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John F. O'Neill
Commissioner
Address:
3085 Veterans Memorial Hwy
Ronkonkoma, NY 11779
Phone: (631) 854-9930

Emergency Services (After 4:30 PM & Weekends, Holidays): (631) 854-9100 

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Medicaid FAQ

  1. Now that I have been approved for Medicaid, what happens?
  2. I need a replacement Medicaid card. What do I do?
  3. I have a Medicaid Only case and I have moved. What should I do?
  4. I need transportation to a medical appointment. Who do I call?
  5. I need to add a person to my Medicaid Only case. What do I do?
  6. What are the locations, phone numbers and hours of the Medicaid offices?
  7. How do I find a doctor who will accept Medicaid?
  8. I have an overage. What does that mean and how do I pay it?
  9. I had bills before receiving Medicaid. Can they be covered? Can my Medicaid coverage be backdated to pay these bills?
  10. My Medicaid card is not working. Why is this happening?
  11. I want to change my Medicaid Managed Care plan. What do I do?
  12. I need help completing my Medicaid Recertification/Renewal form. Can anyone help me?
  13. Why was my case closed/denied?
  14. Did you receive my paperwork?
  15. I am undocumented. Can I apply for Medicaid?
  16. I have a question about the Health Exchange?
  17. What is the status of my application?
  18. I have a question about the Documentation Request Letter I received.
  19. I have a question about the Notice of Decision I received.
  20. I have other Medicaid questions. Is there a website that can help answer them?
  21. Can I renew my Medicaid coverage over the phone?

 

Q1:

Now that I have been approved for Medicaid, what happens?? Back to Top
A: You and your approved family members will each receive a Common Benefits Identification Card (CBIC) with a Medicaid ID number (example: AB12345C). You must show your CBIC card to your doctor, clinic, hospital, or other health care provider in order to receive medical services.Please call your health care provider to find out if they accept Medicaid as payment.

Most people receiving Medicaid in Suffolk County must join a Managed Care plan. Please call New York Medicaid CHOICE to find out if you are required to enroll in Managed Care. If you are required to enroll, New York Medicaid CHOICE will help you to choose the best plan for you and your family. Please call them at 1-800-505-5678.

Q2: I need a replacement Medicaid card. What do I do?? Back to Top
A:

To replace a lost Medicaid card, call the appropriate office listed below for your case type:

If you receive Temporary Assistance with Medicaid, call:

Coram Temporary Assistance:      (631) 854-2300 
Riverhead Temporary Assistance: (631) 852-3500 
Smithtown Temporary Assistance: (631) 853-8714 
South West Temporary Assistance: (631) 854-6600 
           

If you receive Medicaid only (no Temporary Assistance), call:

Riverhead Medicaid: (631) 852-3570
Smithtown Medicaid: (631) 853-8408
SSI Unit (MANIT): (631) 854-5823
Q3:

I have a Medicaid Only case and I have moved. What should I do??

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A:
  • If you have moved to another address in Suffolk County, your Medicaid case can remain open. Please call your Medicaid worker with your new address (see the phone numbers above). If you fail to do this you may not receive notices and recertification forms.
  • If you have moved to another county in New York State, your Medicaid case can be transferred to the new county. You will not have to reapply in the new county. You must advise your Medicaid worker of your new address (see the phone numbers above).  You can also mail in or FAX your new address to your Medicaid worker.
  • If you have moved out of New York State, your New York Medicaid case must be closed and a new case opened in your new home state. You must notify your Medicaid worker as soon as possible that your case should be closed in New York (see the phone numbers above). 

It is important for you to notify all of your case workers (SNAP, HEAP, Temporary Assistance, etc.) so that you will receive all of your DSS mail at the correct address. The SNAP, HEAP and Temporary Assistance programs may have different requirements for consumers who have moved.

Q4:

I need transportation to a medical appointment. Who do I call?

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A:

    

Medicaid Transportation: 1 (844) 678-1103 (24 Hours a Day/7 Days a Week) Persons with an active case, medical need and no means of transportation may get help with transportation to and from health care providers (doctor, clinic, hospital, etc.).  All non-emergency trips require prior approval and must be requested at least 3 days prior to the date of the trip.  Call the number provided above or visit: www.longislandmedicaidride.net

Medicaid recipients who provide their own transport, either by private vehicle or public transportation should also call 1-844-678-1103 for information on reimbursement.                        

