Medical Assistance Guide

Medical Assistance Directory
Table of Contents
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State Medical Assistance Programs

Medicaid
Child Health Plus A
Family Health Plus
Medicare Savings Program
Medicaid Buy-In for Disabled Persons
Expanded Medicaid Programs

IInsurance Programss

Child Health Plus B
Healthy New York
Value Med
GHI Alliance, Inc.

Other Consumer Information

NY Center for Agricultural Medicine and Health
Consumer Information

St. Lawrence County Medical Assistance Programs

Health Living Partnership

Massena Free Clinic

St. Lawrence County Health Initiative, Inc

Assistance Programs for Senior Citizens

St. Lawrence County Office for the Aging Medicare

Prescription Drug Assistance Programs
Patient Assistance Programs (PAPs)

Other Prescription Assistance Resources
Web-based Resources
Non-Profit Warehouse
Retail Drug Cards

Prescription Programs for Senior Citizens
EPIC
National Council on the Aging
Drug Discount Cards *******************************************************************************************************
State Medical Assistance Programs Medicaid Medicaid is a program for New Yorkers who can't afford to pay for medical care. You may be eligible for Medicaid if any of the following are true: * you have high medical bills * you receive Supplemental Security Income (SSI) * you meet income, resource, age or disability requirements. Please refer to this chart for income eligibility guidelines. Please note - Income guidelines are subject to change - please call for current amounts.

Apply for Medicaid through the St. Lawrence County Social Services Department. Call Fred Phelix at 315-379-2175. Please have with you: * proof of income, residency and resources, and * personal identification Child Health Plus A Child Health Plus A (formerly Children's Medicaid) is a no-cost health insurance program for children. To be eligible for Child Health Plus A, children must: * be under the age of 19, * live in NY state, * for children aged 1-18, gross monthly household income (before taxes) is at or below the maximum for your family size and children's ages. * pregnant women count as "2" for family size

For more information or to enroll in Child Health Plus A, call Donna Hynes (Planned
Parenthood), 393-6413, or Tammy Patton (WIC), 386-8128.

Family Health Plus is a no-cost insurance plan available to single adults, couples with children and parents with limited incomes. You may be eligible for Family Health Plus is the following are true: * you are between the ages of 19 and 64, * you are a resident of New York State * you have no health insurance * your gross montly household income (before taxes) is at or below the maximum for your family size in the chart below.

This program extends Medicaid coverage to employed persons who are disabled. You may be eligible for the Medicaid Buy-In if the following apply: * your income is below 250% of the federal poverty level * you have resources less than $10,000 * you are between 16 and 64 years of age * you meet the Social Security definition of disabled * you are engaged in work activity

Expanded Medicaid Programs There are expanded Medicaid programs for: * Pregnant Women * Married Individuals when one spouse requires nursing home placement or qualified for LTHHCP. * Persons with HIV/AIDS * Persons with Traumatic Brain Injury * Children who are disabled * COBRA * Family Planning Contact Trudy Dalton, 379-2105, or Arlena DaFoe, 379-2175, for specific information regarding these programs and the application process. Insurance Programs Child Health Plus B Child Health Plus B is a no-cost or reduced cost health insurance program for children. To be eligible for Child Health Plus B, children must: * be under the age of 19, * live in New York State * for free coverage, gross monthly household income (before taxes) is at or below the maximum for your family size in Column 1 of the chart below. * for reduced cost coverage, gross monthly household income is at or below the maximum for your family size in Columns 2 or 3 of the chart below. * families with household income above the levels in Column 3 pay full premium per child.

Income guidelines are subject to change, please call the contact person below for current amounts. More information is available on the New York State website, www.health.state.ny.us For more information or to enroll in Child Health Plus B, call Donna Hynes (Planned Parenthood), 393-6413 or Tammy Patton (WIC), 386-8128. Healthy New York Healthy New York is a reduced cost Health Insurance Plan available to working, uninsured individuals. You may be eligible for this insurance if all of the following are true: * you or your spouse are working or have worked sometime in the past year, * you have no health insurance of any kind * your employer does not provide health insurance * your gross household income does not exceed the maximum for your family size in the chart below * you have not had health insurance for the 12 months before applying to Healthy New York, or have lost coverage due to a qualifying event * you live in New York State

Income guidelines are subject to change, call for current amounts For more information about Health New York, please call 1-800-HEALTHYNY (1-800-432-5849) or visit the New York State website at www.ins.state.ny.us/healthny.htm

Safety Blue is a low-cost Health Insurance Plan offered through Excellus Blue Cross/Blue Shield of Utica-Watertown. You may be eligible for this insurance if all of the following are true: * you are a resident of St. Lawrence, Clinton, Essex, Franklin, Jefferson and Lewis Counties. * you are between 18 and 64 years of age * you are not enrolled in or eligible for any other health insurance program including Medicaid and Medicare * you are self-employed, or are employed on a seasonal, part-time or temporary basis. * you are not a full-time student * you have had no health coverage for six months before applying * you meet income guidelines, see chart below,

