FAQs

To protect your privacy, we will always ask you to provide three pieces of information to identify yourself. You can use any three of the following:

• MLTC member ID number
• First and last name
• Date of birth
• Full address
• Phone number
• New York Medicaid ID number

For your protection, we do not allow others to see your health information without your permission. There are three ways you can give others permission to see information about your care and services:

1. Call your Care Team with the person you want to have access your information, and give your permission over the phone. Your representative will have access to your information for 14 days from the date of the call.
2. If you want someone to see all your information, you can download this Authorization for Release of Health Information Pursuant to HIPAA form (English, Spanish, Chinese, or Russian). Fill out the form, and send it to us for processing.
3. If you want to allow someone to see just some of your information, write a letter saying that you give your permission to that person to speak on your behalf. Tell us their name, their relationship to you, and the sort of information you are allowing them to see. Send the letter to your Care Team for processing at this address:
   VNS Health
   Health Plans – Care Team
   220 East 42nd Street
   New York, NY 10017

If your home address or other contact information changes, please call us. You will also need to notify your local department of social services of your new contact information. To find the number for your local office, visit the New York State Department of Social Services website.

If your new address is within our service area, your coverage will not be affected. If you move outside of the service area, you may no longer be eligible for our plan, in which case you would be disenrolled. See the counties we serve.

If you need your services put on hold because you will not be at home — for example, if you go away on vacation or have to go into the hospital — please contact your Care Team. To suspend your home health aide services while you’re away, please contact the agency that provides your aide.

If you are dissatisfied with the quality of care you get from your aide, please contact their home care agency. If you are dissatisfied with the agency, please call us at 1-888-867-6555 (TTY: 711).

You can use any doctor you choose for services that are not covered by the plan. However, if you are a member of a Medicare HMO plan, you may have to use doctors and specialists who are part of that plan’s network.

For services covered by MLTC, you can use our online Provider Search tool. Or you can find a list of providers in the Provider & Pharmacy Directory.

If you need help identifying a provider who meets your needs, you can also contact your Care Team.

If you have any questions or concerns about getting authorizations for medical services, please contact your Care Team at 1-888-867-6555 (TTY: 711), and we can help you.

Call us. Please have the bill with you when you call, because the representative will ask you for specific information found on the bill. The representative will work with you and your doctor to clarify the bill and determine whether you may be responsible for any charges.

Some New Yorkers with monthly incomes above the Medicaid limit can be eligible for Medicaid in certain circumstances. The amount above the Medicaid level is called spenddown — also known as surplus or “excess income” — because it must be “spent down” in order to meet the income level requirement for Medicaid. You may receive a bill for this monthly amount, or it may be covered in some other way. Talk to your local social services department for more information. Or call us, and ask to speak with a Medicaid eligibility specialist.

There are a couple of ways to pay your Medicaid spenddown.

• One way is online through our partner, InstaMed. It is fast, easy, and secure. You can pick the way you want to pay (credit card, debit card, or bank account). You can also view your payment history and receipts, and set up automatic payments. Visit vnshealthplans.org/paybill on your phone, computer, or laptop to get started. For more details, check out the flyers below.
  • InstaMed Flyer (English)
  • InstaMed Flyer (Spanish)
  • InstaMed Flyer (Chinese)
  • InstaMed Flyer (Arabic)
  • InstaMed Flyer (Bengali)
  • InstaMed Flyer (Greek)
  • InstaMed Flyer (Haitian-Creole)
  • InstaMed Flyer (Hindi)
  • InstaMed Flyer (Italian)
  • InstaMed Flyer (Korean)
  • InstaMed Flyer (Russian)

• Or you can send us the payment by mail. When you receive a bill for your spenddown, a pre-paid envelope will be included with the statement. Use the envelope to mail us your payment. Include the payment stub from the statement so we can credit your account. If you no longer have the envelope, please use the address below.

If you have any questions about your spenddown, please call:
1-877-357-8544 (TTY: 711) Monday – Friday, 9 am – 4:30 pm.

If you have any questions about using InstaMed, please call:
1-877-357-8544 (TTY: 711) Monday – Friday, 9 am – 4:30 pm.

That’s great! Please tell them to call us at 1-855-282-4642 (TTY: 711). This line is specifically for people interested in joining. The health plan advisors can answer questions about eligibility and explain the enrollment process.