INFORMATION FOR ALL PROVIDERS MANAGED CARE ... - …

Information for All Providers ? Managed Care Information

NEW YORK STATE MEDICAID PROGRAM

INFORMATION FOR ALL PROVIDERS MANAGED CARE INFORMATION

Information for All Providers ? Managed Care Information

Table of Contents

PREPAID CAPITATION PLANS (PCP) ....................................... 2 COUNTY/DISTRICT CODES........................................................ 7

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Information for All Providers ? Managed Care Information

Prepaid Capitation Plans (PCP)

Key:

Plan Type Abbreviation Partial LTC LTC Pace Medicaid Adv Plus

FHP SNP Mainstream Medicaid Advantage FIDA FIDA IDD

HARP

description Long Term Care: Partial Capitation Long Term Care: PACE

Medicaid/Medicare Advantage Plus

Model Contract Link pitation_model.pdf

el_contract.pdf adv_plus_model_contract.pdf

Family Health Plus

Special Needs Plan

Medical Assistance

Medicaid/Medicare Advantage Fully Integrated Duals Advantage Plan Fully Integrated Duals Advantage Plan ? Intellectual and Developmental Disabilities Health and Recovery Plan

_care_fhp_hiv-snp_model_contract.pdf _care_fhp_hiv-snp_model_contract.pdf _care_fhp_hiv-snp_model_contract.pdf advantage_model_contract.pdf _contract_generic.pdf gement/FIDA_IDD

_care_fhp_hiv-snp_model_contract.pdf

Plan Code 82 92 AA AC

AF AG

AH

AP

C2 C7

CC

CD CG CH

Plan ID# 00477156 00894519 04004537 03114514

04342307 03481927

03458546

03466800

01249265 01234037

03320725

04342316 01183013 03072740

PCP Provider Name Affinity Health Plan, Inc. Metroplus Health Plan, Inc. Healthplus HP LLC Catholic MLTC - ArchCare Senior Life

Affinity Health Plan ? Enriched Plan AgeWell New York, LLC

Aetna Better Health

Archcare-Catholic Managed LTCS MLTC HealthNow NY, Inc. (Community Blue) CenterLight HealthCare

Complete Senior Care

Capital District Physician's Health Plan Capital District Physician's Health Plan

Catholic Health Life PACE

Telephone Number (800) 553-8247 (800) 597-3380 (800) 454-3730 (866) 263-9083 TTY (800) 662-1220

(800) 553-8247 (866) 586-8044 TTY (800) 662-1200

(855) 456-9126 TTY (711)

(866) 467-9351 TTY (711)

(716) 887-6900 (877) 226-8500 TTY (800) 650-2774

(888)303-4333 TTY (716) 285-8248

(518) 641-3500 (800) 926-7626 (855) 671-3341 TTY (716) 819-5084

Plan Type Mainstream Mainstream HARP LTC Pace

HARP Partial LTC

Partial LTC

Partial LTC

Mainstream LTC Pace

LTC Pace

HARP Mainstream LTC Pace

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Plan Code Plan ID# PCP Provider Name

