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Integra Synergy MAP (HMO SNP)

Integra Synergy MAP (HMO SNP)

With Integra Synergy MAP (HMO SNP) you can get your Medicare and Medicaid services in one health plan. An Integra Synergy MAP (HMO SNP) care coordinator will help manage your health care needs.

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Eligibility

You may enroll in Integra Synergy MAP (HMO SNP), if you meet the following criteria:

  •  Have both Medicare Parts A and B and full Medicaid benefits (QMB+ and SLMB+)
  •  Live in our service area of Bronx, Kings, New York, Queens or Nassau counties in New York
  •  Not have End Stage Renal Disease (ESRD)
  •  Need Medicaid home care and long-term care services
  •  Be capable, at the time of enrollment of returning to or remaining in your home and community without jeopardy to health and safety, based upon criteria provided by New York State Department of Health
  •  Be eligible for nursing home level of care (as of the time of enrollment) 
  •  Require care management and be expected to need at least one of the following Community Based Long Term Care services for more than 120 days from the effective date of enrollment
  •  Be 21 years of age or older
  •  Reside in the plan’s service area
  •  Not have End-Stage Renal Disease (ESRD), with limited exceptions, such as if you develop ESRD when you are already a member of a plan that we offer, or you were a member of a different plan that was terminated
  •  Is determined eligible for long term care services by the plan or an entity designated by the Department using the current NYS eligibility tool

Plan Information

Integra Synergy MAP (HMO SNP) combines your Medicaid home care and long-term care services and your Medicare services. It combines your doctors, hospital, pharmacies, home care, nursing home care, and other health care providers into one coordinated health care system. It also has care coordinators to help you manage all your providers and services. They all work together to provide the care you need.

With Integra Harmony (HMO SNP), you get all the benefits you would get under Original Medicare, plus extra benefits. In addition, you get your Medicaid benefits (some are excluded from our plan but are available by using your Medicaid card). With our plan, you pay $0 for all your Medicare, Medicaid and prescription drug benefits.  

Examples of the benefits covered by Integra synergy MAP (HMO SNP) include:

  • Doctor’s visits
  • Inpatient and outpatient hospital services
  • Vision
  • Hearing Aids
  • Over the counter allowance
  • Inpatient hospital beyond what Medicare covers
  • Home health care not covered by Medicare
  • Durable Medical Equipment not covered by Medicare
  • Routine transportation to medical appointments
  • Preventive and comprehensive dental services
  • Routine physical exams
  • Nutrition
  • Personal Emergency Response system (PERS)

Medicare Information

For more information about Medicare, you can read the Medicare & You Handbook. It has a summary of Medicare benefits, rights, and protections and answers to the most frequently asked questions about Medicare. You can get it at the Medicare website (https://www.medicare.gov) or by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048. For more information about Medicaid, call New York State Department of Health (Social Services) Medicaid Helpline 1–800–541–2831 Medicaid Helpline. TTY users should call 711.