| SNiP Tips
Who HIV SNPs are for
Who can join an HIV SNP?
HIV Special Needs Plans are for people with HIV who have Medicaid. They don't
have to have AIDS or be sick. If they want to, people with HIV can also enroll their
children up to the age of 19, whether or not the children have HIV. HIV negative spouses
and partners cannot be enrolled in the HIV SNP.
Some people are excluded from joining a Medicaid health plan, including
HIV SNPs. This means that they can't join a mainstream Medicaid health plan or an HIV
SNP. Excluded groups include people who get both Medicaid and Medicare, people who have
to spend down to be eligible for Medicaid, and people who are eligible
for New York's Family Health Plus program. Please see Appendix IV for a full list of
excluded groups.
Does my client need Medicaid to stay in an HIV SNP?
Yes. Even if people switch from traditional Medicaid to an HIV SNP, they have to remain
enrolled in Medicaid to stay in the health plan. Your clients in HIV SNPs will still need
to meet all the guidelines for Medicaid, including recertification.
| SNiP Tip: Your clients can ask their HIV SNP case managers for
help with staying enrolled in Medicaid. |
Do people with HIV and Medicaid have to join HIV SNPs?
No. Right now people who have HIV don't have to join an HIV Special Needs Plan
or any other Medicaid health plan. They can decide to stay in traditional Medicaid,
join a Medicaid health plan, or join an HIV SNP. No one is required to join an HIV SNP
| SNiP Tip: Remember, your clients can receive general enrollment
information about HIV SNPs by calling New York Medicaid Choice at 1-800-505-5678. For
all other questions, call GMHC's Managed Care Consumer Assistance Program at 212/367-1125;
TTY: 212/367-1199. (See Appendix II, "Resources.") |
Will my client ever be required to enroll in an HIV SNP?
Maybe. Sometime in the next few years, HIV SNPs may become mandatory. If this happens, people
with HIV will have to pick an HIV SNP or a mainstream Medicaid health plan. But some groups,
like homeless people, will still be exempt from mandatory enrollment. They will
be able to stay in traditional Medicaid if they want to. When these changes happen, people will
be told and might need more information about HIV SNPs.
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