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Information for All Providers – Managed Care InformationNEW YORK STATEMEDICAID PROGRAMINFORMATION FOR ALL PROVIDERSMANAGED CARE INFORMATION
Information for All Providers – Managed Care InformationTable of ContentsPREPAID CAPITATION PLANS (PCP) . 3COUNTY/DISTRICT CODES. 7Version 2021-1March 8, 2021Page 2 of 7
Information for All Providers – Managed Care InformationPrepaid Capitation Plans (PCP)Key:Plan Type AbbreviationPartial LTCLTC PaceMedicaid Adv PlusFHPSNPMainstreamMedicaid AdvantageFIDA IDDHARPdescriptionLong Term Care: Partial CapitationModel Contract Linkhttp://www.health.ny.gov/health care/medicaid/redesign/docs/mrt90 partial capitation model.pdfLong Term Care: PACEhttp://www.health.ny.gov/health care/medicaid/redesign/docs/mrt90 pace model contract.pdfLong Term Care: Medicaid Advantagehttp://www.health.ny.gov/health care/medicaid/redesign/docs/mrt90 mePlusdicaid adv plus model contract.pdfFamily Health Plushttp://www.health.ny.gov/health care/managed care/docs/medicaid managed care fhp hiv-snp model contract.pdfSpecial Needs Planhttp://www.health.ny.gov/health care/managed care/docs/medicaid managed care fhp hiv-snp model contract.pdfMedical Assistancehttp://www.health.ny.gov/health care/managed care/docs/medicaid managed care fhp hiv-snp model contract.pdfMedicaid Advantagehttp://www.health.ny.gov/health care/medicaid/redesign/docs/mrt90 medicaid advantage model contract.pdfFully Integrated Duals Advantage Plan – https://opwdd.ny.gov/opwdd services supports/people first waiver/careIntellectual and Developmental Disabilities management/FIDA IDDHealth and Recovery Planhttp://www.health.ny.gov/health care/managed care/docs/medicaid managed care fhp hiv-snp model contract.pdfPlan Code8292AAACPlan ID#00477156008945190400453703114514PCP Provider NameAffinity Health Plan, Inc.Metroplus Health Plan, Inc.Healthplus HP LLCCatholic MLTC - ArchCare Senior LifeTelephone Number(800) 553-8247(800) 597-3380(800) 454-3730(866) 263-9083TTY (800) 662-1220Plan TypeMainstreamMainstreamHARPLTC PaceAFAG0434230703481927Affinity Health Plan – Enriched PlanAgeWell New York, LLC(800) 553-8247(866) 586-8044TTY (800) 662-1200HARPPartial LTCAH03458546Aetna Better Health(855) 456-9126TTY (711)Partial LTCAP03466800Archcare-Catholic Managed LTCSMLTC(866) 467-9351TTY (711)Partial LTCAZ05572692AgeWell NY LLC MAP(866)237-3210TTY (800) 662-1200Medicaid AdvPlusC2C70124926501234037HealthNow NY, Inc. (Community Blue)CenterLight HealthCare(716) 887-6900(877) 226-8500TTY (800) 650-2774MainstreamLTC PaceCC03320725Complete Senior Care(888)303-4333TTY (716) 285-8248LTC PaceCDCG0434231601183013Capital District Physician’s Health PlanCapital District Physician’s Health PlanVersion 2021-1March 8, 2021(518) 641-3500(800) 926-7626HARPMainstreamPage 3 of 7
Information for All Providers – Managed Care InformationPlan CodePlan ID#PCP Provider NameTelephone NumberPlan TypeCH03072740Catholic Health Life PACE(855) 671-3341TTY (716) 819-5084LTC PaceCP03506989Centers Plan for Healthy Living(855) 270-1600TTY (800) 421-1220Partial LTCCM05357520Centers Plan for Medicaid AdvantagePlus(833)-274-5627TTY: 1800 421 1220Medicaid AdvPlusEA05410146Elderserve Health MAP, INCE701674982Senior Care Connection (the Eddy)1-800-580-7000TTY/TDD: 711(855) 376-7888TTY (800) 662-1220Medicaid AdvPlusLTC PaceEC03549135Extended MLTC LLC(866) 389-2656(855) 899-6492Partial LTCED03253707Elderplan, Inc dba Homefirst(866) 389-2656TTY (800) 662-1220Partial LTCEEEG0434234303690851Excellus – Blue Option Plus - HARPKALOS HealthEH03234044RiverSpring at Home (Elderserve)(800) 370-3600TTY (866) 236-5800Partial LTCFZ04190745Fallon Health Weinberg PACE(855) 665-1113(TTY 711)LTC PACEGD01788325Fidelis Care at Home(888) 343-3547TTY (800) 695-8544Partial LTCHA06259723Hamaspik MAP INCMedicaid AdvPlusH102104369Senior Health Partners, Inc.(855) 552-4642TTY/TDD: (855) 8544030(866) 585-9280TTY (800) 662-1220HC03522947Hamaspik Choice(855) 552-4642TTY (877) 544-6220Partial LTCHF04003696Healthfirst PHSP Person Wellness Plan(866) 463-6743HARPHI04082293HIP of Greater NY(646) 447-5000HARPHT,98,9900313979HIP of Greater NY(646) 447-5000MainstreamHW01131584HIP Westchester(646) 447-5000MainstreamHY01202822HIP Nassau(646) 447-5000MainstreamIC03866960iCircle Service of the Finger LakesPartial LTCIE01208997Independent Health Association(844) 424-7253TTY (711)(800) 736-5771Version 2021-1March 8, 2021(800) 894-2464TTY (800) 662-1220HARPPartial LTCPartial LTCMainstreamPage 4 of 7
