Empire BCBS Medicaid is a health insurance option for people in New York who are eligible for Medicaid. It offers a range of services, including doctor visits, hospitalization, and prescription drugs. Empire BCBS Medicaid uses technology to help improve the quality of care and customer service. For example, it uses data to identify members who may need extra support, and it offers online tools to help members manage their care. Empire BCBS Medicaid is committed to providing high-quality, affordable health insurance to New Yorkers.
Empire BlueCross BlueShield Medicaid Managed Care Plans
Empire BlueCross BlueShield (Empire BCBS) offers a range of Medicaid Managed Care Plans to New Yorkers who qualify for Medicaid. These plans provide comprehensive health coverage, including medical, dental, vision, and behavioral health services.
Empire BCBS Medicaid Managed Care Plans are available to individuals and families who meet certain eligibility requirements, such as income and residency. To enroll in one of these plans, you can apply through the New York State of Health Marketplace or contact Empire BCBS directly.
Benefits of Empire BCBS Medicaid Managed Care Plans
- Comprehensive health coverage, including medical, dental, vision, and behavioral health services
- Access to a network of qualified providers
- Low or no out-of-pocket costs
- Coordination of care between providers
- Support services, such as transportation and case management
Types of Empire BCBS Medicaid Managed Care Plans
Empire BCBS offers a variety of Medicaid Managed Care Plans to meet the needs of different individuals and families. These plans include:
- HealthPlus:
- Medicaid Managed Care Plan for individuals and families
- MetroPlus:
- Medicaid Managed Care Plan for individuals and families in New York City
- WellCare:
- Medicaid Managed Care Plan for individuals and families in upstate New York
How to Enroll in an Empire BCBS Medicaid Managed Care Plan
To enroll in an Empire BCBS Medicaid Managed Care Plan, you can:
- Apply through the New York State of Health Marketplace:
- Visit the New York State of Health Marketplace website or call the Marketplace Call Center at 1-855-355-5777.
- Contact Empire BCBS directly:
- Call Empire BCBS at 1-800-445-2583 or visit the Empire BCBS website.
Comparison of Empire BCBS Medicaid Managed Care Plans
The following table compares the key features of the Empire BCBS Medicaid Managed Care Plans:
| Plan | Service Area | Monthly Premium | Deductible | Copay |
|---|---|---|---|---|
| HealthPlus | New York State (excluding New York City) | $0 | $0 | $0 for primary care visits, $10 for specialist visits |
| MetroPlus | New York City | $0 | $0 | $0 for primary care visits, $10 for specialist visits |
| WellCare | Upstate New York | $0 | $0 | $0 for primary care visits, $10 for specialist visits |
Eligibility for Empire BCBS Medicaid
Empire BlueCross BlueShield (Empire BCBS) offers Medicaid plans in New York state. Medicaid is a health insurance program for people with low incomes and resources. To be eligible for Empire BCBS Medicaid, you must meet certain requirements, including:
- Be a New York state resident.
- Be a U.S. citizen, a legal permanent resident, or a qualified non-citizen.
- Have income and assets below certain limits. The income and asset limits vary depending on the type of Medicaid program for which you are applying and the number of people in the family.
- Meet other requirements for the specific type of Medicaid program for which you are applying. For example, some Medicaid programs are available only to people who are pregnant, disabled, or children.
You can apply for Empire BCBS Medicaid online, by mail, or in person at a local Social Services office. You can also call the Empire BCBS Medicaid customer service line at 1-800-505-3040 for more information.
Once you have applied for Empire BCBS Medicaid, you will be notified by mail if you are approved or denied. If you are approved, you will receive a Medicaid card that you can use to get health care services from providers who accept Medicaid.
Here is a table that summarizes the eligibility requirements for Empire BCBS Medicaid:
| Requirement | Description |
|---|---|
| Residency | Must be a New York state resident. |
| Citizenship | Must be a U.S. citizen, a legal permanent resident, or a qualified non-citizen. |
| Income and assets | Income and assets must be below certain limits, which vary depending on the type of Medicaid program and the number of people in the family. |
| Other requirements | May need to meet other requirements for the specific type of Medicaid program, such as being pregnant, disabled, or a child. |
Empire BCBS Medicaid: Coverage and Services
Empire BCBS Medicaid is a health insurance program offered by Empire BlueCross BlueShield in New York state. It provides comprehensive coverage for low-income individuals and families who meet certain eligibility requirements. This article provides an overview of the benefits and services covered by Empire BCBS Medicaid.
Benefits and Services Covered
- Medical Care: Empire BCBS Medicaid covers a wide range of medical services, including doctor visits, hospital stays, emergency care, laboratory tests, X-rays, and prescription drugs.
- Mental Health and Substance Abuse Treatment: Empire BCBS Medicaid provides coverage for mental health and substance abuse treatment, including outpatient therapy, inpatient treatment, and medication.
- Dental Care: Empire BCBS Medicaid covers dental services such as cleanings, fillings, extractions, and dentures.
- Vision Care: Empire BCBS Medicaid provides coverage for vision care, including eye exams and glasses or contact lenses.
- Transportation: Empire BCBS Medicaid covers transportation costs to and from medical appointments.
- Home Health Care: Empire BCBS Medicaid provides coverage for home health care services, such as skilled nursing care, physical therapy, and occupational therapy.
- Long-Term Care: Empire BCBS Medicaid provides coverage for long-term care services, such as nursing home care and assisted living.
Additional Benefits:
- Family Planning Services
- Maternal and Child Health Services
- Preventive Care Services
- Vaccinations
| Drug Category | Examples |
|---|---|
| Antidepressants | Prozac, Zoloft, Celexa |
| Antipsychotics | Zyprexa, Risperdal, Abilify |
| Anticonvulsants | Dilantin, Tegretol, Neurontin |
| Antihypertensives | Lisinopril, Atenolol, Metoprolol |
| Antidiabetics | Metformin, Glipizide, Januvia |
Note: This is not an exhaustive list of all covered benefits and services. For more information, please refer to the Empire BCBS Medicaid Member Handbook or contact your local Medicaid office.
How to Apply for Empire Blue Cross Blue Shield (Empire BCBS) Medicaid
Empire BCBS Medicaid is a health insurance program for low-income New Yorkers. It provides comprehensive coverage for a wide range of medical services, including doctor visits, hospital care, prescription drugs, and mental health care. To apply for Empire BCBS Medicaid, you must meet certain eligibility requirements and follow the application process.
Eligibility Requirements
- Be a New York State resident
- Be a U.S. citizen or qualified non-citizen
- Meet income and asset limits
- Not be receiving full-time Medicaid or Medicare benefits
Application Process
- Contact your local Department of Social Services (DSS) office.
- Request a Medicaid application form.
- Complete the application form and return it to your local DSS office.
- Provide proof of your identity, income, and assets.
- Attend an interview with a DSS caseworker.
- Wait for a decision on your application.
Supporting Documents
- Birth certificate
- Social Security card
- Proof of income, such as pay stubs or tax forms
- Proof of assets, such as bank statements or property deeds
- Proof of citizenship or qualified non-citizen status
Application Deadlines
There is no deadline to apply for Empire BCBS Medicaid. However, it is important to apply as soon as possible to avoid any gaps in your health insurance coverage.
Contact Information
For more information about Empire BCBS Medicaid, you can contact the New York State Department of Health at (800) 541-2831.
Additional Resources
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