Medicaid is a program for low-income New Yorkers who are not able to afford medical care. Medicaid in New York State covers a wide range of health care services, from doctor visits to dental care and medical transportation. Here’s all you need to know about the Medicaid benefits you may be eligible for if you live in Nassau County.
How Do I Apply for Medicaid in Nassau County?
There are a few different ways to apply for Medicaid in Nassau County, depending on your age, family situation, disabilities, whether you are pregnant, a parent, or caretaker relative with dependent children.
As a general rule, most people under the age of 65 should apply through the New York State of Health Marketplace, whereas anyone over 65 must contact their Local Department of Social Services.
Read on for more details about the different options.
The New York State of Health Marketplace
The NY State of Health Marketplace was created by the Affordable Care Act to offer individuals and families in New York affordable private and public health insurance.
People belonging to one of the categories below have to apply for Medicaid through the Marketplace:
- Children under the age of 18
- Pregnant women
- Adults under the age of 65
- Disabled adults who are not eligible for Medicare
- Parents and caretaker relatives.
To apply at the Marketplace, call (855) 355-5777 (office hours: Monday – Friday 8 am – 8 pm, Saturday 9 am – 1 pm). The enrollment for Medicaid is open throughout the year.
The Marketplace provides services of Navigators and Certified Application Counselors (CAS) who will assist you in your application process free of charge. You can find an assistor through the Marketplace Navigator Directory.
Local Department of Social Services (LDSS)
The following individuals have to apply for Medicaid through the Nassau County Department of Social Services:
- People aged 65 and older who are not parents or caretaker relatives
- Anyone whose eligibility is based on being blind or disabled
- Individuals who request coverage for Community-Based Long Term care (CBLTC) services, including people with an immediate need for Personal Care Services (PCS) or Consumer Directed Personal Assistance Services (CDPAS)
- Medicare Savings Program enrollees
- Beneficiaries of Medicaid Buy-In for Working People with Disabilities (MBI-WPD)
- Nursing home residents and anyone living in residential treatment center/community residences operated by the Office of Mental Health (OMH)
- Former foster care youth.
Nassau County Department of Social Services
60 Charles Lindbergh Boulevard
Uniondale, NY 11553-3656
Phone: (516) 227-8519 (general information) or (516) 573-8626 (after-hours services).
Hours: Monday – Friday from 8:00 am – 4:00 pm.
Managed Care Organization (MCO)
Managed care is a health care delivery system where Medicaid contracts with various types of Managed Care Organizations (MCOs) to deliver its services to beneficiaries, thus allowing the state to reduce Medicaid program costs.
MCOs in Nassau County include:
- Affinity Health Plan
- Empire HealthChoice HMO
- Health Insurance Plan of Greater New York
- Healthfirst, HealthPlus HP
- New York Quality Healthcare Corporation
- UnitedHealthcare of New York
- WellCare of New York.
You can apply for Medicaid directly through Nassau County managed care organizations. To obtain enrollment forms you can:
- Visit the Nassau County Department of Social Services center in Uniondale (see the address above)
- Call the Nassau County DSS Medicaid at (516) 227-8000
- Call New York Medicaid Choice at (800) 505-5678
- Contact your health plan marketing representative.
How to download the Medicaid application form
You can download the Medicaid application form, including the complete list of required documentation and instructions, from the website of the NYS Department of Health.
Where to get help to apply for Medicaid
Applying for Medicaid can be an overwhelming task. If you want to make sure your application is done correctly and avoid delaying your benefits, it is a good idea to seek expert guidance.
Several assistance options are available for applicants:
- Call Medicaid helpline at (800) 541-2831
- Call New York State Health Department’s Growing Up Healthy Hotline at (800) 522-5006
- Call Nassau County Department of Social Services at (516) 227-8519
- If you are applying through the NY State of Health Marketplace, you are eligible to obtain free in-person help.
- If you are 65 and over and/or living with a disability or blindness, you can get free help through NYC’s Facilitated Enrollment for the Aged, Blind and Disabled Program (FE-ABD). You can contact them by phone at (800) 544 8269 or email at email@example.com.
