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Medicaid Managed Care and
Medicaid HARP

What is Medicaid? 

Medicaid is a state-sponsored health plan for people who have little to no income. CDPHP offers Medicaid coverage to members in the counties identified below.

You may qualify for CDPHP Medicaid if:

  • Your income is below 138 percent of the federal poverty level (approximately $16,394 for a household of one in 2016).
  • You are an adult between the ages of 19 and 64.
  • You are pregnant or have an infant.
  • You are a child between the ages of 1 and 18.
  • You are a parent or caretaker.
  • You are 19 or 20 and live with a parent.
  • You participate in the Family Planning Program.
  • You are not eligible for Medicare.

You may enroll either through the NY State of Health, The Official Health Plan Marketplace, or through the Local Department of Social Services (LDSS), depending on your circumstance. Many people qualify to apply through the NY State of Health. However, if you receive Supplemental Security Income (SSI), live in a nursing home or other treatment center, or participate in a Medicare Savings Program (MSP), you may need to apply for Medicaid through your LDSS. You may be able to choose CDPHP as your Medicaid plan through the LDSS.   

state funded map

These resources will help you manage your health care.

Member Handbook: The handbook describes how your coverage works. 

Health and Wellness Tools 

CDPHP developed the following programs and resources to help you and your family stay healthy.

  • My Health Tracker: Download this free tool and use it to track your doctor appointments, immunizations and screenings, and medications.
  • Quit Smoking: CDPHP offers several resources to help you quit smoking.
  • Free Wellness Classes: CDPHP members can choose from a variety of free fitness and wellness classes. 

CDPHP Medicaid

There are three ways to enroll in CDPHP Medicaid:  

  1. Apply through the NY State of Health or through the Local Department of Social Services (LDSS), depending on your circumstance.
  2. Call the NY State of Health at 1-855-355-5777 (TTY: 1-800-662-1220). Or, contact an in-person assistor to help you.
  3. Contact CDPHP at 1-844-CDPHP-Select (1-844-237-4773) to make an appointment with a Marketplace Facilitated Enroller at a place that is convenient for you.

How to Renew Your CDPHP Medicaid Coverage

It's important to renew your Medicaid coverage so you can continue to receive health care services. If your coverage is not automatically renewed through the NY State of Health and you need assistance, please call 1-844-CDPHP-Select (1-844-237-4773) or email StatePrograms@cdphp.com. You can meet with a Marketplace Facilitated Enroller in a place that is convenient for you.

If you have questions or need assistance, we’re here to help you.

Questions About CDPHP Medicaid?
If you have questions about whether you are qualified for CDPHP Medicaid, how to renew your coverage, or general questions about CDPHP Medicaid, you can email us at StatePrograms@cdphp.com or call 1-844-CDPHP-Select (1-844-237-4773).  

Speak to a Mental Health Professional
If you need to talk to someone about mental health or substance use disorder concerns, call our Behavioral Health Access Center at 1-888-320-9584 Monday through Friday, 8 a.m. to 6 p.m.

Need Help After-Hours?
If you have an emergency and need to speak to a mental health professional after-hours, call CONTACT Lifeline at 1-855-293-0785. You will be immediately transferred to a live, licensed counselor for emotional and crisis support. CONTACT Lifeline is available Monday through Friday, 6 p.m. to 8 a.m., and on weekends and holidays.

Important Websites

For more information about the Medicaid program, visit:

For mental health and substance use disorder assistance, visit:

To enroll in Medicaid coverage or renew your existing Medicaid coverage, visit:

For more information on AIDS/HIV resources and programs, visit:

Additional:

Important Phone Numbers

CDPHP

Member Services - (518) 641-3800 or 1-800-388-2994

Behavioral Health Access Center – 1-888-320-9584 (available Monday – Friday, 8 a.m. to 6 p.m.)
For after-hours help, call CONTACT Lifeline at 1-855-293-0785 (available 6 p.m. to 8 a.m. and on weekends and holidays)

New York State Department of Health (Complaints) - 1-800-206-8125

New York Medicaid Choice - 1-800-505-5678

NYS HIV/AIDS Hotline - 1-800-541-AIDS (2437)
Spanish - 1-800-233-SIDA (7432)
TDD - 1-800-369-AIDS (2437)

HIV Uninsured Care Programs - 1-800-542-AIDS (2437)
TDD - Relay, then (518) 459-0121

Partner Assistance Program - 1-800-541-AIDS (2437)

Social Security Administration - 1-800-772-1213

NYS Domestic Violence Hotline - 1-800-942-6906
Spanish - 1-800-942-6908
Hearing Impaired - 1-800-810-7444

Americans with Disabilities Act (ADA) Information Line - 1-800-514-0301
TDD - 1-800-514-0383

The following updates have been made to your CDPHP Medicaid plan:

Expansion of Benefits

Beginning July 1, 2016, CDPHP will cover more mental health and substance use disorder services, including:

  • Crisis services
  • Assertive Community Treatment (ACT)
  • Personalized Recovery Oriented Services (PROS)
  • Rehabilitation services

For most CDPHP members, nothing will change. CDPHP will continue to cover the behavioral health services it covers now. However, members who use their Medicaid card to get behavioral health services will need to use their CDPHP card beginning July 1, 2016.

New Medicaid Health and Recovery Plans

CDPHP is pleased to offer a new kind of Medicaid plan called a Health and Recovery Plan, or HARP. This new Medicaid plan will be available to members who meet certain guidelines. This plan can help members take care of their mental well-being and physical health. It covers the same Medicaid services members get now, as well as the new mental health and substance use disorder services mentioned above. This new Medicaid plan will also offer extra support to help members find a job or housing, education support services, or family support and training. These and other extra services will be available beginning October 1, 2016. 

Vision Hardware Network Change

CDPHP Medicaid members are required to use an approved network provider for vision hardware. A list of participating vision hardware network providers is available on our Find-A-Doc search tool.

You can get an exam at any participating provider. However, you will have to visit a specific vision hardware network provider for lenses, frames, and contacts.

Medicaid and Child Health Plus Pharmacy Network Update

The pharmacy network for CDPHP Medicaid and Child Health Plus consists of CVS, Hannaford, Price Chopper, ShopRite, Walmart, Target, and certain independent pharmacies. The following pharmacies are not in the state programs network Rite Aid, Kinney Drugs, and Walgreens.

Dental Information

Dental coverage for CDPHP Medicaid is provided through DentaQuest. Once you become a member, you will need to select a primary dental provider and use a separate ID card provided by DentaQuest. To select or change your dental provider, or to request an ID card, please contact DentaQuest at 1-888-278-7310 or visit their website at www. dentaquest.com.

What is HARP?

CDPHP offers a new kind of Medicaid plan called a Health and Recovery Plan, or HARP.medicaid HARP app

This Medicaid plan is available to members who meet state guidelines. This plan can help members take care of their mental well-being and physical health. It covers the same Medicaid services members get now, including crisis services, assertive community treatment (ACT), personalized recovery oriented services (PROS), and services for substance use disorder.

This Medicaid plan will also offer extra support called behavioral health Home and Community Based Services (HCBS), which helps members who qualify find a job or housing, get education support services, and get family support and training. These extra services will be available to HARP members beginning October 1, 2016.

The CDPHP HARP plan is offered in the counties shown below.  

state funded map

medicaid outreach locations