New York Medicaid Advantage Plus (MAP)

At-home care and support for people who have both Medicaid and Medicare.

One card. One number. One plan.

Medicaid Advantage Plus (MAP) provides services and support to dual-eligible Anthem Blue Cross and Blue Shield HP members who need long-term care services in New York.

MAP includes your Medicaid home care and long-term care services plus your Medicare benefits—all in one plan. It helps make all of your benefits work better for you by coordinating your care and services, so you’ll have:

 

 One card for both your Anthem Medicaid and Medicare services.

 

 One number to call Member Services for help: 1-833-713-1080 (TTY 711).

 

 One plan making it easier to get the services you need, when you need them.

Who’s eligible for MAP in NY?

 

The MAP program is a Managed Long-Term Care plan for people who have both Medicaid and Medicare. This plan helps people who need long-term care services like home care and personal care to stay in their homes and communities as long as possible.

 

You may be eligible for MAP through Anthem if you:

 

 Are 18 or older.

 

 Are eligible for both Medicaid and Medicare..
 

 Live in the Bronx, Brooklyn (Kings), Manhattan (New York), Queens,  Staten Island (Richmond), Dutchess, Nassau, Orange, Rockland, Suffolk, Ulster, or Westchester County.
 

 Have a chronic illness or disability (based on an assessment) that makes you clinically eligible for enrollment.
 

 Are eligible for nursing home level of care at the time of enrollment.
 

 Live  in a qualified nursing home.
 

 Have a chronic illness or disability that makes you eligible for services often provided in a nursing home.
 

 Are able to stay safely at home at the time you join the plan.
 

 Are expected to need one or more of the following services for at least 120 consecutive days from the date you join our plan:

  • Nursing services in the home
  • Therapies in the home
  • Home health aide services
  • Personal care services in the home
  • Adult day health care
  • Consumer Directed Personal Assistance Service (CDPAS)
  • Private duty nursing

Interested in becoming a MAP member?

 

Call 855-593-0908 (TTY 711) to find out more about MAP and how to enroll with Anthem.

You must enroll with Anthem Medicare to join MAP
 

MAP combines all your Medicaid and Medicare benefits into one plan. To join, you’ll need to:

 

 Be an eligible Anthem Medicaid member

 Enroll in an Anthem Medicare plan


You’ll keep all your current Medicaid benefits when you join Anthem MAP. You’ll also have access to all your Medicare benefits, which will make receiving healthcare much easier. This program is provided to dual-eligible Anthem members in New York.
 

 

Learn more about the Anthem HealthPlus Full Dual Advantage LTSS (HMO D-SNP) Plan, including:

 

 Summary of Benefits
 

 Evidence of Coverage

 Enrollment instructions
 

 Drug coverage and formulary
 

 

Review plan documents  

What you get with Anthem

Dental care

Vision care

Non-emergency transportation

Care management

Benefits of Anthem MAP services include:

  • Adult day health care
  • Care management
  • Dentistry
  • Durable medical equipment not covered by Medicare
  • Enteral and parenteral supplements
  • Family planning
  • Hearing aids/hearing aid batteries
  • Home health care not covered by Medicare
  • Inpatient mental health care over the 190-day lifetime Medicare limit
  • Home-delivered or congregate meals
  • Medical social services
  • Medical/surgical supplies
  • Nonemergency transportation
  • Nursing home care not covered by Medicare (Medicaid eligibility rules apply)
  • Nutritional counseling
  • Personal care
  • Personal emergency response system
  • Private duty nursing
  • Social day care
  • Social supports and changes to the home
  • Vision care

 

Be sure to review the Anthem HealthPlus Full Dual Advantage LTSS (HMO D-SNP) Plan Documents for a complete list of benefits. For some services, a doctor’s order and/or approval from Anthem may be required.

Coordinated services are services that are not covered by your Anthem MLTC plan. You get these services through Medicare or through fee-for-service Medicaid. Your care manager is here to assist you by arranging and coordinating these services for you:

  • Hospitalization
  • Physician care
  • Specialist care
  • Preventive care
  • Emergency care
  • Lab tests and X-rays
  • Prescription drugs
  • Behavioral health services

 

To join MAP, you must also enroll with Anthem Medicare. Find Medicare doctors in your area today.

Our care management team works to help make healthcare less complicated for our MLTC members. We manage all your physical, behavioral health, and long-term care services through care coordination. These services include:

 

Your care manager
 

You’ll have your own care manager who’ll get to know you, your family, and your care team. They’ll visit in-person to help you:

  • Access the right long-term care services in the right setting.
  • Receive necessary medical supplies and equipment.
  • Find doctors and other resources close to home.
  • Make good healthcare choices.
     

Your care team

 

Your care team includes a care manager, doctors, and family. We’ll work together to help manage your health.

 

Your care plan
 

You’ll get a care plan designed just for you. Your care manager will work with you to decide what care and services are needed to meet your healthcare goals.
 

 

Your health plan support
 

Our team of experienced nurses, social workers, and behavioral health clinicians know your community. They can help you decide on treatment options, find local resources, and learn how to get the most from your benefits.

If your monthly income is more than Medicaid limits, you can spend down the difference. Social Services will review your income before joining Anthem MAP and decide if you must spend down part of your monthly income to meet the Medicaid requirements.

Some services need preapproval or prior authorization. This means that you or your doctor must ask Anthem to approve those services or benefits before you get them. 

 

Your care manager can assist you with getting these services:

  • Adult day health care
  • Audiology/hearing aids
  • Dentistry (no approval is needed for routine dental care)
  • Durable medical equipment
  • Home health care
  • Home-delivered meals
  • Medical social services
  • Nonemergency transportation
  • Nursing home care
  • Nutritional counseling
  • Optometry/eyeglasses
  • Personal care
  • Personal emergency response system
  • Podiatry
  • Private duty nursing
  • Social day care
  • Social and environmental supports

MAP members may go to any Medicaid doctor or clinic providing family planning care. You do not need a referral from your primary care provider.

Call your care manager at 855-661-0002 (TTY 711), Monday through Friday from 8:30 a.m. to 5 p.m. Eastern time.

If you have medical questions and can’t reach your care manager, call our 24/7 NurseLine at 855-661-0002 (TTY 711) anytime, day or night.

Not yet a member? Choose Anthem.

We can help you apply. Call 855-800-4683  (TTY 711), or visit us in person. Find a Community Service Center near you.

Enroll

Understanding your benefits


We want to make sure you receive the best possible care and understand your benefits. Review your plan documents to get started:
 

 Anthem HealthPlus Full Dual Advantage LTSS (HMO D-SNP) Plan Documents