Information for All Providers – Managed Care InformationPlan CodeIHPlan ID#04342325Telephone NumberPlan TypeHARP(855) 457-4636TTY (800) 662-1220(877) 388-5195LTC Pace05922454PCP Provider NameIndependent Health’s MediSourceConnect - HARPElder One (Independent Living forSeniors)Integra MAPIL01278899IPIS01519162PACE CNY (Loretto HMO)IT03475427Integra MLTC, IncKPKX0161789402644562M301825947Healthplus HP, LLCAmerigroup Community Connections(Empire BC/BS Amerigroup HealthPlus)Evercare Choice, Inc. (Elant Choice)(888) 728-7223TTY (800) 662-1220(855) 661-0002TTY (711)(800) 454-3730(866) 805-4589TTY (800) 03466906HealthFirst Complete Care (ManagedHealth, Inc. MAP)United HealthCare of NY, Inc.MetroPlus s Health Plan Inc.MVP, Inc.MZ01778523Senior Network Health, LLCN602188296NA04122776NC04004486Total Aging in Place (Fallon HealthWeinberg)Niagara Advantage Health Plan LLC(d/b/a 413Amida Care Inc., (VidaCare, Inc., SN)Metroplus Partnership Care SNPrime Health ChoicePO04099212Partners Health Plan – FIDA IDDSFSPSP014796700142125001751046HealthFirst PHSP, Inc.Fidelis Care New YorkFidelis Care New YorkVersion 2021-1MVP Harmonious Health Care Plan HARPMontefiore HMOMarch 8, 2021Medicaid AdvPlusLTC PacePartial LTCMainstreamPartial LTC(877) 255-3678 (845)569-2228Partial LTC(855) 556-6683TTY (711)(888) 260-1010TTY (888) 542-3821(877) 842-3210(855) 355-6582TTY (800) 881-2812(800) 920-8889(800) 597-3380(800) 684-9286Partial LTC(888) 355-4764TTY (800) 662-1220(716) 250-3100 (866)882-8185(866) 843-7526TTY (711)(800) 749-0820Partial LTC(646) 786-1800(800) 303-9626(855) 777-4630TTY (855) 777-4613(855) 747-5483TTY (711)(866) 463-6743(800) 749-0820(800) 749-0820SNPSNPPartial LTCHARPMedicaid AdvPlusMainstreamPartial LTCMainstreamHARPMainstreamPartial LTCPartial LTCHARPFIDA-IDDMainstreamMainstreamMainstreamPage 5 of 7
Information for All Providers – Managed Care InformationPlan CodePlan ID#PCP Provider NameTelephone NumberPlan TypeSW03459881Senior Whole HealthPartial LTCTN04342292Molina Healthcare Plan of NY(877) 353-0185TTY (711)TO03685774(315) 476-7921MainstreamTS03056544Molina Healthcare of New York Inc.(TONY)Total Senior Care Inc.LTC 2248Village Senior Services (Village CareMax)VillageCareMAX Total Advantage PlanVS03420871VNS Choice Select Health SNP(866) 939-8613TTY (800) 662-1220(877) 842-3210(855) 877-8868TTY (711)(888) 867-6555TTY (711)(800) 469-6292TTY (800) 662-1220(800) 469-6292TTY (800) 662-1220(866) 469-7774YD02738989Fidelis Care Dual(718) 896-6500YF02927631Fidelis Care MAPYH02932896Senior Whole Health M/M PlusYL03173113Elderplan MAPYN02914056VNS Choice Plus M/MYO03173080YU03238240Empire Blue Cross Blue ShieldHealthPlus (Amerigroup AdvantagePlus)United Health Care M/M(877) 533-2404TTY (800)558-1125(877) 353-0185TTY (711)(866) 386-9437TTY (800) 662-1220(866) 597-6674TTY 711(866) 805-4589TTY (800) 855/2880MedicaidAdvantageMedicaid AdvPlusMedicaid AdvPlusMedicaid AdvPlusMedicaid AdvPlusMedicaid AdvPlusYW02645710Wellcare of NYM/MVersion 2021-1United Healthcare of New YorkNascentia Health (VNA HomecareOptions)VNS Choice(866) 362-3368(866) 491-5746March 8, 2021HARPHARPPartial LTCPartial LTCPartial LTCMedicaid AdvPlusSNPMedicaidAdvantageMedicaidAdvantagePage 6 of 7
Information for All Providers – Managed Care InformationCounty/District CodesBelow is a listing of all the counties and their corresponding district t. 56Wyoming25Madison57Yates26Monroe66New York City27Montgomery9728NassauOffice of Mental HealthAdministered29Niagara9830OneidaOffice for People withDevelopmental Disabilities31Onondaga99Breast & Cervical CancerTreatment Program32OntarioVersion 2021-1March 8, 2021Page 7 of 7
TN 04342292 Molina Healthcare Plan of NY HARP TO 03685774 Molina Healthcare of New York Inc. (TONY) (315) 476-7921 Mainstream TS 03056544 Total Senior Care Inc. (866) 939-8613 TTY (800) 662-1220 LTC Pace UC 04054091 United Healthcare of New York (877) 842-3210
