WILL ENROLLING IN ARCHCARE COMMUNITY LIFE AFFECT MY MEDICARE OR MEDICAID BENEFITS?
No, membership in ArchCare Community Life (MLTC) will not affect coverage for your important Medicare or Medicaid medical benefits. This includes: ambulance, doctor visits, emergency room care, hospitalizations and prescription drug coverage.
WHAT MEDICAID BENEFITS ARE COVERED THROUGH ARCHCARE COMMUNITY LIFE?
The following benefits are covered through ArchCare Community Life:
Visits to dentists
Visits to podiatrists
The following benefits are not covered through ArchCare Community Life:
*Visits to your primary care doctor
*Visits to specialists
*PLEASE NOTE THAT MEMBERS WITH MEDICARE WILL CONTINUE TO BE COVERED BY MEDICARE FOR THESE SERVICES.
HOW MUCH DOES ARCHCARE COMMUNITY LIFE COST?
How much you pay for ArchCare Community Life depends upon your eligibility for Medicare and Medicaid.
If you are eligible for Medicare and Medicaid or eligible for Medicaid only and do not have a spend-down,* there is no cost to you for Community Life-covered services.
If you live in the New York City service area, your spend-down is determined by the New York City Human Resource Administration (HRA).
If you live in Westchester or Putnam counties, your spend-down is determined by the Local Department of Social Services (LDSS).
Also, there is no additional cost to you for authorized covered services in the Community Life provider network. However, if you choose to access services on your own that are not covered or obtain services of a nonparticipating provider that are not authorized by Community Life, you may be subject to payment of these services.
*Spend-down, which is also known as surplus, is the difference between your monthly income and the monthly Medicaid rate.
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