Hamaspik Choice Providers for At-Home Specialty Care

Hamaspik Choice is a managed long-term care plan, often called an MLTC plan, that covers long-term care services so members can stay in their homes and communities. Its covered services include home health aides, personal care aides, consumer directed personal assistance, skilled nursing, adult day health care, physical, occupational, and speech therapy, home-delivered meals, and social and environmental supports. The plan also lists podiatry, optometry, audiology, dentistry, durable medical equipment, prosthetics and orthotics, and personal emergency response systems among its covered services. Members work with nurse and social work care managers who customize their care plans and communicate with their physicians. Hamaspik also offers two Medicare plans for dual-eligible members, Hamaspik Medicare Select and Hamaspik Medicare Choice. Aspire Healthcare Solutions complements this support by bringing specialty care directly to members at home.

According to Hamaspik, individuals must be at least 18 years old, be eligible for Medicaid, be capable of remaining safely in their home and community, live in one of the plan’s covered counties, and be eligible for certain long-term care services, such as in-home nursing, in-home therapies, home health aide services, personal care, consumer directed personal assistance, adult day health care, or private duty nursing. People who are new to Medicaid community-based long-term care services, or who have not received these services for more than 45 days, must first complete an assessment through the New York Independent Assessor to confirm eligibility. Hamaspik Member Services can answer questions about the enrollment process. Aspire Healthcare Solutions does not handle plan eligibility or enrollment, but we can bring specialty care to members once their coverage is in place.

Both plans are designed for people who qualify for both Medicare and Medicaid, but they serve different needs. Hamaspik Medicare Select is an HMO Dual-Eligible Special Needs Plan, or D-SNP, that provides Medicare Advantage and prescription drug coverage for dual-eligible members. Hamaspik Medicare Choice is a Medicaid Advantage Plus plan, or MAP, which combines Medicare Advantage coverage with Medicaid long-term care benefits in one plan. MAP plans are designed for dual-eligible people who also need long-term care services, so their medical care and long-term support can be coordinated together. Each plan’s Evidence of Coverage explains its specific benefits, and Hamaspik Member Services can help members understand which plan they have. Aspire Healthcare Solutions provides at-home specialty care for members of either plan.

Hamaspik Choice lists podiatry, optometry, and audiology among its covered services, along with dentistry, durable medical equipment, and prosthetics and orthotics. These services are generally provided when medically necessary, are often arranged through the member’s care plan, and may require prior authorization. For members of Hamaspik Medicare Select or Hamaspik Medicare Choice, Medicare-covered services such as a yearly diabetic retinopathy exam for people with diabetes, foot care for diabetes-related nerve damage, and diagnostic hearing exams are also part of their coverage. The member’s care manager and Member Handbook are the most reliable sources for how each service is covered and approved. Aspire Healthcare Solutions provides mobile podiatry, optometry, and audiology at home, helping members access these services without the burden of travel.

Hamaspik Choice and Hamaspik’s Medicare plans are health plans. Hamaspik Choice is a managed long-term care plan with a New York State contract, while Hamaspik Medicare Select and Hamaspik Medicare Choice are Medicare Advantage plans with Medicare contracts, and Hamaspik Medicare Choice also holds a New York State contract as a Medicaid Advantage Plus plan. These plans coordinate and cover services for their members through a network of providers. Aspire Healthcare Solutions is not an insurance company, broker, or part of Hamaspik. We are an independent healthcare provider that brings specialty care, including podiatry, eye exams, hearing care, and lab collection, directly to patients at home. For questions about Hamaspik plans or enrollment, contact Hamaspik Member Services, New York Medicaid Choice, or 1-800-MEDICARE.