3/22/2019
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Posted by Provider Relations
The purpose of this ALERT is to inform Providers that the way in which certain Medicaid members renew their coverage is changing. Medicaid MAGI individuals (eligible recipients through the Modified Adjusted Gross Income rules) may now need to renew their coverage through the NYSOH Marketplace rather than through the local Department of Social Services/ Welfare Management System (WMS.) Due to the large number of MAGI enrollees, the transition to NY State of Health Marketplace has been occurring in phases. The next phase of the transition will affect enrollees with a coverage end date of April 30, 2019. This will include Medicaid HARP (Health and Recovery Program) individuals who reside in all NY State counties, except for the five boroughs of NYC (Bronx, Kings, Manhattan, Queens, and Staten Island.)
HARP (Health and Recovery Plan) enrollees with a coverage termination date of 4/30/19 are required to complete the renewal process through the NYSOH Marketplace between 3/16/19 and 4/15/19.
Fidelis Care is available to help your HARP patients with this transition. We are able to assign a Facilitated Enroller (Certified Application Counselor/CAC) to your office upon request or at scheduled days/times. Please contact your Provider Relations representative to arrange for this extra support.
Enrollees may also contact Fidelis Care directly by:
• Calling 1-866-435-9521 Monday - Friday 8:30AM – 6:00 PM
• Visiting one of our Fidelis Care Community Offices fideliscare.org/offices
• Calling their Care Manager at their direct extension or by dialing 1-888-FIDELIS
(1-888-343-3547) choose language, then option 4 and enter extension 16077
PLEASE SHARE THIS ALERT WITH ALL APPROPRIATE STAFF
Additional information on this Transition is provided below:
To assist individuals in their transition, enrollees will receive a “Notice of Recertification for Medicaid” from WMS/LDSS informing identified clients that continued eligibility for Medicaid coverage must be determined through NY State of Health. The notice will include the date the coverage will end. The notice explains that the enrollee will receive a letter from NY State of Health informing them that an account has been created on the NY State of Health Marketplace and how to access their account. NY State of Health will send a letter approximately 55 days before the coverage end date, or sooner for enrollees with a shorter authorization period.
It will be the enrollee’s responsibility to complete his/her renewal by the date specified in the NY State of Health letter. This can be done online using the invitation code in the letter, with a Navigator or Certified Application Counselor, or by contacting the NY State of Health Customer Service Center at (855) 355-5777. Each month enrollees who are due to renew their coverage and have been identified to transition will be receive the notifications below;
PLEASE SHARE THIS ALERT WITH ALL APPROPRIATE STAFF.