Help centerHere’s where you can quickly find accurate information about our plan, policies, providers, or other assistance you may need.
General questions about Partners Health Plan
What is Partners Health Plan?
Partners Health Plan (PHP) is a non-profit managed care program for adults age 21 and older with intellectual and other developmental disabilities. PHP offers a fully integrated managed care program called PHP Care Complete FIDA-IDD Plan for individuals that have developmental disabilities and are eligible for both Medicaid and Medicare.
What is PHP Care Complete FIDA-IDD Plan?
PHP Care Complete is a Fully Integrated Duals Advantage managed care program for persons age 21 years and older with IDD who are dually eligible for both Medicaid and Medicare. This program is approved by both Medicare and the New York State Medicaid program to integrate the full continuum of Medicare and Medicaid benefits, including long-term services and supports and OPWDD services. PHP Care Complete FIDA-IDD offers comprehensive benefits that include:
- Medicare and Medicaid medical, dental, and behavioral health care coverage
- Prescription drug coverage
- OPWDD services such as habilitation
- Other long-term services and supports such as personal care
How do I know if I am eligible for PHP Care Complete FIDA-IDD Plan?
You are eligible to join PHP Care Complete FIDA-IDD Plan as long as:
- 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.
What is OPWDD?
OPWDD is the New York Office for People With Developmental Disabilities. OPWDD determines who is eligible for OPWDD services. The OPWDD website is www.opwdd.ny.gov.
For general information about OPWDD in our nine-county service area, please call: 1-866-946-9733.
What is Medicare and how can I apply?
Medicare is the federal health insurance program for people age 65 and older as well as people younger than 65 with certain disabilities or end-stage renal disease (kidney failure). To apply for Medicare, you can use the online application at the Social Security Administration’s website: www.ssa.gov or call 1-800-772-1213 to find an office near you.
You can call the Social Security Administration from 7 a.m. to 7 p.m. Monday through Friday, or use the 24-hour automated telephone service to get recorded information. The TTY toll-free number is 1-800-325-0778; this number requires special telephone equipment and is only for people who have difficulties with hearing or speaking.
What is Medicaid and how can I apply?
Medicaid is a joint federal and state government program that helps with medical expenses and long-term services and supports for certain people with limited incomes and resources or other disabilities.
If you want to learn more about Medicaid eligibility or if you have other questions, visit the New York State website:www.health.ny.gov.