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 Serices 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)