The NY State of Health: The Official Health Plan Marketplace began offering enrollments into Health and Recovery Plans (HARPs) on June 1, 2018. A HARP is a voluntary Medicaid Managed Care health insurance product for adults 21 and older who need physical and/or behavioral health services, including extra support for reaching their recovery goals, such as finding a job or living independently. A HARP will facilitate the integration of physical health, mental health, and substance use services for individuals requiring specialized approaches, expertise, and protocols which are not consistently found within most medical plans. A HARP provides the same comprehensive benefits found in all Medicaid health plans such as doctor visits, mental health and substance use disorder services, medications, hospital care, and additional specialty services important to people living with mental health or substance use disorders, including enhanced care management. HARPs do not cover permanent placement in a nursing home, but do cover temporary stays. When consumers join a HARP, they will get a primary care provider (PCP). The plan the consumer enrolls into will provide the consumer with a choice of PCPs within the network. New York State determines if individuals are eligible for HARP. Individuals must be 21 or older; insured only by Medicaid and eligible for Medicaid Managed Care; living with mental health or substance use disorders; not participating or enrolled in a program with the Office for People with Developmental Disabilities (OPWDD); and not recipients of Traumatic Brain Injury (TBI), Nursing Home Transition and Diversion (NHTD), or Office of Mental Health (OMH) waiver services.
On Nov. 1, 2018, the NY State of Health will be entering its sixth open enrollment period for Qualified Health Plans (QHPs) with coverage beginning Jan. 1, 2019. Open enrollment is the time when individuals can enroll in a health insurance plan for part or all of the next “plan year.” Qualified Health Plans provide comprehensive coverage including free preventive care. Many individuals and families will be eligible for financial assistance to reduce the cost of coverage. Not only are there tax credits to reduce monthly premiums, but you may also be eligible for cost-sharing reductions to reduce co-payments, deductibles, and out-of-pocket maximums. It’s also important to remember that individuals who qualify for the Essential Plan, Child Health Plus, or Medicaid may enroll during any month of the year. In addition, individuals who have qualifying events—that is, significant life changes like marriage, death, divorce, the birth of a baby or adoption, or the loss of health coverage from employment--may enroll in, or change health plans, outside of the open enrollment period, as long as they do so within 60 days of the qualifying event.
Individuals seeking in-person assistance from a Navigator can call the Healthcare Consortium at 518-822-9600 or toll free 1-800-980-5530 to schedule an appointment at any one of our 25 locations throughout Columbia and Greene counties. Appointments may be made during regular business hours of operation, as well as in the early morning, evenings, and weekends. Walk-ins are also welcome.
Additionally, the Customer Service Center (1-855-355-5777) is open 8 a.m.-8 p.m. Monday through Friday and 9 a.m.-1 p.m. Saturday and can assist the public in more than 48 different languages. New Yorkers can also access available plans, estimated costs, and financial assistance for their county by using the Tax Credit and Premium Estimator at www.nystateofhealth.ny.gov.
Celebrating 20 years of serving Columbia and Greene counties, the Healthcare Consortium is a non-profit organization whose mission is to improve access to healthcare and support the health and well-being of our rural community. The agency is located at 325 Columbia St. in Hudson. For more information: visit www.columbiahealthnet.org or call 518-822-8820.