60day Notice

  • Notice also available in Portable Document Format (PDF)

New York Medicaid Choice

1–888–401–6582

New York State Medicaid Managed Care Enrollment Program

P.O. Box 5081, New York, NY 10274–0792

                                                                                                                                <Date of Letter>
<Barcode> <Letter Code>
<Name>
<Address>
<City>, <State>, <Zip>

IMPORTANT: You´re being enrolled into <MAP Plan> on January 1, 2020.

Dear <Member Name>:                                                                                  <CIN>

Recently, <FIDA Plan> sent you a letter to say that the FIDA plan will not be offered after December 31, 2019. That letter also said that you will be automatically enrolled into another type of plan offered by <Plan Company Name>, unless you make another choice.

This letter is to tell you that you will be enrolled into <MAP Plan> for your Medicaid services (ID #:________________). You will also be automatically enrolled into <HMO/SNP> for your Medicare coverage.

You will be in both plans starting January 1, 2020, unless you make another choice. To make another choice, you must call us before December 31, 2019. If you do not make a change by January 1, 2020, you will be eligible for other opportunities to change your coverage after that date.

Read on to learn more about <MAP Plan>, as well as, other choices available to you. If you have questions about the information in this letter, call us at 1–888–401–6582. We can help in your language. TTY users can call 1–888–329–1541.

How does <MAP Plan> work?

<MAP Plan> is a Medicaid plan. <HMO/SNP> is a Medicare plan.

The two partner plans are for people who have Medicare and Medicaid and who need health and long–term care services, like home care, to stay in their homes and communities.

The two plans will work together to give you many of the same services you get now from your FIDA plan. You will also still have a Care Manager who will help you get all the services you need.

What services will be covered by <MAP Plan>?

The two plans will cover many of the Medicare and Medicaid benefits you get now, including:

  • Prescription drugs covered by Medicare Part D and Medicaid
  • Services you get now or that you might need, such as help with your personal care or with taking medications. This includes home care if you are living at home or nursing home care if you reside in a nursing facility.
How will this change affect me?
  • You will not pay a plan premium, deductible or copayment when you get services from a provider or pharmacy in your health plan´s provider network.
  • Every health plan has a network of providers like doctors, dentists, hospitals and personal care providers who provide your health care services. If your providers are not in the plan´s network, they can join it. You may need to see a different provider if your provider does not join your health plan´s network.

    Note: Our counselors can help you find out if your providers are already working with <MAP Plan>. Call us at 1–888–401–6582. TTY: 1–888–329–1541.
What do I need to do to join <MAP Plan>?

You do not have to do anything. You will be automatically enrolled in both the Medicaid and Medicare plans. Your new coverage will start January 1, 2020.

What are my other options?

You can call us to find out more about your other Medicaid and Medicare options. These are:

  1. Join a Medicaid Advantage Plus Plan that is run by another organization. You will get your Medicare and Medicaid services from two partner plans.
  2. Join the Program of All Inclusive Care for the Elderly (PACE). You will get your Medicaid and Medicare services from the PACE program. In PACE, you go to a single center to receive all of your care.
  3. Join a Medicaid MLTC Plan (also known as a partial plan). With this type of plan, you go back to using Original Medicare (red–white–and blue card). You could also join a separate Medicare Advantage Plan.
What if I have more questions?

Our counselors will be glad to answer your questions about your Medicaid plan choices. We will also connect you by phone to organizations that can answer questions about Medicare.

Thank you,
New York Medicaid Choice

SM–<Plan>–E–1019

1–888–401–6582
TTY: 1–888–329–1541

Monday – Friday 8:30 am to 8 pm
Saturday – 10 am to 6 pm