If you are 65 and older and in need of health insurance, the Dept of Human Services can help...

• If you reside in Monroe County, call 585.753.6960
• If you reside in Livingston County, call 585.243.7300

Call 585.613.7662 for a Facilitated Enroller near you

Benefits

Health Insurance Benefits

MEDICAID
Provided by a Managed Care Plan or Fee-for-Service
CO-PAYS MAY APPLY IN SOME INSTANCES - NO PREMIUMS

Inpatient Hospitalization Emergency Care Outpatient Care Lab Tests and X-rays Primary and Preventive Health Care/Education Vision, Speech and Hearing Services Durable Medical Equipment Prescription Drugs Prosthetics and Orthotics Second Medical/Surgical Opinions Dental Care Diabetic Supplies and Equipment Smoking Cessation Products Short-term Rehabilitation** Home Health Care (some limits apply)

Family Planning/Reproductive Health Physicians/Nurse Practitioners/Midwives Radiation/Chemotherapy/Hemodialysis Mental Health/Alcohol & Substance Abuse Treatment (as medically necessary) Over-the-Counter Drugs (with a written prescription) Emergency and Non-emergency medical transportation Hospice Care Private Duty or Skilled Nursing Care Personal Care Aide Services Adult Medical Day Care Orthodontia Medical/Surgical Supplies Orthopedic Shoes

FAMILY HEALTH PLUS
Provided by a Managed Care Plan only
CO-PAYS APPLY - NO PREMIUMS

Inpatient Hospitalization Emergency Care Outpatient Care Lab Tests and X-rays Primary and Preventive Health Care/Education Vision, Speech, and Hearing Services Durable Medical Equipment Prescription Drugs Prosthetics and Orthotics Second Medical/Surgical Opinions Dental Care provided only by Fidelis Care

Diabetic Supplies and Equipment Smoking Cessation Products Short-term Rehabilitation Home Health Care (some limits apply) Family Planning/Reproductive Health Physicians/Nurse Practitioners/Midwives Radiation/Chemotherapy/Hemodialysis Mental Health/Alcohol & Substance Abuse Treatment (some limits apply) Emergency Ambulance Transportation Hospice Care

CHILD HEALTH PLUS
Provided by a Managed Care Plan Only
NO CO-PAYS - PREMIUMS MAY APPLY

Inpatient Hospitalization Emergency Care Outpatient Care Lab Test and X-rays Primary and Preventive Health Care/Education Vision, Speech, and Hearing Services Durable Medical Equipment Prescription Drugs Prosthetics and Orthotics Second Medical/Surgical Opinions Dental Care

Diabetic Supplies and Equipment Smoking Cessation Products Short-term Rehabilitation Home Health Care (some limits apply) Family Planning/Reproductive Health Physicians/Nurse Practitioners/Midwives Radiation/Chemotherapy/Hemodialysis Mental Health/Alcohol & Substance Treatment (some limits apply) Over-the-Counter Drugs (with a written prescription) Non-airborne Emergency Ambulance Services Hospice Care

* Managed care plans available: Excellus Bluecross Blueshield, Fidelis Care and MVP

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Family Health Plus Co-Pays

Brand name prescription drugs	$6.00 for each prescription and refill
Generic prescription drugs	$3.00 for each prescription and refill
Clinic visits	$5.00 per visit
Physician visits	$5.00 per visit
Dental service visits (Fidelis Care only)	$5.00 per visit up to a total of $25.00 per year
Lab tests	$0.50 per test
Radiology services (e.g., diagnostic x-rays, ultrasound, nuclear medicine, oncology services)	$1.00 per x-ray
Inpatient hospital stay	$25.00 per stay
Non-urgent emergency room visit	$3.00 per visit
Covered over-the-counter drugs (e.g., smoking cessation products, insulin)	$.50 per drug
Covered medical supplies (e.g. diabetic supplies such as syringes, lancets, Test strips, enteral formula)	$1.00 per supply

* Pregnant women or individuals under age 21 will not have to pay the co-payment.

** If you cannot afford the co-payment at the time of service, tell your provider. The provider must still provide services and bill you later.

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