MAP Frequently Asked Questions

1. What is Managed Long-Term Care Plan?
2. What is Medicaid Advantage Plus Plan?
3. When will my benefits go into effect?
4. What if I don't have my Centers Plan for Healthy Living member card yet and I need to see my doctor?
5. I have a Medicare ID card, what should I do with it?
6. If I am moving, what should I do?
7. I lost my wallet and my Member ID card and the OTC card were in my wallet, what should I do?
8. What is a Primary Care Physician (PCP)?
9. Can I change my Primary Care Physician?
10. Can I get care from a specialist?
11. Can I get a second opinion?

• What is managed long-term care (MLTC)?
  Managed Long Term Care Plans help provide long-term services and support to people who are chronically ill (i.e. have a long-lasting health problem) or disabled, and who wish to stay in their homes and communities. These services, such as home care or adult day care, are provided through managed long-term care plans that are approved by the New York State Department of Health.

• What is a Medicaid Advantage Plus plan?
  A Medicaid Advantage Plus plan is a coordinated care plan that combines Medicare and Medicaid services and coordinates your long-term care services.  This plan is designed for individuals with Medicare and full Medicaid who need, or are expected to need, more than 120 days of community-based long-term care services. 

• When will my benefits go into effect?
  Generally, your benefits will go into effect the first day of the month immediately following the month you enrolled. For instance, if you join in December, your Centers Plan for Medicaid Advantage Plus (HMO-D-SNP) benefits become effective on January 1.  You can also reach our Member Services and confirm your enrollment effective date by calling 1-833-274-5627, TTY users call 711, seven days a week, from 8 am to 8 pm.

• What if I don’t have my Centers Plan for Healthy Living membership card (i.e. member ID card) yet and I need to see my doctor?
  If you need to see your doctor before your member ID card has arrived, we can help your doctor confirm your effective date of enrollment. Just call Member Services at 1-833-274-5627, or for TTY users call 711, seven days a week, from 8 am to 8 pm, and they will gladly help you.

• I have a Medicare ID card, what should I do with it?
  IT IS VERY IMPORTANT THAT DO NOT USE YOUR MEDICARE CARD. Keep your Medicare card in a safe place, where you can find it.   Once your Centers Plan Medicaid Advantage Plus enrollment becomes effective, all you will need to access your benefits is your new Centers Plan for Medicaid Advantage Plus member ID card. If you did not get your member ID card, need a new Centers Plan for Medicaid Advantage Plus member ID card, or have any questions, please contact Member Services 1-833-274-5627,  TTY users call 711, seven days a week from 8 am to 8 pm, and one of or friendly representatives will help you.

• If I am moving, what should I do?
  Our service area includes the following counties in New York State: Bronx, Kings, Nassau, New York, Queens, Richmond, and Rockland. If you are moving out of the service area you need to contact us and tell us of the details of the move. You can contact the Member Services at 1-833-274-5627, TTY users call 711, seven days a week, from 8 am to 8 pm.

• I lost my wallet and my Member ID card and the OTC card were in my wallet, what should I do?
  Should you either lose or misplace any of your cards, it is important that you call us as soon as possible so that we can update your records and request replacements as soon as possible. Call Member Services at 1-833-274-5627,  TTY users call 711, seven days a week, from 8 am to 8 pm, and one of our friendly representatives will be happy to help you.

• What is a Primary Care Physician (PCP)?
  When you become a member of Centers Plan for Medicaid Advantage Plus, you must select a plan physician (a doctor who participates with Centers Plan for Medicaid Advantage Plus as your PCP. As a Physician, your PCP meets state requirements and is trained to give you basic medical care. For your convenience, your routine healthcare care will be provided by your Primary Care Physician, who will also coordinate the rest of your benefits and services for which you are covered a member of Centers Plan for Medicaid Advantage Plus. Remember, you must get all your Medicare health services from Centers Plan for Medicaid Advantage Plus in-network/participating providers. 

  Your PCP can be a: 

• Internal Medicine Physician;
• Family Practice Physicians;
• General Practice Physician; or
• Sometimes, Obstetrician/Gynecologists (see your Evidence of Coverage for additional information).

If you need to help finding an in-network PCP or other provider, please call Member Services at 1-833-274-5627, or for TTY users 711, seven days a week from 8 am to 8 pm.  You can ask for help finding a provider, or request an updated list.  If you prefer you can search our provider directory on our website at www.centersplan.com/plans.

Can I change my Primary Care Physician?
Yes, you can change your Primary Care Physician to another physician within the Centers Plan for Healthy Living network at any time. You can change your Primary Care Physician by either:

·   Calling Member Services and speaking with one of our friendly representatives at 1-833-274-5627, or for TTY users call 711, seven days a week from 8 am to 8 pm.

·  Or, if it is more convenient for you, you can mail your request for a new PCP to:

Centers Plan for Healthy Living
Member Services
75 Vanderbilt Avenue
Staten Island, NY 10304

Either way, once we process your request, we will send you a new Centers Plan for Medicaid Advantage Plus member ID card.

Can I get care from a specialist?
Yes, you can get care from a specialist. However, you must see a specialist who is in the Centers Plan network. You may also need prior authorization from Centers Plan before receiving certain types of care. When this happens, your PCP will contact Centers Plan and let you know when authorization is given. If you have any questions, or need additional information please call 1-833-274-5627, or for TTY users call 711, seven days a week from 8 am to 8 pm. 

Can I get a second opinion?
You can get a second opinion. However, you must first contact your primary care physician, who will ask Centers Plan to authorize the additional doctor’s visit. You will need to pay any applicable co-payments for a specialist visit when you go for your second opinion.