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Wayne Resource Guide Health Insurance


If you need Health Insurance, then you need to read this!

Facilitated Enroller Program
The Facilitated Enroller (FE) program is free and helps to make sure children and adults have access to comprehensive, affordable health insurance. Learn more about all your program options through FE's at locations outside the Department of Social Services. There are several experienced FE's able to meet with you at community locations like local Wayne County libraries. The FE's will present you with all your health insurance program options, assist you in selecting a program and applying for NYS-sponsored free or low-cost health insurance.

What is a Facilitated Enroller (FE)? A Facilitated Enroller will help you to understand the coverage you qualify for, select the best program to meet your needs, and review the documentation you will need for your application, and then help you to complete the application. There are four organizations in Wayne County providing this service: Fidelis Care, Inc., the S2AY Network; Thompson Health Network; and Wayne County Department of Social Services.
The first step is to call one of the numbers below. Find out which documents to bring; and schedule an appointment to meet. During the appointment, the FE will help you fill out the application, check your documents and make copies, as required. The FE will forward your application to the appropriate agency and encourage you to call again, should you receive any letters from the insuring agency or the Department of Social Services. You do not need to go to DSS to apply for NYS sponsored insurance.
Please note: Starting April 1, 2010, you can mail completed applications for Medicaid directly to: Wayne County Department of Social Services, 77 Water St., Lyons, NY 14489. In-person interviews are not required anymore.

There are many locations around Wayne County to complete applications for Health Insurance with a Facilitated Enroller:

Centers for Medicare & Medicaid Services
7500 Security Blvd., Baltimore MD 21244
800.633.4227
TTY/TDD 877.486.2048
www.medicare.gov
The Centers for Medicare & Medicaid Services (CMS) is a branch of the U.S. Department of Health and Human Services. CMS is the federal agency that administers the Medicare program and monitors the Medicaid programs offered by each state. English and Spanish-speaking Customer Service Representatives (CSRs) at 800.MEDICARE can answer your questions. 800.MEDICARE CSRs can give you information about Medicare coverage and costs, health plan options, and your Medicare claims. For example, 800.MEDICARE CSRs can: answer general Medicare questions, order Medicare publications, help you compare Medicare health plans, Medigap policies, and prescription drug plans, answer questions about your claims and other insurance coverage, check your eligibility for certain preventive services, give referrals to helping agencies and partners such as State Medicaid agencies, help you find a participating Medicare provider, help you find and compare hospitals, home health agencies, nursing homes and dialysis facilities in your area. 800.MEDICARE (800.633.4227) 24/7 days a week, including some federal holidays.

Child Health Plus
NYS Health Department
800.698.4KIDS
TTY 877.898.5849
www.health.state.ny.us
Childrens health insurance explained: New York State has a health insurance plan for kids, called Child Health Plus. Depending on your family's income, your child may be eligible to join either Children's Medicaid or Child Health Plus. Both Children's Medicaid and Child Health Plus are available through dozens of providers throughout the state. To be eligible for either Children's Medicaid or Child Health Plus, children must be under the age of 19 and be residents of New York State. Whether a child qualifies for Children's Medicaid or Child Health Plus depends on gross family income. Children who are not eligible for Medicaid can enroll in Child Health Plus if they don't already have health insurance and are not eligible for coverage under the public employees. state health benefits plan. Some children who were covered by employer- based health insurance within the past six months may be subject to a waiting period before they can be enrolled in Child Health Plus. Determining whether your child is subject to a waiting period will depend on your household income and the reason your child(ren) lost employer-based coverage.

FidelisCare_2016.jpgFidelis Care
1250 Pittsford Victor Rd., Bldg. 200, Pittsford 888.343.3547
www.fideliscare.org
Fidelis Care offers quality, affordable coverage for children and adults of all ages and at all stages of life, including products available through NY State of Health: The Official Health Plan Marketplace. With more than one million members across the State, Fidelis Care was founded on the belief that all New Yorkers should have access to affordable, quality health insurance. Follow us on Twitter at @fideliscare and on Facebook at facebook.com/fideliscare.

Legal Assistance of Western New York ®
361 S. Main St., Geneva
315.781.1465
866.781.5235
www.lawny.org
Assistance related to access to health insurance or scope of coverage of health insurance.

Medicaid/Wayne County Dept. of Social Services
77 Water St., Lyons
315.946.7603
www.co.wayne.ny.us
Medical assistance or Medicaid is available to help people who cannot afford to pay for all of their medical care. Contact local DSS office for information and application. Mon.-Fri. 9am-5pm.

