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
Version 2019-2
June 25, 2019
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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
Version 2019-2
June 25, 2019
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Information for All Providers ? Managed Care Information
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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June 25, 2019
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Information for All Providers ? Managed Care Information
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
Version 2019-2
June 25, 2019
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