Medicaid is an essential health coverage program that provides benefits to millions of eligible Americans, including low-income adults, individuals with disabilities, pregnant women, children, and senior citizens. Read on for more details about health care services that are covered by Medicaid and the application process for Onondaga County residents.
How Do I Apply For Medicaid in Onondaga County?
There are several different ways to apply for Medicaid in Onondaga County.
New York State Department of Health Marketplace
The following individuals must apply for Medicaid through the New York State Department of Health Plan Marketplace:
- People under the age of 65 who are not disabled are not eligible for Medicare
- Pregnant women
- Children under the age of 18
- Parents and caretaker relatives of individuals eligible for Medicaid.
Medicaid applications through the New York State Marketplace should be submitted online.
If you need additional information or require help with your application, you can call the Marketplace at (855) 355-5777 or TTY: (800) 662-1220 for the hearing impaired. The office hours are Monday – Friday 8 am – 8 pm, Saturday 9 am – 1 pm.
The Marketplace provides services of Navigators and Certified Application Counselors (CAS) who will assist you in the application process at no cost. You can find an assistor in Onondaga County through the Marketplace Navigator Directory. The Marketplace assistors are culture sensitive and offer help in several different languages at convenient times, including evenings and weekends.
Local Department of Social Services
If you belong to one of the following categories, you are required to apply to Medicaid through the Onondaga County Department of Social Services (DSS):
- Individuals age 65 and above who are not parents or caretaker relatives of individuals eligible for Medicaid, when age is a condition of eligibility
- Individuals whose Medicaid eligibility is based on being blind or disabled or who request coverage for Community Based Long Term Care Services (CBLTC)
- Medicare Savings Program (MSP) beneficiaries
- Medicaid Buy-In For Working People With Disabilities enrollees (MBI-WPD)
- Residential treatment center/community residences operated by the Office of Mental Health (OMH)
- Women who fall under the Medicaid eligibility category of Presumptive Eligibility (PE) for Pregnant Women.
Address:
Onondaga County Department of Social Services
421 Montgomery Street
Syracuse, NY 13202
Phone: (315) 435-3525
Office hours: Monday – Friday 8 am – 4 pm
The office is fully accessible for people with disabilities.
Website: www.ongov.net/dss
Prenatal Care Medicaid Coverage Application Centers
Medicaid in Onondaga County offers selective coverage for prenatal care. To apply, visit or call one of the locations below:
St. Joseph’s Hospital Health Care
301 Prospect Ave.
Syracuse, NY 13203
Phone: (315) 448-5060
SUNY Upstate Medical University
90 Presidential Plaza
Syracuse, NY 13202
Phone: (315) 464-5677
Syracuse Community Health Center
819 S. Salina St.
Syracuse, NY 13202
Phone: (315) 476-7921
UHCC Women’s Health Care Service
90 Presidential Plz Ste 3121
Syracuse NY, 13202
Phone: (315) 464-5210
Managed Care Organization (MCO)
Managed care is a health care delivery system where Medicaid contracts with Managed Care Organizations (MCOs) to deliver its services to beneficiaries, allowing the state to reduce Medicaid program costs.
It is possible to apply for Medicaid directly through a managed care organization. For more information about Medicaid managed care programs and Medicaid enrollment, call New York Medicaid CHOICE enrollment program at (585) 753-6702 or (800) 505-5678.
Required documentation
When applying for Medicaid in Onondaga County, you will be asked to present relevant documentation showing proof of your eligibility, such as:
- Birth certificates for all applicants
- Social Security Card for all applicants
- Proof of citizenship (birth certificate, naturalization certificate, passport)
- Verification of income, including wages, Social Security, pensions, veteran’s benefits, and interest or dividends
- Verification of resources, including bank accounts, trust funds, insurance, burial accounts, vehicles, and property
- Veteran Discharge papers, where applicable
- Medicare and other health insurance cards. If you already have health insurance, you are not required to cancel it before applying for Medicaid. Medicaid may pay the premiums on your existing policy if you qualify, although your eligibility will depend on several different factors
The enrollment for Medicaid is open throughout the year.
What Services Does Medicaid Provide for Residents in Onondaga County?
Medicaid provides full coverage of common medical expenses for eligible individuals. In the State of New York, the program also covers a number of additional support services that may not be available in other states.
