HIV Special Needs Plans
HCAI has also participated in the development of HIV Special Needs Plans (HIV SNPs) for populations needing more intensive services than those provided by Medicaid managed care plans. Implementation of the HIV SNPs in New York City has been a collaborative effort between the New York State Department of Health, AIDS Institute; the New York City Department of Health and Mental and Mental Hygiene, Division of Health Care Access and Improvement, and the New York City Human Resources Administration.
Currently there are three HIV SNPs enrolling members. A list of HIV SNP Health Plans is available, along with their service areas, in English and Spanish.
Facts About HIV SNPs
Enrollment in a HIV Special Needs Plan will be voluntary. You will have several choices:
- • Fee-for-Service Medicaid
- • An HIV Special Needs Plan
- • A Medicaid Managed Care Health Plan
Individuals interested in enrolling into an HIV SNP will be entitled to all the benefits available from a Medicaid Managed Care Health Plan along with additional services such as:
- • HIV SNP Case Management Services
- • Treatment Adherence Services
- • HIV Prevention and Risk-Reduction Education
Certain services such as prescription/non-prescription drugs, and certain other services will remain on a fee-for-service basis. If a consumer enrolls in an HIV SNP, s/he will use his/her Medicaid benefits card to access these services.
If a consumer enrolls in a mainstream health plan and wants to enroll in an HIV/SNP, s/he must disenroll from the mainstream health plan and complete a new enrollment form for the HIV/SNP.
Non-infected children of SNP enrollees under the age of 19 can join the SNP too.
Persons with HIV can enroll in an HIV/SNP regardless of current family member enrollment into a Medicaid managed care health plan - this is an exception to the "same family rule."
If a consumer is currently seeing a provider and wants to continue to see that provider, the health plan should assist him/her in making sure that the provider also participates in the HIV SNP provider network or s/he can call New York Medicaid CHOICE at 1-800-505-5678. Before making the final choice, the consumer should call the provider to make sure that the doctor is taking new patients.
If the consumer is ready to enroll or needs more time to decide which option s/he wishes to consider, the Marketing Representative is responsible for giving him/her a business card which should have his name, the name of the health plan and a telephone contact number.
If the consumer has a newborn after she enrolls in an HIV/SNP or a Medicaid managed care plan, the baby will be automatically enrolled in the same health plan as the mother.
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