Benefits and Services

Your benefits and services

Senior Whole Health of New York’s Medicaid Managed Long Term Care Plan is committed to maximizing your quality of life, health, security and independence.

As part of our ongoing commitment to your well-being, your Senior Whole Health of New York Care Manager monitors your medical and social needs and makes the necessary changes to your plan of care as your conditions and needs change.

Our Senior Whole Health of New York Medicaid Managed Long Term Care Plan has $0 copays and no deductibles for any of the services or benefits we offer. Some examples are:

In-Home Care Services

  • In-Home Care Services
  • Home assessments
  • Professional nursing services
  • Home health care
  • Personal care
  • Housekeeping services
  • Home delivered meals
  • Home safety modifications
  • Medical Supplies and Equipment
  • Personal Emergency Response Services (PERS)

Medical and surgical supplies

  • Oxygen
  • Prosthetics and orthotics

Specialty Care

  • Dental care
  • Eye exams
  • Foot care
  • Hearing exams

Rehabilitation Therapies

  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Respiratory therapy

Other Care & Services

  • Adult day health program
  • Transportation to and from doctor and health care related appointments
  • Help with medication management
  • Nutritional counseling and dietary supplements
  • 24/7 phone access to a Senior Whole Health of New York Care Manager
  • Care coordination

Getting Care

Primary and acute care services are not covered services in the Senior Whole Health of New York plan. Instead, these services are covered by your Medicaid and/or Medicare. This means you get to maintain your relationship with your current PCP to assure there is no disruption in medical care. If you need help finding a PCP in your community, your Care Management Team can assist you.

How to choose a provider for covered services

For services covered by Senior Whole Health of New York, you may choose any provider from our network of providers that offers the services you need. Read more about how to choose a doctor here.  Look for a PCP who:

  • Is accepting new patients
  • Is convenient (nearby, wheelchair accessible, etc.)
  • Speaks your language or has staff who do
  • Understands your culture

Getting care outside of your service area

If you plan to be away from home or outside our service area, please notify your Care Manager as early as possible so we can arrange any needed services. We’ll work with you and continue to provide non-emergency covered services to the extent they can be arranged with area providers. If you are out of the area and have an emergency, go to the nearest emergency facility.

Deciding where to get emergency care

When you need care right away, there are options.

Emergency services

Emergencies are times when there could be serious danger or damage to your health if you don’t get care right away. If you have an emergency, call 911 or go to the nearest hospital emergency room (ER).

Call your PCP and Senior Whole Health of New York as soon as you can after you visit the ER. Your PCP can help with your follow-up care.

Urgent care

An urgent medical condition is when care is needed for a sudden illness, injury, or condition that is not an emergency but needs to be treated in the next 24 to 48 hours. If you need help finding a nearby urgent care center call Member Services at 1-877-353-0185, 24 hours a day for guidance. Our nurses can advise you on where to go when you need care. Call your PCP and Senior Whole Health of New York as soon as you can after you visit urgent care. Your PCP can help with your follow-up care.

Your PCP

When you’re sick or hurt, always call your PCP first (unless it’s an emergency). Even if you call outside of their normal hours, someone from the office should be on call and able to help.