PHP Care Complete FIDA-IDD Plan

Eligibility

Who is eligible for PHP Care Complete FIDA-IDD Plan?

The program is voluntary and participants may enroll if you meet the following criteria:

  • Age 21 or older at the time of enrollment;
  • Entitled to benefits under Medicare Part A, enrolled in Medicare Part B, eligible to enroll in Medicare Part D, and eligible for full Medicaid benefits;
  • Reside in Bronx, Kings, New York, Queens, Richmond, Rockland, Nassau, Suffolk or Westchester Counties;
  • Eligible for OPWDD services in accordance with NYS Mental Hygiene Law 1.03(22); and
  • Determined to be eligible for ICF-IID level of care; and
  • If receiving Section 1915(c) waiver services as an alternative to ICF-IID placement, enrolled in the Section 1915(c) OPWDD Comprehensive Waiver.

Contact us to enroll

If you are interested in enrolling in PHP Care Complete FIDA-IDD Plan, please call our Participant Services staff seven days a week at 1-855-747-5483 or TTY/TDD: 711 and we will gladly answer any questions you may have and put you in touch with the state’s Enrollment Broker (i.e., New York Medicaid Choice) to complete the enrollment process. Once your enrollment has been approved, New York Medicaid Choice will inform us about your Enrollment Effective Date (usually the first day of the month following your enrollment) and we will make sure you receive a Participant ID Card, Participant and Family Handbook/Evidence of Coverage, a Provider and Pharmacy Directory, and other informational materials about our program and services. A PHP Care Manager will also contact you to schedule an initial evaluation and assessment.


Disenrollment rights & responsibilities

You and/or your authorized representative have the right to disenroll from PHP Care Complete FIDA-IDD Plan at any time for any reason. PHP will never ask or encourage you to disenroll nor will we try to convince you to remain enrolled. We may contact you to find out the reason for the decision and to explain how Medicaid and Medicare coverage will be provided to you following your disenrollment, but PHP staff will make no effort to convince you to remain enrolled.

To request disenrollment from PHP Care Complete FIDA-IDD Plan, you and/or your authorized representative must contact NY Medicaid Choice by calling 1-844-343-2433 (TTY: 1-888-329-1541) or by calling 1-800-MEDICARE.

When you voluntarily disenroll from PHP Care Complete FIDA-IDD Plan, you will remain enrolled until the last day of the month in which the disenrollment request was received, and will return to Original Medicare or Medicare Advantage and Fee-For-Service Medicaid the first day of the following month if no other action is taken. If you decide to enroll in another managed care option, please let your Care Management Team know as soon as possible so that we can assist you during the transition process.

GET HELP

Supporting the life you choose

Contact us at (855) PHP-LIVE  (747-5483) or TTY/TDD: 711

or
Visit the Online Help Center