- If you have questions about individual SSI claims, call the Social Security Administration at (800) 772-1213 or visit the Social Security website for additional information.
- You may also want to seek help from a lawyer when applying for Medicaid. There are many law firms in Nassau County practicing Medicaid and Medicare law that may be able to help you.
Will I need to cancel my insurance before applying for Medicaid?
You can keep your health insurance while you’re applying for Medicaid. Medicaid may pay the premiums on your existing policy if you qualify, although this will vary depending on a number of different factors.
What Services Does Medicaid Provide For Residents in Nassau County?
Medicaid is a federal program administered by each individual state. This means that the State of New York determines what benefits you are offered by Medicaid if you live in Nassau County.
Medicaid provides a wide range of health services for New York State residents, including:
- Doctor and clinic visits for regular medical checkups and follow-up care
- Medicine, medical supplies, and medical equipment (wheelchairs, crutches, canes, etc.)
- Drug prescriptions, where health care providers are required to select the cheapest option of the drugs they prescribe
- Certain over-the-counter medications
- Smoking cessation agents
- Laboratory tests and X-ray services
- Emergency care
- Hospital inpatient and outpatient services
- Treatment in psychiatric hospitals, mental health facilities, and facilities for the mentally retarded or the developmentally disabled for patients who are younger than 21 or older than 65
- Family planning services
- Prenatal care
- Early periodic screening, diagnosis, and treatment for children under the age of 21.
Besides the above mentioned benefits that are required for all states, New York Medicaid also offers a number of additional services to its residents, for example:
- Essential dental services
- Vision benefits including eye exams reimbursed every two years, medically necessary eyeglasses, and contact lenses
- Custodial care or assistance with activities of daily living in a nursing facility
- Care through home health agencies and personal care
- Medicaid in New York also offers the Consumer Directed Personal Assistance Program (CDPAP) where assistance for homecare is provided by the patient’s friends or family members. To benefit from this service requires a nursing assessment.
New York Medicaid covers all forms of emergency and non-emergency medical transportation, such as:
- Transportation to and from emergency medical care and services, for example, emergency ambulance transportation to a hospital
- Transportation to and from Medicaid billable non-emergency medical care or services using public transportation, personal vehicles, taxis, wheelchair vans, and ambulances.
Note that in non-emergency situations, the approval of the Department of Social Services is required to ensure that the mode of transportation is appropriate to the medical needs of the patient and that the least costly appropriate transportation is used.
Non-emergency medical transportation in Nassau County is managed by ModivCare. As a Medicaid enrollee, you can schedule a ride by calling (844) 678-1103 Monday-Friday 7 am – 6 pm. You will need to contact them at least 72 hours in advance. For emergency transportation, call 911.
Health services that are not covered by Medicaid in New York include most over-the-counter medications, missed appointments, cosmetic surgery, and medical treatments that are provided outside of the US.
Supplemental Security Income (SSI) and Medicaid
In the state of New York, all Supplemental Security Income recipients are automatically eligible to receive Medicaid.
Location of Medicaid Offices in Nassau County
There are various reasons you may want to visit your local Medicaid office, for instance:
- You have questions regarding your Medicaid eligibility
- You need assistance filing your Medicaid application form
- You would like to apply for Medicaid in person
- You were denied Medicaid benefits
- You want to renew your enrollment
- You need proof that you are enrolled in Medicaid.
To visit the Medicaid office and speak to a program representative, you should call and schedule an appointment in advance. Make sure to bring the necessary documentation to prove that you meet the requirements to enroll, such as:
- Proof of citizenship (passport, immigration records)
- Proof of residency (copy of lease, utility bills)
- Proof of income (tax return documents, pay stubs, Social Security documents).
The Nassau County New York Medicaid has its office in Mineola.
The office address is:
Nassau County New York Medicaid Office
1550 Franklin Ave
Mineola, NY 11501
Phone: (516) 227-8000
If you have any general, non state-related Medicaid questions or you wish to give program feedback or report fraud, you can contact the Center for Medicare and Medicaid Services in Baltimore, Maryland.