Eligibility For Enrollment In Our Plan
If you are:
1. 21 years of age or older
2. Reside in Dutchess, Rockland, Albany, Orange, Putnam, Washington, Warren county.
3. Have a chronic illness or disability that makes you eligible for enrollment.
4. Able to return to or stay safely at home at the time you join the plan.
5. Require care management and are expected to need at least one (1) or more of the following community based long term care services for more than 120 days from the date that you join our plan:
• Nursing services in the home
• Therapies in the home
• Home health aide services
• Personal care services in the home
• Adult day health care
• Private Duty Nursing
• Consumer Directed Personal Assistance Services (CDPAS)
6. Medicaid eligible or already have Medicaid
You might be able to join PRIME HEALTH CHOICE, LLC.
Once you contact us and verbalize your willingness to join the plan, PRIME HEALTH CHOICE, LLC will send the nurse to complete all necessary paperwork and if all eligibility requirements for the program will be met, we will submit your application to New York Medicaid Choice or the Local Department of Social Services (LDSS).
If you do not meet the eligibility requirements for the program, you will receive a notice from us informing you of the decision.
If you change your mind at any point prior to enrollment and no longer want to apply for enrollment in our plan, you can request an application for withdrawal.
Enrollment in our program is based on your meeting the eligibility criteria established by the New York State Department of Health and approval from New York Medicaid Choice or LDSS. We will not discriminate based on health status. We will cover the cost of all health-related covered services.
Why Use Prime?
- We offer a streamlined referral process.
- We provide easy access to all services.
- We are available 24 hours a day, 7 days a week.