Are you eligible?
To join RiverSpring MAP (HMO D-SNP), you must:
- Be entitled to Medicare Part A and be enrolled in Medicare Part B;
- Be enrolled with the New York State Medicaid program;
- Live in the counties of Bronx, Kings, Nassau, New York, Queens, Richmond, and Westchester;
- Be a United States citizen or be lawfully present in the United States;
- Be 18 years of age or older at time of enrollment;
- Be eligible for nursing home level of care as of the time of enrollment;
- Be capable at time of enrollment of returning to or remaining in your home and community without jeopardy to your health and safety, based upon criteria provided by the New York State Department of Health; and
- Require at least one (1) of the following Community Based Long Term Care Services (CBLTCS) for more than 120 days from the effective date of enrollment:
- Nursing services in the home;
- Therapies in the home;
- Home health aide services;
- Personal care services in the home;
- Adult day health care;
- Private duty nursing; or
- Consumer Directed Personal Assistance Services
You will be excluded from joining RiverSpring MAP (HMO D-SNP) if:
- You are medically determined to have End Stage Renal Disease (ESRD) at time of enrollment, unless you meet certain exceptions to Medicare Advantage eligibility requirements;
- You are a resident of a New York State Office of Mental Health (OMH) facility or a psychiatric facility;
- You receive comprehensive private health care coverage, except for Medicare;
- You are enrolled in another managed care plan capitated by Medicaid;
- You are enrolled in the Restricted Recipient Program;
- You are enrolled in a Home and Community-Based Services waiver program;
- You are a resident of the Office for People with Developmental Disabilities (OPWDD) program or enrolled in the OPWDD day treatment program;
- You are expected to be Medicaid eligible for less than three months;
- You are receiving hospice services (at time of enrollment); or
- You are a resident of an Office for Alcoholism and Substance Abuse Services (OASAS) residential treatment program.
How to Join
Must I Join?
Enrollment in RiverSpring MAP (HMO D-SNP) is voluntary.