NOTE:

Effective December 1, 2015, Managed Care plans will no longer provide Non-Emergency Medical Transportation as part of their benefit package.  As of December 1, 2015, persons enrolled in Managed Care plans and in need of Non-Emergency Medical Transportation must access www.longislandmedicaidride.net and follow the instructions above to receive help with transportation.                            

Remember to contact the LogistiCare Reservation Line at 1-844-678-1103 at least three (3) days prior to the date of the trip for all requests for transportation.

Q5:

I need to add a person to my Medicaid Only case. What do I do??

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A:

If the person you want added to your case is a child, you can send a letter to your worker including the full name, date of birth and social security number of the child.

If the person you want added to your case is an adult, this person must complete an Access New York Health Insurance Application and provide documentation of current income and residence. A link to the application is located at http://www.health.ny.gov/forms/doh-4220all.pdf. The completed application should be sent to the appropriate address below.

If you need a person added to your SNAP, HEAP or Temporary Assistance case, you must contact the worker for that program. 

 
Q6:

What are the locations, phone numbers and hours of the Medicaid?

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A:

Riverhead Medicaid Office

893 East Main Street

Riverhead, NY 11901

New Applications: 631 854-9916

Open Cases: 631 852-3570

Phone Hours: 8:00 AM - 4:00 PM


         

 Smithtown Medicaid Office
200 Wireless Blvd.
Hauppauge, NY 11788

New Applications: 631 854-9916
Open Cases: 631 853-8408

Phone Hours: 8:00 AM - 4:00 PM
Q7: How do I find a doctor who will accept Medicaid?? Back to Top
A:

Persons with a Medicaid card can call 1-800-541-2831 to find out the names of primary care physicians and specialists who accept Medicaid.

To Look up Doctors in your area who accept Medicaid & Medicare:   www.nydoctorprofile.com

To Look up Dentists (for Kids & Adults) in your area who accept Medicaid:  www.insurekidsnow.gov

Q8:

I have an overage. What does that mean and how do I pay it??

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A:

If your monthly income is over the Medicaid level, you may still be able to get help with your medical bills. The amount your income is over the Medicaid level is called an overage (or spenddown or excess income). It is like a monthly deductible that you are responsible for before Medicaid will start to pay your medical bills. The Notice of Decision letter you received tells you the amount of your overage. Once you have medical bills at least equal to your overage or you pay the amount of your overage to the Suffolk County Department of Social Services office, Medicaid will pay your medical bills for the rest of that month. You can also pay the amount of your overage to the Suffolk County Department of Social Services by check or money order (cash can only be accepted at the Suffolk County Department of Social Services Administrative Offices at 3085 Veterans Memorial Highway, Ronkonkoma, NY 11779). Bills and checks/money orders (payable to Suffolk County Department of Social Services, with your case number written on the check/money order) and should be mailed to: Suffolk County Department of Social Services, Medicaid Overage Unit, PO Box 18100, Hauppauge, NY 11788.

Not everyone is eligible to have an overage. You must be under age 21, age 65 or older, certified blind or certified disabled, pregnant or a parent of a child under age 21. This allows you to become eligible for Medicaid even though your monthly income is too high. You can spenddown to the Medicaid level in one of two ways:

1. Outpatient Care and Services (One Month Eligibility)

If you need outpatient care, in a hospital, clinic or doctor’s office, prescription drugs or medical supplies, you may be able to get help with these bills. If you have medical bills that are equal to or more than your monthly excess income, you can get Medicaid outpatient services for one month. The Excess Income Program can provide outpatient coverage for one month at a time. You must then bring in or send your medical bills to the Overage Unit when they at least equal your excess income amount. These bills can be paid or unpaid. You may also pay the amount of the overage with a check or money order or combine your bills with your money payment to equal the amount of your overage. You will need to do this each month you need outpatient care.

2. Inpatient/Hospital Care and Services (Six Months Eligibility)

If you need inpatient hospital care or need help paying your inpatient hospital bills, you may be able to get Medicaid inpatient services, in addition to the outpatient care described above. You must have medical bills that are at least equal to your monthly excess income amount for six months. These bills can be paid or unpaid. They can also be for medical services other than hospital care. Once your medical bills at least equal your excess income amount for six months, you must send these bills to your Medicaid worker. You will then receive Medicaid for six months for any bills above and beyond the amount of the six month overage. After that six month period, your overage will return to a monthly program.

Persons with questions regarding their current Medicaid overage please call 631-854-5879.

