Medicaid is a federal healthcare program that’s available in New York State designed to help residents in need obtain the medical care and support they need at little to no cost. The program provides full cost coverage of most common medical expenses, and in Onondaga County Medicaid also covers a few additional support services for eligible individuals. The application process and specific details of the Medicaid program varies from state-to-state and county-to-county, so it’s important to be aware of your own state’s and county’s requirements. This article will look at the details of Medicaid in Onondaga County.
Check out our Medicaid guides for other locations:
How do I apply for Medicaid in Onondaga County?
In Onondaga County, eligible individuals can apply for Medicaid coverage at a designated Medicaid office where they can get an application and guidance from a certified Medicaid counselor if necessary. It’s also possible to call one of these offices to have an application form sent directly to you, or in certain situations you can apply online through the online application system.
For adults ages 19-64 (who aren’t eligible for Medicare), pregnant women and infants, children ages 1-18, and parents or caretaker relatives of Medicaid eligible individuals, Onondaga County requires applicants to submit their applications online through the New York State Marketplace. Individuals in this category may still visit or call an application center if needed to get additional information, but it’s recommended that the final application be submitted online.
The following individuals must apply in person at a Medicaid Application Center:
● Individuals age 65+ for whom age is a factor in Medicaid eligibility
● Applicants for the Medicaid Savings Program (MSP)
● Enrollees for the Medicaid Buy-In or Working People with Disabilities Programs
● Former foster care youth
● Residents of long-term care facilities such as nursing homes
● Individuals who are blind or disabled and are applying based on their disability or who are applying for CBLTC (community-based long-term care) or require Personal Care Services (PCS) or Consumer Directed Personal Assistance Services (CDPAS).
● Women who fall under the Medicaid eligibility category of Presumptive Eligibility (PE) for Pregnant Women
Prenatal Care Medicaid Coverage Application Centers
Medicaid in Onondaga County offers selective coverage for prenatal care. If you wish to apply for Medicaid to cover prenatal care services, you can visit one of the following locations:
301 Prospect Ave.
Syracuse, NY 13203
90 Presidential Plaza
Syracuse, NY 13202
819 S. Salina St.
Syracuse, NY 13202
What services does Medicaid provide for residents in Onondaga County?
Medicaid in Onondaga County is available to many people and has good coverage for a variety of situations. Here are the services that Medicaid provides for eligible residents of Onondaga County:
● Long-term care coverage is available to eligible individuals who are currently residing in a nursing home or long-term care facility. Long-term health care services and costs covered by Medicaid include adult day care, housekeeping, physical therapy, Personal Emergency Response Systems (PERS), transportation, and more.
● Dental care, vision care, and auditory care are all covered for Medicaid recipients. The cost of appointments and Medicaid plan-approved medications are covered so long as the recipient visits a Medicaid-approved medical provider.
● The CDPAP (Consumer Directed Personal Assistance Program) is available to Medicaid recipients residing in Onondaga County. This program permits elderly or disabled individuals to either designate family members as their official caretakers or to choose a specific caretaker with a certain knowledge base or qualifications. The CDPAP program supports Onondaga residents by giving them more freedom and comfort in their homes and with the people who care for them.
● Home care services are also available in Onondaga County (and throughout the rest of New York State as well). This is a more affordable and often more accessible alternative to traditional long-term care facilities such as nursing homes, and it can often be more comfortable for the patient. Home care services covered by Medicaid in Onondaga county include caregiver fees, home safety modifications, housekeeping, personal care assistance, transportation, and more.
● Nutrition services like nutrition counseling, dietician fees, and the cost of having a personalized health and nutrition plan developed may be covered for certain eligible Medicaid patients in Onondaga County.
● Prenatal care services are covered by Medicaid for eligible individuals.
● Disability-related Medicaid coverage is provided to those patients in need who are eligible to receive it.
● Emergency hospital care is covered by Medicaid in Onondaga County although a certain copay amount may be required depending on the circumstances and length of the visit.
● Eligible children and teenagers can receive Medicaid coverage in Onondaga County and throughout New York State. The Children’s Medicaid program covers the majority of medical costs, including most doctor’s visits, dentist appointments, eye exams, pediatric care, speech therapy, emergency care, and more.
