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Preferred Care Option

You’re Covered

Usted Tiene Cobertura

Preferred Care Option is a special health plan for Medicaid-eligible New Yorkers.  You can get regular check-ups, go to the hospital, and get other important benefits—at no cost to you.

Family Health Plus from Preferred Care provides free comprehensive coverage for eligible adults- including check-ups, hospital visits and prescriptions.  This plan is for singles, couples without children, and parents ages 19-64 who do not have health insurance (either on their own or through their employer), but who have incomes too high to qualify for Medicaid.  You must be a New York State resident and U.S. citizen (or fall under certain immigration categories).  Call us for details.

(Medicaid and Family Health Plus are New York State government-sponsored health programs.)

 

What will I receive once I enroll?

  • An ID card with your doctor’s name and telephone number on it
  • No limit on needed doctor visits
  • 24-hour medical coverage
  • A toll-free 24-hour hotline
  • Preferred Care people who speak your language- English, Spanish, and more
  • Free HealthyYousm classes to help you and your family lead healthier lives (classes on stopping smoking, childbirth and parenting, reducing stress, managing diabetes, and more)

Preferred Care Option covers you with:

Medicaid

Managed Care

Family

Health Plus*

No limit on needed visits to your doctor (Primary Care Physician)

Covered in full

$5 copay

Maternity and baby care

Covered in full

Covered in full

Non-urgent emergency room

Covered in full

$3 copay

Eye exams and eyeglasses

Covered in full

Covered in full

Many specialists to choose from

Covered in full

$5 copay

Lab, X-ray and other tests and treatments

Covered in full

$0.50 - $1 copay per test

Hearing services

Covered in full

Covered in full

Physical, occupational and speech therapy

Covered in full

Covered in full with some visit limits

Care managers to help you live well with ongoing illnesses like diabetes and asthma

Covered in full

Covered in full

Transportation for medical care—depending on what county you live in

Covered in full

Emergency transportation only

HealthyYousm classes and programs to help you get and stay healthy!

Free!

Free!

The Healthy Beginnings program to take care of new moms—includes a WalMart® gift certificate!

Free!

Free!

Family planning and reproductive health services

Covered in full

Covered in full

Prescription drugs, over the counter drugs, and medical supplies (can be filled at any participating Medicaid pharmacy, if your doctor orders them)

Covered through Medicaid

$3 copay for generic
drugs and $6 copay for brand name drugs

HIV testing and counseling—as part of a family planning visit

Covered through Medicaid

Covered in full

Dental services

Covered through Medicaid

No coverage

*Some Family Health Plus members are exempt and do not have to pay these copayments.

Am I eligible to join?

Are you under 65 years old and currently receiving Medicaid?

If you answered yes, you may be eligible for Preferred Care Option. Check with your local Social Services agency to see if you can sign up for Preferred Care Option, including Family Health Plus for adults ages 19 - 64.

How do I enroll in Preferred Care Option or Family Health Plus?

It takes only a few minutes to fill out an application at your Department of Social Services office. Or you can call Preferred Care Member Services Monday – Friday from 7 a.m. – 8 p.m. to enroll by phone.

Call us to learn more about Preferred Care Option and Family Health Plus at:

(585) 327-2470 or (800) 852-7826.
TTY users may call (585) 325-2629 or (800) 252-2452.

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Disclaimer:
This summary of benefits is only an overview of plan provisions. While every effort has been made to ensure that this summary accurately reflects the provisions of each plan, it is the plan contract that governs the operations of individual plans and payment of all benefits. Please check with your company's plan administrator for a more detailed plan description.

 

Last updated: December 13, 2007


Preferred Care Option le cubre con:

  • Ninguna limitación en el número de visitas necesarias al doctor (médico de cabecera)
  • Cuidados de maternidad y bebé
  • Atención de emergencia no urgente
  • Exámenes de la vista y lentes sin coste alguno
  • Muchos especialistas para elegir
  • Laboratorio, radiografías y otros exámenes y tratamientos
  • Servicios para el oído
  • Terapia física, ocupacional y del habla
  • Administradores para el cuidado de la salud para ayudarle a vivir bien con enfermedades permanentes
  • Transporte para el cuidado médico – dependiendo delcondado en el que vive

Si no tiene un doctor, le ayudaremos a encontrarlo.

Además puede recibir servicios de Medicaid, como son:

  • Servicios de planificación familiar y reproducción
  • Medicamentos con receta, medicamentos sin receta y suministros médicos (pueden obtenerse en cualquier Farmacia que participe en el plan Medicaid, si su doctor los receta)
  • Pruebas y asesoramiento de VIH (HIV en inglés) – como parte de una visita de planificación familiar
  • Servicios dentales

¿Soy elegible para inscribirme?

¿Recibe Medicaid actualmente o sus ingresos están justo por encima del límite para poder recibir Medicaid?

Si contestó que sí, usted puede tener derecho a recibir Preferred Care Option. Verifique con su agencia local de servicios sociales para ver si puede inscribirse a Preferred Care Option, incluyendo Family Health Plus para adultos con edades comprendidas entre los 19 y los 64 años.

¿Cómo me inscribo a Preferred Care Option o Family Health Plus?

Rellenar la solicitud en la oficina del Departamento de Servicios Sociales sólo lleva unos minutos. O, si ya tiene Medicaid, puede llamar a Servicios para Miembros de Preferred Care de lunes a viernes de 7 a.m. a 8 p.m. para inscribirse por teléfono.

Llámenos al (585) 327-2470 o al (800) 852-7826.

Si utiliza equipo auditivo (TTY) puede llamar al (585) 325-2629 o al (800) 662-1220.

¿Qué recibiré una vez inscrito?

•   Una tarjeta de identificación con el nombre de su doctor y su número de   teléfono

• Visitas necesarias ilimitadas al doctor

• Cobertura médica las 24 horas

• Una línea para llamadas gratis las 24 horas

• Personal de Preferred Care que habla su idioma – inglés,

español, y más

• Clases de salud HealthyYousm gratis para ayudarle a mejorar su salud y la de su familia de diferentes maneras (dejar de fumar, parto y crianza de hijos, reducción de estrés, control de diabetes, y más)

 

Llámenos para averiguar más sobre Preferred Care Option:

(585) 327-2470

(800) 852-7826 (llamada gratis)

(585) 325-2629 (TTY)

(800) 662-1220 (llamada TTY gratis)

¡O llame a su agencia local de servicios sociales para ver si puede inscribirse a Preferred Care Option!

(De nuevo a tapa)

 

Disclaimer:
This summary of benefits is only an overview of plan provisions. While every effort has been made to ensure that this summary accurately reflects the provisions of each plan, it is the plan contract that governs the operations of individual plans and payment of all benefits. Please check with your company's plan administrator for a more detailed plan description.

Last Updated: December 13, 2007


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