GHI is a private insurance company which offers basic medical and hospital coverage. There are two plans available to St. Lawrence County residents, the Value Plan and the 365 Day Hospital Plan. For more information on GHI plans, call 1-800-444-2333, or visit the GHI website, www.ghi.com Other Consumer Resources New York Center for Agricultural Medicine and Health NYCAMH offers a variety of farm safety and health services to the agricultural community, including health screenings for farmers and their families in the following areas: * Hearing * Breathing * Fit-testing * Blood pressure/cholesterol * Vision * Skin Cancer NYCAMH prefers to have a minimum of 25 people attend screenings. To schedule a screening in your area, please contact NYCAMH at 1-800-343-7527. Consumer Information The New York State Health Accountability Foundation website contains information on rating many health plans on various components of the benefits that are offered in order for consumers to make informed choices when choosing an insurer. Contact NYSHAF online through their website, www.nyshaf.org or by telephone at 1-516-326-7767. St. Lawrence County Medical Assistance Programs Healthy Living Partnership The Healthy Living Partnership provides screening mammograms, clinical breast exams, PAP Smears and pelvic exams for eligible women in St. Lawrence County and colorectal screening for men and women age 50 and older. You may be eligible for HLP: * based on your gross monthly income * if you do not have insurance * if you have insurance with a high deductible * if your insurance doesn't cover these services For assistance or help with appointments, call: Healthy Living Partnership 1-877-239-8969 or 315-386-2325 Massena Free Clinic for Adults The Free Clinic provides primary medical care for uninsured individuals 19 years of age and older. The Clinic is open by appointment only on Thursdays from 2-5. Please call after 9:00 am on Thursdays for information or to make an appointment. 315-769-8017 139 Main Street Massena, NY 13662 St. Lawrence County Health Initiative, Inc. Preventive Health Screenings - In partnership with St. Lawrence County Public Health, SLCHI offers free screenings for cholesterol, glucose, blood pressure and BMI at locations throughout the county. Screenings are advertised in local papers and are listed on this website on the Access to Care Page. Follow-up Testing and Care - SLCHI will pay for limited follow-up testing and care for uninsured individuals who have a positve result at a screening. SLCHI will also pay for certain tests your doctor may order during an office visit. SLCHI requires that individuals apply for, and be turned down for, Family Health Plus before we can pay for any services. Education and Referrals - SLCHI offers community education on health-related issues, including nutrition and physical activity, and provides referrals for health, nutrition and other services in the community. Tobacco Cessation Services - SLCHI offers individual and group cessation services for children and adolescents through age 20. In addition to browsing this website, you may call SLCHI at 1-866-667-5244 for more information on any of these programs. Assistance Programs for Senior Citizens St. Lawrence County Office for the Aging The Office for the Aging provides referrals and programs for individuals and families needing assistance to access resources specific to Senior Citizens. Please call the office for more information at, 315-386-4730. 80 State Highway 310 Canton, New York 13617 Medicare Medicare is a health insurance program for residents who are 65 years of age or older or for residents who have a disability. Please contact the Social Security Administration for more information. 818 Commerce Park Drive Ogdensburg, NY 13669 315-393-1417 Information is also available on the web at www.ssa.gov. Prescription Drug Assistance Programs Patient Assistance Programs (PAPs) - NEW PROGRAM !!!!! The New York Chapter of Partnerships for Prescription Assistance has launched a new program to assist individuals in finding and applying for prescription assistance programs. The site can be accessed online at www.pparxny.org. Other Prescription Assistance Resources Web-based Resources www.medicare.gov/Prescription/Home.asp Based on the information you enter, the site searches for programs in this state or programs for certain diagnoses or medication. www.benefitscheckup.org Provides individuals 55 and over with a confidential personalized report of public and private programs that can help save money on prescription drugs. Non-Profit Warehouse's Prescription Drug Discount Program The Non-profit Warehouse offers a drug discount card program to any individual regardless of age or income. The free card allows the holder to receive discounts on prescriptions at any of the 45,000 participating pharmacies or through a mail order program. To start saving, click on the following link www.nonprofitwarehouse.com and print out the card. Present the card, along with your prescription, to a participating pharmacy (listed below the card on the website). You will pay the discounted cash price, or the pharmacy's usual and customary price, whichever is lowest. You may photocopy the card as many times as you need and distribute them to anyone that does not have a prescription drug benefit. The pharmacy card cannot be combined with insurance or any other offer. Retail Drug Cards There are several companies that offer retail prescription discount programs. These companies charge a monthly or yearly fee. Below is a listing of some companies that offer discount cards. These listings are for information only and are not endorsements of these services. NationsRx- www.doctorsavings.com DestinationsRx, Inc. - www.destinationrx.com MemberHealth, Inc. - www.mhrx.com AARP - (American Association of Retired Persons) - Open only to AARP members. www.aarppharmacy.com YOURRxPlan - www.yourplan.com Prescription Programs for Senior Citizens EPIC EPIC is the New York State Elderly Pharmaceutical Insurance Coverage Program which provides assistance with prescription medication. Please call for enrollment and eligibility information, 1-800-332-3742. National Council on the Aging - Benefits Check-up Benefits Check Up helps thousands every day to find programs for people ages 55 and over that may pay some of their costs of prescription drugs, health care, utilities, and other essential items of services. www.benefitscheckup.org Drug Discount Cards Some drug manufacturer's offer drug discount cards for the elderly and disabled. GlaxoSmithKline's Orange Card - 1-888-672-6436 Eli Lilly's, Lilly Answers Card - 1-877-795-4559 Novartis' The CareCard - 1-866-974-2273 Pfizer's The Share Card - 1-800-717-6005 The Together Rx Card - 1-800-865-7211