Medicaid
About the Program
Medicaid continues to be the single largest program cost in the social services budget. Medicaid consists of 12 distinct programs, each targeting a particular income or age group. Unlike Temporary Assistance, Medicaid eligibility is determined on an individual basis, rather than for an entire family or household. New programs have expanded eligibility categories for children and the elderly.
Medical Assistance
Medical assistance budgets for payments for the medical care, nursing home care, drugs, and other professional services for eligible individuals. This is a federal program.
Access New York Health Care Website Link
Places to go to apply for health insurance in Ontario County:
- Excellus Blue Cross / Blue Shield Facilitated Enrollers (800) 716-4885*
- Fidelis Care Facilitated Enrollers (888) 343-3547*
- Geneva DSS 83 Seneca St Geneva (315) 789-1767 or (877) 542-8938
- Ontario County DSS 3010 County Complex Drive, Canandaigua (585) 396-4060 or (877) 814-6907
- S2AY Rural Health Network Facilitated Enrollers (800) 346-2211*
- Thompson Health Facilitated Enrollers (888) 758-7658*
Note: *Facilitated Enrollers cannot assist with applications for the nursing home population.
Interviews & Applications
Face-to-face interviews are no longer required. Applications may be mailed in or dropped off at the local office.
Charts:
The Medicaid Unit in Ontario County is made up of several sub-units that are responsible for the myriad of programs that the New York State Department of Health has instituted over the years. These programs include full Medicaid which pays for all medical care, Chronic Care which pays for nursing home services, payment of Medicare premiums, AIDS health insurance premiums, family planning services, Medicaid for the working disabled, and for pregnant women. Each program has its own eligibility criteria. The total Medicaid caseload increased 8%.
There are four agencies who have Facilitated Enrollers throughout the county that can assist in taking applications for Medicaid. They are Thompson Health, S2AY Rural Health Network, Excellus, and Fidelis. These applications are then submitted to the Medicaid Unit to process.
We continue to work closely with Lifetime Care and several other area agencies in providing Medicaid coverage to pregnant women through the MOMS program.
There are outside agencies who submit applications for the Family Planning Benefit Program and other agencies who submit applications for the Medicare Savings Program. The state also sends lists of people who applied to Social Security for help in paying for their Medicare Part D Premium for the agency to determine eligibility for payment of their Medicare Part B premium. Total number of Medicaid applications registered for the year was 4,662 for all programs. The caseloads have changed as follows: Community Medicaid (+8%), Family Health Plus (+7%), SSI Medicaid (+2%), SSI Food Stamps (+5%), and Chronic Care (-1%).
Anyone in receipt of Medicaid in Ontario County who does not have other health insurance is mandated to enroll in a Managed Care Plan. There are now three plans available. They are Excellus, MVP and Fidelis. Many of the exceptions to enrollment in Managed Care have been eliminated, requiring most individuals to enroll in a Managed Care Plan if they do not have private third party health insurance. New York Medicaid Choice has assumed responsibility for the education and enrollment process.
The state Enrollment Center started taking a large number of the Community Medicaid Renewals but returned that duty to the county after four months due to numerous problems that need to be resolved before moving forward.
The AD/DCAP Unit continues to assist Temporary Assistance clients in applying for SSI benefits so they can transition from the Cash Assistance Programs to receiving a higher level of income through Social Security’s Supplemental Security Income Program.
