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Medicaid Care ScreeningReview the exact form

Eligibility, explained carefully

Each service is reviewed on its own.

A screening can identify possible needs. A Social Care Navigator reviews the official eligibility pathway, service by service, before a connection can be authorized.

Read the NYSDOH eligibility summary

What the official review considers

Four parts of an Enhanced HRSN review.

These requirements are considered together. A Social Care Navigator completes the official eligibility assessment.

  1. An identified unmet health-related social need.

  2. Enrollment in an eligible Medicaid Managed Care plan.

  3. Membership in at least one Enhanced Population.

  4. Any additional service-specific social-risk, clinical, medical-necessity, documentation, authorization, and nonduplication requirements.

One part of the review

Enhanced Populations

Membership in at least one of these groups is one part of the review. It does not automatically approve a service.

  1. 01

    Medicaid high utilizers.

  2. 02

    People enrolled in a New York State-designated Health Home.

  3. 03

    People with substance use disorder.

  4. 04

    People with serious mental illness.

  5. 05

    Adults or children with an intellectual or developmental disability.

  6. 06

    Pregnant people and people up to 12 months postpartum.

  7. 07

    Certain people up to 90 days after release from incarceration who have a chronic condition.

  8. 08

    High-risk children under age 18.

Two carefully qualified examples

Some services have limited periods of support.

Rent and temporary housing

Up to 6 months

Some qualifying Medicaid Managed Care members with an unmet housing need may be authorized for rent, back-rent, or temporary-housing support for up to six months. Additional Enhanced Population, housing-risk, homelessness-risk, clinical, documentation, and program criteria apply. Payment goes to an approved landlord or housing provider, not directly to the member. Approval, amount, duration, and regional availability are determined through the Social Care Network process.

Pregnancy and postpartum nutrition

Up to 12 months postpartum

Qualifying pregnant or postpartum Medicaid Managed Care members with an unmet nutrition need may be authorized for certain meals, food prescriptions, or pantry-stocking support throughout pregnancy and for up to 12 months postpartum. Certain qualifying prepared-meal services may provide up to three meals per day, seven days per week. The exact service, frequency, duration, and availability depend on the official eligibility assessment, service-specific requirements, authorization, current program rules, and regional capacity.

A path remains open

Medicaid Fee-for-Service members and Medicaid Managed Care members who do not qualify for Enhanced HRSN Services may still receive navigation to existing federal, state, local, and community programs.

What happens next

A clear sequence, without promises.

  1. 01

    Screening

    A website screening identifies possible needs to discuss.

  2. 02

    Navigator assessment

    A Social Care Navigator reviews the official eligibility and service requirements.

  3. 03

    Authorization and connection

    When appropriate, the Social Care Network process determines authorization and a possible connection.

Screening does not determine eligibility or guarantee a service. A website screening identifies possible needs, and a Social Care Navigator performs the official eligibility assessment.

Questions

Need to ask something?

For general questions, contact Medicaid Care Screening by email.

info@medicaidcarescreening.com