Monroe Plan for Medical Care
1120 Pittsford-Victor Rd., Pittsford
585.244.5550
www.monroeplan.com
Monroe Plan provides several services and programs through our patient centered approach to help individuals manage their health, focus on preventive services, manage chronic conditions and assist with selecting the right services, at the right time in the right setting. This approach engages individuals to take an active role in their health and helps the community, employers and government agencies address and control costs and utilization. NYS Medicaid for Health Home Case Management.

New York State of Health
855.355.5777
www.nystateofhealth.ny.gov
It's your place to shop, compare and enroll in a low-cost quality plan that's right for you. And it's the only place you can receive financial assistance based on your income, to lower your costs even more. * NY State of Health is an organized marketplace designed to help people shop for and enroll in health insurance coverage. Individuals, families and small businesses can use the Marketplace to help them compare insurance options, calculate costs and select coverage online, in-person, over the phone or by mail. The Marketplace helps people to check their eligibility for health care programs like Medicaid and sign up for these programs if they are eligible. The Marketplace also tells what type of financial assistance is available to applicants to help them afford health insurance purchased through the Marketplace. * Learn more through these key resources: Tax Credit and Premium Estimator, Navigator and Plan Maps, Certified Brokers List, Videos, FAQs, Materials (like fact sheets) in English, Materials in Additional Languages, Customer Service Center: 1-855-355-5777.

NYS Health Insurance Programs
New York State Department of Health
Corning Tower, Empire State Plaza, Albany
www.health.state.ny.us
Depending on your family size, age, and household income New York
State offers many insurance options to support your health such as:
Child Health Plus
Medicaid
Medicaid Buy-in Program for Working People with Disabilities
Medicaid Obstetrical & Maternal Services (MOMS) Program
Family Health Plus
Family Health Plus Employer Buy-In
Elderly Pharmaceutical Insurance Coverage (EPIC)
AIDS Drug Assistance Program (ADAP)
HIV Uninsured Care Programs (ADAP)
HIV Special Needs Plans (HIV SNPS)
Managed Care
Prenatal Care Assistance Program (PCAP)
Medicaid Cancer Treatment Program: Breast, Cervical, Colorectal and
Prostate Cancer
Child and Adult Care Food Program (CACFP)
Health Insurance Portability and Accountability Act (HIPAA)
Long Term Care
Early Intervention Program
WIC (Special Supplemental Nutrition Program for Women, Infants & Children)
Commodity Supplemental Food Program
Farmers Market Nutrition Program
Healthy New York Program
Medicare
Veterans Health Information Clearing House
Workers' Compensation Preferred Provider Organizations (PPO)
Infertility

Sodus Community Health
6692 Middle Rd., Ste 2100, Sodus
315.483.1199
www.localcommunityhealth.com
Comprehensive medical, dental and behavioral health services for the entire family. Multi-lingual staff. Most insurances accepted. Generous sliding fee scale for the uninsured. Patient Navigators & Certified Applications Counselors available for assistance with referrals and applying for health insurance. Mon., Wed., Fri. 8-4 / Tues. 8-7 / Thur. 8-8.

U.S. Department of Health and Human Services
877.Kids.Now
877.543.7669
www.insurekidsnow.gov
Offers health insurance coverage for children through Medicaid and the Children's Health Insurance Program (CHIP). These programs serve families who are not able to afford health insurance coverage in the private market or do not have coverage available to them. Every state's program is unique and has individual income eligibility rules and benefits covered, but in general, children in families with incomes up to $44,100 per year (for a family of four) are likely to be eligible for coverage. Medicaid and CHIP cover doctor visits, dental care, prescription medicines and immunizations, as well as services like hospitalizations and care for children with special health care needs. There may be premiums or other cost sharing associated with this coverage, but the programs are designed to be affordable. Call our Hotline: 877.Kids.Now 877.543.7669 or call your local Facilitated Enroller for more information on healthcare for children.

Wayne County Department of Aging & Youth
1519 Nye Rd., Lyons
315.946.5624
www.co.wayne.ny.us
Provides neutral, unbiased information about Medicare, supplemental insurance, HMOs, Medicaid, Medicare buy-in programs, EPIC, and long term care insurance. We also help with understanding billing questions, filing claims and comparing policy coverage.

WorkPays N.Y.
800.342.3009
www.mybenefits.ny.gov
Program for working individuals having difficulty making ends meet, support with child care, insurance, tax preparations, home energy assistance and food benefits.



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