Partnership In Care (PIC) HIV

Partnership in Care (PIC) provides a team approach to caring for people living with HIV/AIDS and other select groups. The Health and Wellness team includes an HIV Specialist as your primary care provider (PCP). Our Care Managers help you make appointments and stay on top of your medications. We can make it easier to see specialty providers, such as Hepatitis C experts, dermatologists, and heart specialists. Our team of experienced clinicians can also help you and your family to get drug treatment or support services, like counseling, public benefits, legal help, and other services.

MetroPlusHealth Partnership in Care (PIC) Special Needs Plan (SNP) is open to most Medicaid-eligible adults and children living with HIV/AIDS in New York City. Children (up to age 21) of Partnership in Care members are also eligible to enroll, even if they are HIV-negative. Homeless residents of New York City may also be able to enroll.

If you live in New York City, are on Medicaid, and are receiving care for transgender health, you may also be eligible to enroll. Your children may also qualify to enroll in the SNP. Learn more in the Plan Materials section below.

In addition, our HARP-eligible members are eligible for Behavioral Health (BH) Home and Community Based Services (HCBS). For more information, click here.

DID YOU KNOW? There are many supports and services available to the LGBTQI community here in New York City. Learn more about where you can find help in our LGBTQI Resource Guide below.

Effective February 1, 2022, in order to improve access to services, NYS is transitioning four BH HCBS to a new service array called Community Oriented Recovery and Empowerment (CORE) Services. These four services include Community Psychiatric Support and Treatment (CPST), Psychosocial Rehabilitation (PSR), Family Support and Training (FST), and Empowerment Services – Peer Support (Peer Support). BH HCBS Short-term and Intensive Crisis Respite services will be transitioned to Crisis Intervention Benefit Crisis Residence services, already available to all adult Medicaid Managed Care enrollees. All other existing BH HCBS will remain available as BH HCBS with previously established requirements, workflows, and processes.

CORE services are specialty services that can help people meet their recovery goals, like getting help with finding a job or going to school, or living more independently.

For members who are 21 or older, covered by Medicaid, and enrolled in a Health and Recovery Program (HARP), CORE services may be just right. Additionally, some individuals enrolled in HIV-Special Needs Plans or Medicaid Advantage Plus Plans will be eligible for CORE. CORE services are covered by health insurance, at no cost to our members.

Learn more about CORE services below. Questions about CORE services? Call us at 1-800-303-9626 or speak with your behavioral health provider.

Effective January 1, 2019, new mental health and substance use services are available with NYS Children’s Medicaid. These services give children/youth (under age 21) and their families the power to improve their health, well-being and quality of life, strengthening families and helping them make informed decisions about their care. Services are provided at home or in the community. Learn more here.

IMPORTANT NOTICE TO OUR MEDICAID MEMBERS: Announcing a New Foster Care Transition to Medicaid Managed Care- Special Population

Starting July 1, 2021, MetroPlusHealth will cover Article 29-I Voluntary Foster Care Agency (VFCA) Health Facility services for children and youths under age 21 in foster care and other special populations, as indicated.

Also starting July 1, 2021, some children and youth must join a Medicaid managed care plan, including:

• children and youth placed in foster care in New York City, and
• children and youth placed in foster care and a 29-I VFCA Health Facility

Some children and youth placed in foster care cannot join a Medicaid managed care plan. They will keep getting services through regular Medicaid.

Members enrolled in our Medicaid, PIC (HIV-SNP), or Enhanced (HARP) plans who get all required doses on or after 11/01/2021 earn 1,000 reward points ($100 value)!

Visit MetroPlusHealth Rewards to let us know you have completed your vaccinations, or call us at 1-800-510-3944 (TTY: 1-844-488-9723) Monday-Friday 8 a.m. to 8 p.m. ET and you will earn your reward points instantly. Then, shop hundreds of items in the MetroPlusHealth Rewards Catalog!

Get a COVID-19 vaccine now and earn rewards!

Important Notice: Effective October 1, 2021, our members now access their behavioral health services through MetroPlusHealth. Learn more here.

IMPORTANT NOTICE TO OUR PARTNERSHIP IN CARE MEMBERS 18 YEARS AND OLDER

MetroPlusHeath is proud to offer benefits and services that help you live a healthy life. Starting July 1, 2022, you can join a no-cost Medically Tailored Meals program that provides healthy meals straight to your home.

Through this program, you and other members who qualify can get:

• Help from a registered dietitian and nutritionist. This person is a food and nutrition expert and will help give guidance and support in choosing healthy foods.

Up to three meals per day delivered to your home for six months at a time. You may be able to continue receiving meals as long as you are eligible for this program. These meals are tailored for your specific health needs and can help you gain access to healthy, nutritious foods. Learn more below.

Important notice about your Partnership In Care (PIC) managed care plan benefits.

Starting January 1, 2023, MetroPlusHealth will cover Gambling Disorder Treatment provided by Office of Addiction Services and Supports (OASAS) certified programs.

You can get Gambling Disorder Treatment:

• face-to-face; or
• through telehealth.

Learn more below, in the Plan Materials section.

If you would like a hard copy of this handbook, you can submit a request online here or call us at 1-800-303-9626 (TTY: 711). Please be sure to tell us which plan handbook – for example, Partnership in Care (PIC) – you need.

Recently, we sent you an announcement along with your new ID Card about our new partnership with DentaQuest, a dental vendor. Starting January 1, 2023, you can begin to use your new ID Card for all your health care needs, including dental services with DentaQuest. Remember to bring your new ID card when you visit your dentist.

Your oral health is important to us. Partnering with DentaQuest, we are able to bring their experience and passion for improving oral health care to you. Their dental network is 65% larger than what we have been offering, with more dentists and specialists available than before. Learn more about your new dental benefit here.

IMPORTANT INFORMATION: MONKEYPOX CASES ARE RISING IN NYC.

Monkeypox cases are rising in NYC. Learn more about Monkeypox, including prevention and treatment, here.