A Community Health Plan
Member Programs and ServicesPlan Benefits
As a member, you have the benefits available in regular Medicaid, plus you get the special care and support you need to get and stay healthy. Benefits include inpatient and outpatient medical care, hospital care, lab and radiology services, prescription drugs (co-pays may apply), dental, vision care, and more.
For quick reference about plan benefits, consult our Plan Benefit Guide
For full benefit information, consult our Member Handbook
To ensure that our members receive high-quality care, personalized assistance, and timely services, each member is assigned to an Integrated Care Team (ICT), which works with you to track progress on your Individualized Care Plan and health goals.
Your ICT includes:
- Care Coordinator – Your team leader coordinates with your primary care provider, specialists, hospitals, health homes, and other resources to ensure that you receive appropriate care and services.
- Case Management Coordinator – Conducts phone assessments with you at least twice a year and helps connect you to community resources such as case management, mental health and substance abuse treatment, housing and legal services, transportation assistance, and overall health education and support.
- Health Navigators – Ensure that you have the resources you need to stay in care by helping you choose a doctor who fits your specific needs and linking you with community-based agencies for additional support and services.
Amida Care wants to help our members living with HIV to Live Your Life… Undetectable. For most people living with HIV, taking antiretroviral (ARV) medications exactly as prescribed by your Primary Care Provider (PCP) will bring down the amount of HIV in the blood to a very low level. This is sometimes called an “undetectable” viral load or “viral load suppression.” People living with HIV who reach an undetectable viral load live longer, are healthier, and are unable to transmit HIV sexually to other people.
The LYLU program helps you take your ARV medications regularly and get undetectable. If you enroll in the program and your viral load is already undetectable or becomes undetectable, you will receive $100 for each quarter (three-month period) that you stay undetectable. Amida Care will connect you to supportive services decided on by you and your PCP to help you achieve this goal.
Find out if you are eligible to enroll in the LYLU program: Talk to your PCP, speak with an Amida Care Member Services Representative at 1-800-556-0689 / TTY 711, or email firstname.lastname@example.org.
Staying healthy is about more than doctor’s visits and medication. Our Live Your Life wellness program helps our members learn new ways to improve their health . . . and have fun in the process! Our free monthly member events throughout NYC include healthy cooking, art therapy, meditation, yoga, African and Latin dance, and more.
Amida Care’s Member Advisory Council (MAC) is a group of member representatives from many of our primary care sites. These representatives attend quarterly meetings where they discuss their perceptions and evaluations of member experience at Amida Care. Input from the MAC helps Amida Care improve its member services. The MAC also elects two of its members to serve on Amida Care’s Board of Directors.
We invite our members to attend regularly scheduled Town Hall meetings throughout the five boroughs to ask questions about our plan benefits and services and provide feedback about their experience with Amida Care.
Members can visit our walk-in service center at 234 West 35th Street in Manhattan to get personal assistance – no appointment is necessary.
As an Amida Care member, you can earn Healthy Rewards dollars just for receiving a variety of health care services that help you take good care of your health, including screenings, vaccines, immunizations, and preventive care visits. Funds will be added to your Healthy Rewards Visa card as you earn them.
Amida Care’s Workforce Initiative Network (WIN) (also known as the Peer Training Initiative) is a free vocational training program for Amida Care members, which helps them develop marketable job skills for entering or returning to the workforce. Members of the WIN program are trained to use their life experience for jobs in health navigation and outreach. The program is offered four times per year in collaboration with Housing Works (six-week training) and ASCNYC (12-14 weeks).
As of November 2017, Amida Care’s Medicaid Live Life Plus Plan is open to all transgender individuals who qualify, regardless of HIV status. Seven percent of Amida Care’s members – more than 400 – are people of transgender experience. Transgender members have access to a full range of free or low-cost health benefits and services, including:
- Experienced doctors, clinics, hospitals, and pharmacies throughout NYC
- Transgender care that includes hormone therapies, PrEP and PEP, and gender-affirming surgeries
- Help with housing referrals, job training, and other support programs
- Treatment for mental health conditions, HIV, sexually transmitted infections, and substance use
Amida Care’s Homeless Outreach Management and Empowerment (HOME) Program assists our members who are homeless or at risk of homelessness and connects them to vital health and social services, including connections and referrals to housing, education, legal and employment services. For more information, call 844-704-HOME (4663) or email HOME@amidacareny.org.
Our Better Days Program assists formerly incarcerated men and women who are HIV positive and returning to the community from jail or prison. We can assist members with finding a doctor immediately after release and help them with other services and referrals they need to get back on track. For more information about these programs and services, please contact Member Services at 1-800-556-0689 (TTY 711).