How to Navigate Medicaid

Finding answers to your Medicaid and insurance plan questions can be timeconsuming and difficult, which is why SOMOS Community Care has placed all the information you need in one place.  

Medicaid Beneficiary Frequently Asked Questions

What is SOMOS Community Care?

SOMOS Community Care is a network of diverse community-based primary care physicians, specialists, and service providers in the New York City area that speak your language and understand your culture. Our network providers serve more than 650,000 Medicaid beneficiaries.

How do I find a SOMOS doctor that speaks my language? 

Use our Provider Directory to find a SOMOS Community Care physician in your area that speaks your language. You can search  by name, specialty, and location.

Do SOMOS Community Care doctors accept my insurance?

Once you find a SOMOS Community Care provider, you will have to contact their office directly to verify that they accept your insurance. Their phone number is available through the search results in our Provider Directory.

Can I change doctors if I receive Medicaid?

Each Medicaid insurance plan has its own rules and guidelines. To find out if you can change your provider, you will have to contact your insurance plan’s customer service. To find out more about Medicaid, click here. (Link to Medicaid page in each language)

Can I change my SOMOS Community Care Doctor?

To find out if you can change your provider, you will have to contact your insurance plan’s customer service. To find out more about Medicaid, click here. (Link to Medicaid page in each language)

How do I know what insurance I have?

To verify who your insurance provider is, contact Medicaid by calling 1-888-692-6116 or visiting them online at:
https://www.nystateofhealth.ny.gov.

Before contacting Medicaid, make sure that you have your New York Benefit ID Number and Access Number available.

What is an authorized representative?

An authorized representative is a trusted person that you authorize to renew and discuss your Medicaid application and coverage. When designating an authorized representative, please note that this person will have access to your health information.

How do I designate or change an authorized representative? 

If you would like to authorize or change a representative at renewal or anytime in between renewals, you may fill out this form (DOH-5247), and submit it with your renewal. An authorized representative can apply for and/or renew your Medicaid application, discuss your Medicaid application or case, and/or get notices and correspondence for you.

 

If I have an immediate need for Personal Care Services or Consumer Directed Personal Assistance Services, can I get my eligibility for these services processed more quickly?

If you already have Medicaid coverage that does not include coverage for community-based long-term care services, you must send in an a form entitled “Access NY Supplement A” (DOH-4495A)/(DOH-5178A), if needed, a physician’s order for services, and a signed “Attestation of Immediate Need” (OHIP-0103) to your local Department of Social Services.

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