Eligibility

Adult

To be eligible for New York State Medicaid Health Home Care Management, individuals must have:

Two or more medical or mental health chronic conditions, or one single qualifying condition.

Examples of chronic conditions are:

  • substance abuse disorder
  • HIV/AIDS
  • asthma
  • diabetes
  • heart disease
  • obesity
  • mental illness
  • drug and alcohol problems

One single qualifying chronic condition:

  • HIV/AIDS or
  • Serious Mental Illness (SMI)

For a complete list of chronic conditions, visit the Department Of Health website: www.health.ny.gov.

If you are a Medicaid or Medicaid Managed Care recipient or believe you may qualify for Medicaid, think about the following questions:

  • Do you have chronic or mental health conditions for which you need regular doctors’ care?
  • Do you have a doctor you can see when you need to?
  • How many times have you been in the emergency room or hospital in the past six months? Twelve months?
  • Do you have a safe place to live?
  • Do you have someone in your life to help you whenever you need help?
  • Do you have difficulty keeping medical appointments?

Child

To meet eligibility, your child must be 17 years old or younger.

Your child must have two or more medical or mental health chronic conditions such as, but not limited to:

  • Alcohol or substance abuse
  • Mental health condition
  • Cardiovascular disease
  • Asthma
  • Obesity BMI>25

or your child must have one of the single-qualifying conditions such as,

  • HIV/AIDS
  • Complex trauma
  • Severe Emotional Disturbance(SED)

For a complete list of chronic conditions, visit the Department of Health website: www.health.ny.gov.

For more information about  Health Home Care Management Program visit the Department of Health website: https://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/index.htm

If you meet the eligibility criteria and are in need of Care Management Services, you can be enrolled in the Health Home Program.

This is a voluntary service. Medicaid pays for Care Management services for those who are eligible. It does not cost you anything to enroll.

Think you may be eligible? Call 1-855-784-1262 or email referrals@cnyhealthhome.net.

Who Is Eligible