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Medicaid Advantage Plus (MAP)

man and caregiver

BCBS ID

One card

Dialing

One number

Umbrella

One plan

The Medicaid Advantage Plus program is a Managed Long-Term Care plan for people who have both Medicaid and Medicare. This plan helps people who need health and long-term care services like home care and personal care in order to stay in their homes and communities as long as possible. You’ll get your Medicaid home care and long-term care services, plus your Medicare services, from the MAP plan.
 
MAP 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 Empire Medicaid and Medicare services.
  • One number to call for help getting services or answers about your benefits: 1-800-950-7679 (TTY 711).
  • One plan to make it easier for you to get the services you need, when you need them.

 When you join Medicaid Advantage Plus, you must also enroll with Empire Medicare.

View Empire Medicare plans

 

Is MAP right for you?

You are eligible to enroll in MAP if you:

  • Are 18 or older.
  • Are eligible for both Medicaid and Medicare.
  • Live in Brooklyn, the Bronx, Manhattan, Queens or Staten Island.
  • Have a chronic illness or disability, based on an assessment, making 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 making 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 Services
    • Private duty nursing

Call 1-800-950-7679 (TTY 711) to find out more about MAP and how to enroll with Empire.

What you get with Empire MAP

MAP toothbrush image

Dental care

MAP Eyechart image

Vision care

MAP Car image

Nonemergency transportation

MAP Care coordinator

Care management


Covered services

When you join our plan, you keep all your current Medicaid benefits. Below is a partial list of Empire MAP services that you may be eligible for. These benefits are covered when you join our MAP program, so you never have any copays, except for those applying to pharmacy items. 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
  • Meals (home-delivered or congregate)
  • 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

Coordinated services of Medicare benefit

Coordinated services are those services covered through fee-for-service Medicaid or Medicare. 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

When you join Medicaid Advantage Plus, you must also enroll with Empire Medicare.

View medicare doctors

Monthly spend down

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

Prior approvals

For some covered services, you may need a physician’s order and/or prior approval from Empire before you receive 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

Family planning services

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

Already a member? We’re glad you chose Empire.

Already a member? We’re glad you chose Empire.

We want you to understand your benefits and receive the best possible care. Here are some resources to help.

Member handbook

Complete benefit information can be found in your member handbook.
 
Medicaid Advantage Plus Member Handbook – English (coming soon)
Medicaid Advantage Plus Member Handbook – Spanish (coming soon)
Medicaid Advantage Plus Member Handbook – Chinese (coming soon)
Medicaid Advantage Plus Member Handbook – Korean (coming soon)
Medicaid Advantage Plus Member Handbook – Russian (coming soon)
 

Personal care manager

Your care manager is here to answer your questions and work with your providers to make sure you have the right care at the right time. To reach your care manager, call Member Services at 1-800-950-7679 (TTY 711). You can call Monday through Friday from 8 a.m. to 8 p.m. Eastern time, Saturday from 9 a.m. to 5 p.m. Eastern time.
 

24/7 NurseLine

If you have medical questions and cannot reach your care manager, you can always call our 24/7 NurseLine and speak directly to a nurse. Call 1-800-950-7679 (TTY 711) anytime, day or night.