Community Care Medicaid Managed Care

No cost coverage for you and your family (some copays apply for prescriptions)
At BlueCross BlueShield, we believe you and your family should never have to go without care because medical expenses have become too costly. Community Care is here to protect the health of you and your family.

How do I know if I qualify?

Community Care gives you the chance to choose your Medicaid health plan, but you must meet the following qualifications:

  • You must be Medicaid eligible or enrolled in Medicaid
  • You must be a New York State resident living in Allegany, Cattaraugus, Chautauqua, Erie, Orleans or Wyoming counties

Benefits under Community Care
When you’re covered with Community Care, simply show your member ID card when you receive care and you’ll pay no fee for the following services:

  • Doctor visits
  • Immunizations that guard against sickness and childhood diseases
  • Hospitalization for medical or surgical care
  • Dental Care ( Routine, preventive, emergency dental and orthodontia if medically necessary) from Healthplex
  • Vision care with a routine eye exam and eyeglass frames every two years
  • World-wide emergency and urgent care for life-threatening sickness or serious illness
  • Consumer Directed Personal Care (CDPAP)- must be medially necessary and the aide is chosen and directed by you

Prescriptions* and dental care are covered by BlueCross BlueShield of Western New York.
(*copayments may apply for adults over 21 years of age)

View the Medicaid and Family Health Plus Formulary (list of covered drugs) for Medicaid and Family Health Plus members.

Until recently, all Medicaid and Family Health Plus members were required to fill their “specialty drug” prescriptions through Accredo.  You may continue to get your medication through Accredo; however, you now can get your specialty prescription(s) at one of the pharmacies that work with BlueCross BlueShield of Western New York (e.g., CVS, Walgreens, Rite-Aid).  In order to obtain these from a pharmacy outside of Accredo, you will need to contact BlueCross BlueShield of Western New York at 1-866-231-0847.  We will need to know the medication needed along with what pharmacy you want to receive your medication from.  BlueCross BlueShield of Western New York will then work with your pharmacy to provide your medication in a timely manner. 

Beginning October 1, 2013 Community Care will be providing the hospice benefit.  This service will be included as part of your Community Care benefit package.

  • Hospice care provides non-curative medical and support services for members certified by a physician to be terminally ill with life expectancy of one (1) year or less.  Hospice may be provided in your home or in an inpatient hospital setting.
  • Hospice programs provide patients and their families with palliative and supportive care to meet the special needs arising out of physical, psychological, spiritual, social and economic stresses experienced during the final stages of illness, and during dying and bereavement.
  • For children under age twenty-one (21) who are receiving hospice services, medically necessary curative services are covered, in addition to palliative care

This service must be medically necessary and arranged by Community Care.

For more information call Member Services Department at 1-800-888-5407.

 

Choose Your Doctor
Because Community Care is part of the BlueCross BlueShield family, you can choose your personal doctor from our participating network. If you want to keep the doctor you see now, call and ask if he or she is part of our network. If you need help finding a doctor, just call us at 1-716-887-7520 or toll free at 1-800-888-5407 and we’ll help you find one in your neighborhood. Women are also eligible to choose an obstetrician/gynecologist from our network of doctors.
Find a Doctor

Find a Dentist for an Adult
Find a Dentist for a Child

How to Apply

If you are Medicaid eligible, you may be entitled to quality benefits at no cost to you through Community Care. To request an application packet, call us today at 1-716-887-7520 or toll free at 1-800-888-5407. Information about Community Care is also available at your Local Department of Social Services.

Request more information from BlueCross BlueShield of Western New York

Review complete information from New York State