Medicaid Transportation Companies That Service Onondaga County
Medicaid covers both medical and non-medical transportation services for eligible recipients in New York State. In Onondaga County there are many transportation services that offer transport by taxi, bus, ambulatory vehicle, or ambulance. The ability to go from Point A to Point B is extremely important and these companies dedicate themselves to assisting Medicaid recipients with their transportation needs.
In Onondaga County it’s possible to either call Medical Answering Services (MAS) and they will arrange transport with one of these companies, or you can call a company of your preference directly to schedule transportation. Some, though not all, transport companies may require you to book transport with them through MAS for legal or logistical reasons.
**Provides non-emergency patient transportation services
Band Aid Personal Care Transportation Service
**Offers both medical and non-medical transportation for ambulatory passengers
**Provides gas cards, bus tokens, and taxi rides to those in need
**Make sure to schedule transportation in advance according to the rules listed at the website
If you have an emergency and must ride in an ambulance to a hospital, make sure that you or a caregiver/representative contacts your Medicaid coverage provider to ensure that the trip is covered. Emergency transport services are covered in Onondaga County and in New York State regardless of the ambulance transport provider.
Doctors That Accept Medicaid in Onondaga County
In New York State, the Medicaid program is specifically designed to lower medical costs and make healthcare more accessible to individuals with fewer resources or a greater need. The Medicaid program also works to improve the quality of the care that’s provided. The Medicaid program has an established network of practitioners and providers for patients to choose from. This network makes it possible for Medicaid to monitor and improve care and coverage wherever possible. Patients on the Medicaid Managed Care Plan are generally asked to choose a Primary Care Practitioner (PCP) as their doctor to provide for most medical care needs. The PCP must be able to create a care plan for the patient and also refer them to specialized care professionals and other medical establishments within the Medicaid network should the need arise.
Doctors and care providers who are within the Medicaid network can provide services to Medicaid recipients with full (or almost full) coverage. These providers are paid by Medicaid directly rather than the patient having to pay after the appointment.
Here are some doctors in Onondaga Country who are a part of the Medicaid provider network:
Dr. Denise Octavani, MD
Compassionate Family Medicine
311 Green St.
Syracuse, NY 13203
Dr. Walter Allen Hall, MD
Upstate Medical University
725 Irving St., Ste 503
Syracuse, NY 13210
Dr. Anil K. Verma, MD
Psychiatric Wellness Care
1816 Erie Blvd. East
Syracuse, NY 13210
Dr. Dignant Nanavati, MD
Brighton Medical Associates
182 Intrepid Ln.
Syracuse, NY 13205
Well-Women Care and Special Deliveries
4850 Broad Rd., Ste 2v
Syracuse, NY 13215
CDPAP Eligibility in Onondaga County
CDPAP, also known as the Consumer Directed Personal Assistance Program, is a program in New York State that caters to elderly or disabled people who utilize home health services and require the assistance of a home care aide. The CDPAP allows these people to choose who they want to be their caregiver, whether that person be a qualified professional or a friend or family member. The program offers training and Medicaid-covered payment to family members or friends chosen as caregivers by a patient.
There are specific eligibility requirements to be admitted to the CDPAP program in Onondaga County. Medicaid recipients must be in need of help with performing daily activities such as those described in the ADL (the Activities of Daily Living) tests. Most Medicaid eligible individuals are also eligible to be a part of the CDPAP program. The patient (or a representative) must be able to communicate their needs and desires clearly to the hired home health professional in order to train them. This is a necessary requirement to qualify for the program. If the home health caregiver is a friend or family member, that person must be willing and fully capable of learning about and performing the day-to-day tasks or medical responsibilities necessary to care for the patient.
Location of Medicaid Office(s) in Onondaga County
The following are the locations of the primary management and administration centers for the Medicaid program in Onondaga county:
421 Montgomery St., 400
Syracuse, NY 13202
Open M-F from 8am-4pm
Syracuse New York Medicaid Office
615 Erie Blvd West, 301
Syracuse, NY 13204