HIV Special Needs Plan (HIV SNP) is a special public health insurance option for individuals on Medicaid living with HIV/AIDS and their children up to age 19, whether or not the children have HIV or AIDS. The doctors, nurses, and other care providers who participate in HIV SNP are trained to treat the special needs facing people living with HIV/AIDS. To voluntarily join an HIV SNP, an individual chooses a primary care provider (a doctor or nurse practitioner) who will coordinate your health care needs. Each plan has its own group of doctors, providers and hospitals. You can choose the one in which your current doctor belongs, is closest to your home or has the services you need most.
Currently, there are five managed care plans that can enroll individuals in a HIV Special Needs Plan.
Find a list of these plans (in PDF)
Eligibility Requirements Include:
- Health Coverage: Must be enrolled in Medicaid and have tested positive for HIV
What health services are covered by HIV SNP?
The same services covered by Medicaid:
- Regular checkups;
- Hospital inpatient and outpatient services;
- Emergency room care;
- Prescription drugs;
- Specialist care;
- Home health care;
- Nursing home care;
- Dental care;
- Prenatal care;
- Smoking cessation agents;
- Medical supplies and equipment.
Services offered by HIV SNP:
- Care coordination: Care is coordinated by primary care providers who are HIV specialists;
- HIV SNP Case Management: A case manager helps coordinate additional services if needed including family counseling, public benefits, drug treatment, legal help, and other services. A case manager helps make medical appointments and manage your care.
- Treatment Adherence Services: Treatment adherence services help you to remember and keep track of your vital medications, deal with side-effects from your medications, and give you advice about new medicines and treatments.
- HIV Prevention and Risk-Reduction Education: An HIV SNP also offers important education. This education can include counseling, reading materials, and health education classes. This education can help you reduce the chance that you may get new infections or infect others, by letting you know:
- Where to get free male and female condoms;
- Where to get clean needles and syringes and more important, where to get counseling services to help stop injection drug use; and
- Ways to talk to your partner about HIV risk.
How to Enroll in HIV Special Needs Plan
- Contact New York Medicaid CHOICE HelpLine counselors at 1-800-505-5678 to answer questions about choosing a doctor and choosing a plan that serves your area. If you would like to continue to see your current doctor, ask her if she is a HIV SNP provider;
- Call the New York Medicaid CHOICE HelpLine at 1-800-505-5678 to request an enrollment package. Everything you say is kept confidential.
- Contact the managed care plan that you are considering joining to learn more about its HIV SNP services. The managed care plan can help you complete the necessary HIV SNP enrollment forms.
Other Helpful Resources
For more information regarding this and other public health insurance programs, please contact an agency listed below:
Human Resources Administration at 1-718-557-1399
New York State Department of Health at 1-800-541-2831or visit its website at New York State Department of Health