.
- Child Health Plus
- Chronic Care/Nursing Home Care
- Family Planning Benefit Program
- Home Care Programs
- Medicaid (Transitional and Provisional)
- Medicare Buy-in for Working People with Disabilities (MBI-WPD)
- Medicare Savings Program
- Prenatal Care
- Supplemental Security Income (SSI)
- Waiver Services
Eligibility for each program is based on the applicant’s income, resource and household size guidelines set by the state of New York. Please be advised that eligibility criteria listed in our programs are not all-inclusive and are merely a snapshot of generalized guidelines to follow for each program. Complete information on program eligibility can be obtained by contacting and/or conducting an interview with a Medicaid Examiner.
- Effective January 1, 2010, the resource test was eliminated for Medicaid applicants/recipients who are not age 65 or over, certified blind, or certified disabled.
- Effective April 1, 2010, a personal interview is no longer required to apply for Medicaid. Applications can be picked up at DSS or mailed to anyone upon request.
For more information, please call the Medicaid unit at 315-366-2211.
Other NYS Programs
There are programs through the State of New York to help people who are not eligible for the Medical Assistance Programs:
Application: This one application can be used to apply for Child Health Plus, Medicaid, and the Family Planning Benefit Program. Based upon the information you provide, you will be told which program you and/or your child(ren) are eligible for. The online version of the application is read only. It may be printed out and manually completed, but cannot be completed online.
Please Note: This application will help you determine the kind of information that is needed to see if you are eligible for public health insurance. Although you do not have to have a personal interview to apply for public health insurance, you may request application assistance. If you need help filling out the application or need help determining what documents you need to submit, you can call 877-934-7587 or call or visit your local department of social services.
For More Information
For more information regarding Medicaid, frequently asked questions, Medicaid updates, local departments of Social Services, statistics, and a host of related links, please visit the New York State Department of Health website.