Frequently Asked Questions
Partners Health Plan is committed to ensuring that you have all the information you need to make informed decisions. We've compiled common questions that have been asked to help you get started with answers. Do you have a question that is not on our Frequently Asked Questions list? We would love to answer YOU! Please complete the online contact us form below and a member of our Outreach Team will contact you.
The PHP Care Complete FIDA-IDD Medicare-Medicaid Plan Partners Health Plan is a person-centered health plan, created to specifically support people who have intellectual and developmental disabilities. Existing Medicaid and Medicare benefits are provided through an integrated benefit design that includes a dedicated Care Coordination team to address each individual’s medical, behavioral, long-term services, and social needs.
This is an acronym for, "Fully Integrated Duals Advantage plan, specializing in serving members with Intellectual and Developmental Disabilities."
- Are over the age of 21.
- Have active Medicaid and Medicare. (PHP can help you apply if needed.)
- Are eligible for OPWDD (Office for People with Developmental Disabilities) Waiver services.
- Reside in our service area (Currently 9 Counties: Rockland, Westchester, Bronx, Manhattan, Queens, Brooklyn, Staten Island, Nassau and Suffolk)
With PHP you will gain a comprehensive and integrated support plan that coordinates all of your health needs and OPWDD Waiver services. Our two-person Care Coordination team will support you in obtaining appropriate person-centered services such as medical, vision, and medication. We also offer other benefits such as Durable Medical Equipment, Telehealth, Self-Direction, Home Care, Community Habilitation, transportation, and much more. Your PHP team will coordinate and communicate with you, your family, and all of your providers (Doctors, Residence, Day Program, Community Habilitation, etc.) to ensure quality healthcare and services.
No. Enrollment is not required to maintain your current level of service. Joining the plan is voluntary and you can disenroll at any time
There are zero out of pocket expenses for members. There are $0 deductibles, $0 co-payments, and no annual premiums.
PHP will coordinate benefits with most third party insurances.
No. Enrollment in PHP does not affect your eligibility for Medicare or Medicaid. You will still get them and use your PHP Participant ID Card to access your FIDA-IDD benefits and services. **You can continue to use your New York State benefit card for food stamps.
In some cases you may be able to keep your care manager. Ask us for more information. PHP will help to transition you from your current Care Manager to a two-person Care Coordination team. Each PHP member receives support from a Clinical Team Leader and a Care Manager. Clinical Team Leaders are either Licensed RNs or Licensed Social Workers. ** People who reside in an ICF (Intermediate Care Facility) gain a Clinical Team Leader and keep their QIDP within the ICF.
Yes. PHP has over 35,000 providers in our network. We have contracted a panel of quality providers and continue to expand our network.**PHP acknowledges the importance of Continuity of Care therefore, during the initial transition phase new members can continue seeing their current providers, even if they are not in network, for the first 90 days. For behavioral health services we offer up to 2 years of Continuity of Care.
An Ombudsman is an independent service that offers free assistance to individuals enrolled in our plan. The ombudsman can support members as needed in accessing care, understanding and exercising rights and responsibilities, and appealing adverse decisions made by the plan.
You can call NY Medicaid Choice 1-844-343-2433 (TTY 1-888-329-1541) to either enroll by phone or request a meeting with an Outreach Associate to discuss the benefits of PHP. Call today to see if our plan is right for you.
Are you ready to enroll in PHP Care Complete FIDA-IDD Plan?
To enroll, visit or call NY Medicaid Choice at 1-844-343-2433 (TTY: 1-888-329-1541), Monday through Friday, 8:30 AM to 8:00 PM, and Saturday, 10:00 AM to 6:00 PM.
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