Eligibility Requirements

In order to enroll in Centers Plan for Medicaid Advantage Plus (HMO D-SNP), you must:

1. Have full benefit Medicaid coverage;
2. Have Medicare Part A and B coverage or be enrolled in Medicare Part C;
3. Live in Bronx, Erie*, Kings, Nassau, Niagara*, New York (Manhattan), Queens, Richmond, Rockland, Suffolk*, or Westchester*.
4. You are a United States citizen or are lawfully present in the United States;
5. Be 18 or older;
6. Be eligible for nursing home level of care (as of the time of enrollment);
7. Be capable, at the time of enrollment, of returning to or remaining in your home and community without jeopardy to your health and safety (that is, you must be able to return to, or remain in, your home and community safely); and
8. Be expected to require at least one (1) of the following Community Based Long-Term Care Services (CBLTCS) covered by Centers Plan for Medicaid Advantage Plus for more than 120 days from the effective date of your enrollment:
• nursing services in the home;
• therapies in the home;
• home health aide services;
• personal care services in the home;
• adult day health care;
• private duty nursing; or
• Consumer Directed Personal Assistance Services (CDPAS)

*Coming Soon

Plan Benefit Highlights

Combine all your coverage into one convenient plan with Centers Plan for Medicaid Advantage Plus (also known as the MAP plan)!

Centers Plan for Medicaid Advantage Plus combines your Medicare (including prescription drug coverage) and Long-Term Care coverage into one convenient plan; and there is no monthly premium because your premiums are paid by Medicaid. 

Centers Plan for Medicaid Advantage Plus (HMO D-SNP) includes many benefits, such as:

• $0 copay for Primary Care Physician (PCP) visits
• $0 copay for specialist visits
• $290 monthly benefit is a combined (i.e., OTC and SSBCI benefits) monthly  allowance which can also be used towards your groceries and utilities benefit (if you qualify). This means that there is only one monthly allowance of $290 for all three benefits. If you do not qualify for the SSBCI benefit, the $290 monthly allowance can only be used on covered OTC items. Unused amounts cannot be carried over from month to month. The grocery and utilities benefit mentioned in this document is a Special Supplemental Benefit for the Chronically Ill (SSBCI), and not all members will qualify.
• $0 copay for covered Dental services
• $0 copay for Vision and Hearing services.
• $0 copay for Long Term Support Services (LTSS) such as:
  • • Personal Care Services in the Home
    • Adult Day Health Care
    • Social and Environmental Support, and
    • Home Health Care services.

This information is available for free in other languages. Please call member services at 1-833-274-5627; TTY users please call 711, from 8:00 AM to 8:00 PM seven days a week.

Esta información puede estar disponible en diferentes idiomas o formatos. Favor de llamar al 1-877-940-9330 (TTY 711) de 8:00 a.m. a 8:00 p.m., 7 días a la semana. Si necesita obtener información en otro formato o idioma, comuníquese con el Servicio de Atención al Cliente al número mencionado anteriormente.

Medicare Disclaimers

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