CP

03506989 Centers Plan for Healthy Living

CM

05357520 Centers Plan for Medicaid Advantage

Plus

CR

04131540 Crystal Run Healthcare LLC

E7

01674982 Senior Care Connection (the Eddy)

EC

03549135 Extended MLTC LLC

ED

03253707 Elderplan, Inc dba Homefirst

EE

04342343 Excellus ? Blue Option Plus - HARP

EG

03690851 KALOS Health

EH

03234044 River Spring at Home (Elderserve)

FH

03870064 FIDA Care Complete

FI

03864784 Elderplan FIDA Total Care

FJ

03864500 RiverSpring FIDA Plan

FM

03878457 Healthfirst AbsoluteCare FIDA Plan

FW

03885696 VNSNY Choice FIDA Complete

FY

03866988 SWH Whole Health FIDA

FZ

04190745 Fallon Health Weinberg PACE

GD

01788325 Fidelis Care at Home

H1

02104369 Senior Health Partners, Inc.

HC

03522947 Hamaspik Choice

HF HI HT,98,99

04003696 04082293 00313979

Healthfirst PHSP Person Wellness Plan HIP of Greater NY HIP of Greater NY

Telephone Number

(855) 270-1600 TTY (800) 421-1220

(833)-274-5627 TTY: 1800 421 1220

(844) 638-6506 (855) 376-7888 TTY (800) 662-1220

(866) 389-2656 (855) 899-6492

(866) 389-2656 TTY (800) 662-1220

(800) 894-2464 TTY (800) 662-1220

(800) 370-3600 TTY (866) 236-5800

(800) 466-2745 TTY (800) 421-1220 (855) 462-3167 TTY (711) (800) 950-9000 TTY (866) 236-5800 (855) 675-7630 TTY (711)

(866) 783-1444 TTY (711)

(844) 861-3432 (855) 665-1113 (TTY 711)

(888) 343-3547 TTY (800) 695-8544

(866) 585-9280 TTY (800) 662-1220

(855) 552-4642 TTY (877) 544-6220

(866) 463-6743

(646) 447-5000

(646) 447-5000

Plan Type Partial LTC

Medicaid Adv Plus Mainstream LTC Pace

Partial LTC

Partial LTC

HARP Partial LTC

Partial LTC

FIDA FIDA FIDA FIDA

FIDA

FIDA LTC PACE

Partial LTC

Partial LTC

Partial LTC

HARP HARP Mainstream

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Plan Code HW HY IC

IE IH

IL

IS

IT

KP KX

M3

MA

MF

MH

MO MP

MR MT MV MZ

N6

NA

NC OD OM OZ

Plan ID# 01131584 01202822 03866960

PCP Provider Name HIP Westchester HIP Nassau iCircle Service of the Finger Lakes

01208997 04342325

01278899

01519162

Independent Health Association

Independent Health's MediSource Connect - HARP Elder One (Independent Living for Seniors) PACE CNY (Loretto HMO)

03475427 Integra MLTC, Inc

01617894 02644562

01825947

Healthplus HP, LLC

Amerigroup Community Connections (Empire BC/BS Amerigroup Health Plus) Evercare Choice, Inc. (Elant Choice)

04342334 MVP Harmonious Health Care Plan HARP

03594052 Montefiore HMO

03420808

01403176 03466906

HealthFirst Complete Care (Managed Health, Inc. MAP) United HealthCare of NY, Inc.

MetroPlus MLTC

00477023 04053201 01111375

01778523

Excellus Metroplus Health Plan Inc. MVP, Inc.

Senior Network Health, LLC

02188296 04122776 04004486

Total Aging in Place (Fallon Health Weinberg) Niagara Advantage Health Plan LLC (d/b/a Elderwood) NYS Catholic Health Plan - Fidelis

02191582 02191362 01659989

Amida Care Inc., (VidaCare, Inc., SN) Metroplus Partnership Care SN YourCare Health Plan, LLC (Buffalo Comm Health Plan)

Telephone Number (646) 447-5000 (646) 447-5000 (844) 424-7253 TTY (711) (800) 736-5771

(855) 457-4636 TTY (800) 662-1220 (888) 728-7223 TTY (800) 662-1220 (855) 661-0002 TTY (711) (800) 454-3730 (866) 805-4589 TTY (800) 855-2880

(877) 255-3678 (845) 569-2228

(855) 556-6683 TTY (711) (888) 260-1010 TTY (888) 542-3821 (877) 842-3210 (855) 355-6582 TTY (800) 881-2812 (800) 920-8889 (800) 597-3380 (800) 684-9286

(888) 355-4764 TTY (800) 662-1220 (716) 250-3100 (866) 882-8185 (866) 843-7526 TTY (711) (800) 749-0820

(646) 786-1800 (800) 303-9626 (800)-683-3781

Plan Type Mainstream Mainstream Partial LTC

Mainstream HARP

LTC Pace

LTC Pace

Partial LTC

Mainstream Partial LTC

Partial LTC

HARP

Partial LTC

Medicaid Adv Plus Mainstream Partial LTC

Mainstream HARP Mainstream Partial LTC

Partial LTC

Partial LTC

HARP SNP SNP Mainstream

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