Mandatory Medicaid benefits
The mandatory Medicaid benefits are common for all states and include:
- Regular medical checkups and follow-up care
- Laboratory tests and X-ray services
- Medicine, medical supplies, and medical equipment such as wheelchairs, canes, and crutches
- Immunizations
- Drug prescriptions for the cheapest drug options
- Smoking cessation agents
- Emergency care
- Hospital inpatient and outpatient services
- Family planning (birth control) services
- Prenatal care
- Early periodic screening, diagnosis, and treatment for children
- Treatment in psychiatric hospitals, mental health facilities, and facilities for the mentally retarded or the developmentally disabled.
Additional New York Medicaid services in Onondaga County
New York Medicaid offers a wide range of additional health services to its residents, for example:
- Essential dental, auditory, and vision care including eye exams, medically necessary eyeglasses, and contact lenses. The cost of appointments and Medicaid plan-approved medications are covered so long as you visit a Medicaid-approved medical provider.
- Long-term care coverage for eligible individuals residing in a nursing home or long-term care facility. The long-term health care services and costs covered by Medicaid include adult day care, housekeeping, physical therapy, Personal Emergency Response Systems (PERS), and transportation.
- Home care services, which are a more affordable and accessible alternative to traditional long-term care facilities like nursing homes. Home care services covered by Medicaid in Onondaga County include caregiver fees, home safety modifications, housekeeping, personal care assistance, as well as transportation.
- Nutrition services including nutrition counseling, dietician fees, and the development of a personalized health and nutrition plan.
- Eligible children and teenagers can receive Medicaid coverage through the Children’s Medicaid program that covers most medical costs, including doctor’s visits, dentist appointments, pediatric care, speech therapy, and emergency care.
CDPAP Eligibility in Onondaga County
The Consumer Directed Personal Assistance Program (CDPAP) is available to Medicaid recipients residing in Onondaga County. This program allows elderly, disabled, and chronically ill individuals to designate a family member, a friend, or a neighbor as their caretakers to assist them with tasks of daily living and/or skilled nursing care. The CDPAP program gives Onondaga residents the freedom of receiving necessary care in the comfort of their homes with the people they know well instead of having to be placed in an assisted living facility.
Medical transportation
New York Medicaid covers both emergency and non-emergency medical transportation to and from medical care and services for Onondaga County residents. Emergency transport services are covered by Medicaid in New York State regardless of the ambulance transport provider. This includes anything from public transportation to personal vehicles, taxis, wheelchair vans, and ambulances.
However, you will need to receive the approval of the Department of Social Services to ensure that the mode of transportation is appropriate to your medical needs and that you are using the least costly appropriate transportation method.
In Onondaga County, there are several transportation services that offer transport by taxi, bus, ambulatory vehicle, or ambulance:
Highland Patient Transportation
Phone: (315) 254-6287
Band Aid Personal Care Transportation Service
Phone: (315) 863-6938
Email: bandaid609@yahoo.com
ACR Health Medical Transportation
Phone: (315) 475-2430
Jordan-Elbridge Transportation Program (JET)
Phone: (315) 604-1322
St. Camillus Medical Transportation Services
Phone: (315) 703-0752
Alternatively, you can contact Medical Answering Services (MAS) by calling (585) 288-4680 and they will arrange transport with one of the medical transportation companies. Please note that these providers can offer only non-emergency transportation. For emergency medical transportation, call 911.
Location of the Medicaid Office in Onondaga County
The management and administration center for the Medicaid program in Onondaga County is located at the following address:
Onondaga County Department of Social Services
421 Montgomery St.
Syracuse, NY 13202
Phone: (315) 435-3525
Office hours: Monday-Friday 8 am – 4 pm
You may want to contact the Medicaid office in person in one of the following cases:
- You have questions regarding your Medicaid eligibility
- You need assistance to fill out your Medicaid application form
- You wish to renew your Medicaid enrollment
- You were denied Medicaid benefits
- You need to show proof that you are enrolled in Medicaid.
Before visiting the office, you should call and schedule an appointment. Make sure to bring all the necessary documentation to prove that you meet the requirements to enroll in Medicaid.
If you’re not certain whether you qualify for Medicaid or not, you can schedule an interview with an Onondaga County DSS representative who will help you determine your eligibility and answer any questions you might have.
General inquiries about Medicaid
If you have any general, non state-related questions about Medicaid or if you wish to provide feedback about the program or report fraud, contact the Center for Medicare and Medicaid Services in Baltimore, Maryland.
Phone: (877) 267-2323
Email: medicaid.gov@cms.hhs.gov
Website: www.medicaid.gov