Enhanced Care (Medicaid Managed Care)

Enhanced Care is our state-sponsored Medicaid Managed Care plan. There is no monthly premium payment for this plan. However, pharmacy copays may be required in some instances. To be eligible, individuals must reside in the Bronx, Kings, Nassau, New York, Queens, Richmond, Suffolk or Westchester county. Additional eligibility factors may include:

  • Low-income individuals, families, and children
  • Pregnant women
  • People with disabilities

Children under age 21 who are covered by Medicaid and have mental health or substance use needs can get additional Special Services for Children at no extra cost. These services are provided at home or in the community.

Effective July 1, 2021, EmblemHealth will cover Article 29-I Voluntary Foster Care Agency (VFCA) Health Facilities services for children and youth under age 21. The 29-I VFCA Health Facilities work with families to promote wellbeing and positive outcomes for children in their care. The 29-I VFCA Health Facilities use trauma-informed practices to meet the unique needs of each child.

Eligible members can receive the following 29-I VFCA Services:

  • Core Limited Health-Related Services
  • Other Limited Health-Related Services when medically necessary, including:
    • Screening, diagnosis, and treatment services related to physical health
    • Screening, diagnosis, and treatment services related to development and behavioral health
    • Children’s Family Treatment and Support Services (CFTSS)
    • Home and Community Based Services (HCBS)

Looking to become a member?
Call: 888-447-2863 (TTY 711), Monday through Friday,
8 am to 8 pm.

What drugs are covered in this plan?

We cover pharmacy benefit services for all our Medicaid Managed Care members. You must use our network pharmacies to fill all of your prescriptions and any covered over-the-counter medications, diabetic supplies, select durable medical equipment and medical supplies.

See which doctors participate in this plan

Medicaid Managed Care members get access to excellent doctors within the EmblemHealth network for no monthly premium payment, although pharmacy copayments are required for some individuals.


 

Plan documents

  • Medicaid Managed Care QuickStart Guide

  • Enhanced Care (Medicaid Managed Care) Member Handbook

    Last updated: 9/1/2021
  • Enhanced Care (Medicaid Managed Care) Benefit Summary

    Last updated: 9/1/2021
Member Rights and Responsibilities

Know your rights

Member Rights and Responsibilities

Understanding your rights and responsibilities as a plan member can help you and us make the most of your membership. 

EmblemHealth Facilitated Enrollment Site Listings

The dates, times and locations in this listing are subject to change. Please call us at 888-447-2863, 8 am to 8 pm, 7 days a week, to make an appointment to visit with a Facilitated Enroller in your preferred language.

  • All
Results for
Show map