Q9:

I had bills before receiving Medicaid. Can they be covered? Can my Medicaid coverage be backdated to pay these bills??

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A:

Medicaid can cover bills for care you received up to three full months before you applied for Medicaid. You must have been eligible for Medicaid for this backdate period. If you submitted these bills when you applied for Medicaid or Temporary Assistance, your worker would have determined if you were eligible for backdated coverage. If you did not submit these bills when you applied for Medicaid or Temporary Assistance, you can submit them now. You can send them with a note of explanation to the worker and address named on your Medicaid or Temporary Assistance acceptance letter.

Q10:

My Medicaid card is not working. Why is this happening??

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A:

There could be many reasons why your Medicaid card is not working.

  • If you have an overage that has not been paid yet for the month, your card will not work.

  • If your case has not been recertified, your card will not work. You should have received a recertification notice instructing you to complete and mail in a form (with the requested documentation) in order to continue your case.

  • Does DSS have your correct address? If mail was returned to DSS as undeliverable with no new address on file with the post office, your case would be closed. You must give any new address to all of the units that have your case. This means that you must contact Medicaid, SNAP, HEAP and Temporary Assistance when you move and let them know your new address.

Q11:

I want to change my Medicaid Managed Care plan. What do I do??

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A:

Call New York Medicaid CHOICE at 1-800-505-5678 to receive information, to enroll in a plan or to change your plan.

Q12:

I need help completing my Medicaid Recertification/Renewal form. Can anyone help me??

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A:

If you received a recertification/renewal package from New York Health Options and you need help with the form, call 1-855-NY-ENROLL (1-855-693-6765). Renewal Assistants are available from 8:00 AM-8:00 PM Monday to Friday, and 9:00 AM-1:00 PM Saturday. You can also contact an enrollment facilitator in your county for help with your renewal. Enrollment facilitators are organizations or health plans in your community that can answer questions about applications and renewals for New York's public health insurance programs. Suffolk’s enrollment facilitators are:        

Nassau/Suffolk Hospital Council  (631) 656-9783 
Community Health Advocates  (888) 614-5400 
Public Health Solutions 

(646) 632-5986

You can also receive assistance in completing your Medicaid Recertification form at the Medicaid offices listed above.
Q13:

Why was my case closed/denied??

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A:

When your case was closed or denied you received a Notice of Decision on your case. This letter explained why your case was closed or denied and included your worker’s name and phone number. If you have questions about this decision, please call your worker.

Q14:

Did you receive my paperwork??

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A:

If you mailed your paperwork to the correct address, there should be no problems with the delivery to the Medicaid office.

Q15:

I am undocumented. Can I apply for Medicaid??

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A:

Temporary Non-Immigrants (example, foreign students, visitors, tourists, etc.) and undocumented aliens can only receive Medicaid for the care and services necessary for the treatment of an emergency medical condition if all eligibility requirements are met (proof of identity, income, State residence, etc.).

Q16:

I have a question about the Health Exchange??

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A:

All questions regarding the Health Exchange must be directed to the New York State Department of Health at 1-855-NY-ENROLL (1-855-693-6765). The Suffolk County Department of Social Services does not have access to Health Exchange information. If you received a letter or notice from the Health Exchange, it included a phone number. Please call that number for further information.

Q17:

What is the status of my application??

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A:

You should receive a decision on your Medicaid application within 45 days of your application (30 days for children and pregnant women, 90 days if a disability must be determined). If you have not heard by that time, please call your worker.

Q18:

I have a question about the Documentation Request Letter I received.?

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A:

The Documentation Request letter you received has the name and phone number of your worker. Please call your worker if you have questions about the documentation you must submit.

Q19:

I have a question about the Notice of Decision I received.?

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A:

The Notice of Decision Letter you received includes the name and phone number of your worker. If you have questions about this decision, please call your worker.

Q20:

I have other Medicaid questions. Is there a website that can help answer them??

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A:

New York State Department of Health has a very informative website that can answer many general questions about Medicaid (http://www.health.ny.gov/health_care/medicaid/#qualify).

Q21:

Can I renew my Medicaid coverage over the phone??

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A:

Most Suffolk County Medicaid consumers are now able to renew their Medicaid coverage by phone.  A Medicaid specialist will take your information and advise you if any documents are needed to process your renewal.  This option is not available to consumers in Nursing Homes.

Please call 631 853-8755 Monday through Friday from 8:00 am – 4:00 pm. to schedule a telephone renewal appointment