Medicaid of New York, known officially as New York State Medicaid, is a state and federally funded program designed to provide health insurance coverage to low-income individuals and families, including children, pregnant women, elderly adults, and people with disabilities. Established as part of the Social Security Act in 1965, the program has expanded over the decades to cover a diverse range of healthcare services. Today, it stands as one of the largest insurance programs in New York, serving millions of residents who require accessible healthcare.
New York State Medicaid offers a variety of plans to meet different healthcare needs. Key offerings include Managed Care Plans, which provide coordinated healthcare services through a network of providers who focus on preventive and primary care. It also extends support through programs like Children's Health Insurance Program (CHIP), long-term care services, and more specialized assistance such as behavioral health services. This robust network ensures that enrollees have access to necessary medical care while also focusing on maintaining cost-effectiveness and quality standards for both patients and providers.
An HMO (Health Maintenance Organization) plan typically requires you to use doctors and hospitals within its network and get a referral from your primary care physician (PCP) to see a specialist. A PPO (Preferred Provider Organization) plan offers more flexibility to see both in-network and out-of-network providers without a referral, usually at a higher cost.
The best way to find an in-network provider is to use the 'Find a Doctor' or 'Provider Directory' tool on the official Medicaid of New York website. You can also call the member services number on the back of your insurance card for assistance.
A deductible is the amount you must pay out-of-pocket for covered health care services before your insurance plan starts to pay. For example, if you have a $1,000 deductible, you pay the first $1,000 of covered services yourself.
