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Public Health Insurance

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For help with insurance, please reach out to ACT and/or the REAP office and social workers. Additionally, the following resources have previously been noted to be available, although they may not be up to date (please reach out to ACT/REAP/SW for the latest resources!).

Medicaid

The patient must be a US citizen or legal resident to be eligible for Medicaid. Pregnant women do not have to be legal residents or US citizens to be eligible for Medicaid.

The criteria below indicate the patient may be eligible for Medicaid.

Patient receives Supplemental Security Income.Patient has accumulated expensive medical bills.Patient is pregnant.Patient is disabled.Patient has a monthly income less than 138% of the Federal Poverty Level (FPL).

Review required documents with the patient.
REAP documentation Checklist - English
REAP documentation Checklist - Spanish

Call the REAP Office to schedule an appointment.

Medicare

Check for eligibility.The patient is eligible for Medicare if any of the cases below apply.

The patient is 65 years or older and a US citizen (or legal resident).The patient has been receiving SSDI for at least 24 months.The patient receives continuing dialysis for end stage renal disease.The patient is eligible for SSDI and has been diagnosed with ALS.

Review required documents with the patient.
REAP documentation Checklist - English
REAP documentation Checklist - Spanish

Call the REAP Office to schedule an appointment.

NYS Health Exchange

Only US citizens and legal residents are eligible for insurance through the exchange. People with incomes under 400% of FPL may be eligible for cost sharing subsidies and premium tax credits to make their healthcare more affordable. Those with incomes under 138% are eligible for Medicaid.

Patients may apply for insurance by making an appointment with REAP, or by coming to EHHOP when an Exchange counselor is in clinic (February 8th, March 8th).

Counsel the patient to bring the following documents when applying for insurance.

In the case of naturalized citizens, bring naturalization documents with C-file number
Legally married patients filing taxes separately are not eligible to receive tax credit for Exchange insurance

Name as it appears on patient’s legal documents or identification card.Social Security Number (if patient has one).Date of birth (for all household members).Tax filing status (Does patient file taxes? If so, does the patient file them alone or with his/her spouse? How many dependents does the patient claim?)The name and address of patient’s current employer.Income information (It might be helpful to bring last’s year tax returns for everyone in the household, paystubs, W2 forms, or if the patient is self-employed, a record of last three months earnings and expenses).Information about any other health insurance the patient or other family member may have (this includes long term care insurance, retiree coverage, etc.)If applicable, immigration (“Alien”) number for immigrant family members (e.g. Green Card number, employment authorization number)Information about disability status (Is the patient disabled? Does the patient need home care? Is the patient in a residential treatment facility?)Additional documents on the REAP Documents Checklist should be brought to the appointment.

REAP documentation Checklist - English
REAP documentation Checklist - Spanish

The following information should also be brought to the appointment to chose the best plan for the patient.

The name and address of the family doctor, or primary care physician, pediatrician for all household members.The name of any specialist doctors or providers used by members of your household. (How often to you see these doctors?)The name of any hospital or clinics you or members of your household use.A list of any medications you or members of your household use. (What is the dosage? How often to you refill it? Generic or Brand?)A list of any other medical needs that are important to you or a member of your household (for example: diabetes management, physical therapy, weight loss services).

To make an appointment for the patient, call the REAP Office.

If the patient would like to explore the Exchange on their own, direct them to the websites below.

New York State Health Exchange website: https://nystateofhealth.ny.gov
Community Service Society (the Exchange Navigators) website: http://www.cssny.org/issues/entry/access-to-health-care
Community Service Society contact info: click here.

Federal Poverty Level Determination

Description for 1

For more information on the Federal Poverty Level click here.

REAP Office Contact information

REAP Office
1403-5 Madison Avenue,
New York, NY 10029
(East side of Madison Ave. between 97th and 98th)
Call: 212-423-2800

REAP Referral Process

Effective July 5th, 2017 please use the new REAP Referral Line (212-423-2813) when referring patients to REAP.
During business hours (M-F, 9am-5pm), REAP will respond to referrals in real time & make appointments as needed.
Outside of business hours, REAP referral forms can still be faxed or emailed.
If you leave a detailed voicemail with your name, phone number, and email, you will be contacted appropriately.

Whenever possible, please have the patient with you when you call the REAP Referral Line.
Before calling, please take note of the following items:

Please use the attached REAP Referral Call Guide when calling the Referral Line. The more information you have when calling, the more accurate REAP can be in determining appropriate follow-up.If during the call it is determined that an appointment is appropriate, you will know when the appointment is scheduled and with whom your patient will meet before the call ends.Please note the document list on the 2nd page of the REAP Referral Call Guide. Let the patient know to bring these documents to their first appointment whenever possible.Once an appointment is made you will receive follow up emails from either our Administrative Assistants or Care Coordinators informing you of whether the patient showed for the appointment and what next steps were communicated with the patient.You can reply to the Care Coordinator or call them back to get an update on the referral.

Counsel the patient to bring the following documents when attending their first REAP appointment:

Basic Documentation List:
Please note that this is not a comprehensive list and additional documents may be requested at the end of an appointment.

Proof of Birth such as a birth certificate, naturalization certificate, passport, Permanent Resident Card, Employment AuthorizationProof of Residence such as a current postmarked envelope, rent receipt, gas or electric bill, telephone billProof of Income such as most recently filed tax return OR if you don’t file taxes, pay stubs (last 4 weeks worked), social security award letter, pension letter, unemployment insurance statementProof of Resources such as most current bank statement(s), current tax return, life insurance policy, retirement account statementProof of Health Insurance such as Medicaid, Child Health Plus, Essential Plan, Medicare, commercial health insurance

REAP Referral Call Guide (.docx)
REAP Referral Call Guide (Google Doc)
To make make a REAP referral, please call 212-423-2813. REAP Referral Line