In anticipation of the auto-assigment of HIV positive beneficiaries in Brooklyn to mainstream plans I asked my sources at Medicaid CHOICE to explain how the process will work. Here’s a summary of the response I received:
Non SSI consumers will be auto-assigned in November for a December 1st, 2010 effective date, if they did not make a plan choice, request an exemption or an extension.
SSI consumers will be auto-assigned in December for a January 1st, 2011 effective date, if they did not choose a plan or request an exemption.
Once an HIV consumer is auto-assigned, they have 90 days to transfer into any plan (mainstream or SNP). After the 90 day grace period, they are locked into the plan and may only transfer into a SNP (unless they have a good cause reason to transfer into a mainstream).
HIV consumers will only be auto-assigned into a mainstream plan.
Consumers in Plans may transfer into a SNPby calling New York Medicaid CHOICE and the transfer will be effective the 1st of the following month.
Bronx notices are expected to be sent beginning November 2010.
New York Medicaid CHOICE
New York Medicaid CHOICE has a toll-free Consumer Help Line that is open Mon – Fri 8:30 AM to 8:00 PM and Saturdays 10:00 AM to 6:00 PM. Consumers can call 1-800-505-5678 for questions about Medicaid managed care and to arrange for individual counseling or to find out where the nearest group presentation is held.
Valuable information about Medicaid Managed Care in New York City can be found on the New York City Department of Health and Mental Hygiene website here: http://www.nyc.gov/html/doh/html/hca/hca1.shtml