Care for you and those
you love in one comprehensive plan
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Check out our Healthcare Resources Page,or download the prescription form below:
Member Rights and Responsibilities
- Be cared for with respect, without regard for health status, sex, race, color, religion, national origin, age, marital status, or sexual orientation.
- Be told where, when, and how to get the services you need from Hamaspik and your practitioner.
- Be told about your member rights and responsibilities.
- Suggest changes to Hamaspik’s policies and member rights and duties.
- Be told by your PCP what is wrong, what can be done for you, and what will likely be the result in language you understand.
- Get a second opinion about your care.
- Give your OK to any treatment or plan for your care after that plan has been fully explained to you.
- Discuss treatment options regardless of cost of benefit coverage.
- Refuse care and be told what you may risk if you do.
- Get a copy of your medical record and talk about it with your PCP, and to ask, if needed, that your medical record be amended or corrected.
- Be sure that your medical record is private and will not be shared with anyone except as required by law, contract, or with your approval.
- Make complaints and/or appeals about Hamaspik and its services.
- Use the Hamaspik complaint system to settle any complaints, or complain to the New York State Department of Health or the local Department of Social Services any time you feel you were not fairly treated.
- Use the State Fair Hearing system.
- Appoint someone (relative, friend, lawyer, etc.) to speak for you if you are unable to speak for yourself about your care and treatment.
- You have the right to formulate advance directives regarding your care
- Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.
- Work with your PCP to guard and improve your health.
- Find out how your health care system works and understand your health problems.
- Listen to your PCP’s advice and ask questions when you are in doubt.
- To the best of your ability, help your PCP create treatment goals.
- Provide information that is needed for your care to Hamaspik and your PCP.
- Follow plans and instructions for care you have agreed to.
- Call or go back to your PCP if you do not get better, or ask for a second opinion.
- Treat health care staff with the respect you expect yourself.
- Tell us if you have problems with any health care staff. Call Member Services.
- Keep your appointments. If you must cancel, call as soon as you can.
- Use the emergency room only for real emergencies.
- Call your PCP when you need medical care, even if it is after-hours.
Care that benefits you

Unlimited Access
When you enroll in the Hamaspik Medicaid plan, you receive comprehensive Medicaid services, and have access to all of the doctors, healthcare professionals, medical groups, hospitals and healthcare facilities that are part of your plan’s network.

Vast Network
Our provider network includes hundreds of physicians in every county within our service area, covering your primary care needs and all of your other health and behavioral needs. The network also features many of New York’s leading hospital systems and their affiliated doctors.

Preventive Health Services
Hamaspik Medicaid covers a broad range of preventive care screenings and services for adults and children. To learn more about these services,

Behavioral Health Services
With Hamaspik Medicaid, you are covered for a broad range of Medicaid services. Inpatient care, outpatient services, and home and community-based services are covered for both adults and children.

Financial Support
As a member of Hamaspik Medicaid HMO, your services are provided at no cost to you. The only exception to this is your prescription drugs, which have a small co-payment. Co-payment amounts are as follows:
• $3.00 for non-preferred Brand Name Drugs;
• $1.00 for Generic Drugs and preferred Brand Name Drugs;
• $0.50 for Non-Prescription (Over the Counter) Drugs.
Make the most of your benefits
with these services from our partners
Comprehensive Dental Benefits
Your membership in Hamaspik Medicaid includes care that keeps your smile in the best of health:
- Members have access to services at zero additional cost
- Visit a large network of dental care providers
- Get 100% coverage on preventative care and eligible procedures
- Click below to find out more.
Vision Benefits
Your Hamaspik Medicaid membership includes access to vision care services with our partnered providers:
- Members have access to services at zero additional cost
- Visit a large network of dental care providers
- Get 100% coverage on preventative care and eligible procedures
- Click below to find out more.
Quality assurance is ensured
Hamaspik has programs in place to ensure our members always receive safe, appropriate care. We are committed to providing the highest caliber of healthcare services; therefore, we have created a Quality Improvement program aimed at maintaining this focus.
Learn MoreProblem with your coverage?
If you have a concern about your healthcare or would like to file a complaint about your Hamaspik plan, please contact Member Services within 60 days of the problem. We want to understand your concerns and help you to resolve them. Depending on the situation, your case will be handled as a grievance, or as an appeal. You can file a grievance in writing, over the phone, via fax or email. You can find detailed information about grievances and appeals in your Member Handbook.
1-888-426-2774
For TTY/TDD services, call 711
Hamaspik Medicaid
Attn: Grievances and Appeals
58 Route 59, Suite 1
Monsey, NY 10952
quality@hamaspik.com
Fax: 1-845-503-0999
What to expect
After you file a grievance, Hamaspik looks carefully into your case and will seek to resolve the problem right away. We will respond with the following:
- The person who is working on your complaint
- The contact information for this individual
- Any additional information we will need to investigate your complaint
The next steps
We will investigate your concern, and will notify you of our decision within 30 days. (or within 24 hours for expedited grievances). We will send you a letter that explains the results of our investigation, and it will include reasons for our course of action.
You will be informed on how to appeal a decision if you disagree with our findings. If we are unable to make a decision about your complaint due to missing information, we will also notify you.
Coverage decisions
Hamaspik Medicaid makes a coverage decision every time we decide what services are covered. You or your doctor can also contact us to request a coverage decision if you are unsure if a particular medical service is included in your plan, or if the service that you want to request requires a prior authorization. Your doctor may need to provide us with information about why you need to receive the service that you are requesting.
You may also appeal any coverage determination, if you disagree with our decision.
If you have a question about how to ask for a service to be authorized, or how to file an appeal, we also encourage you to contact Member Services.
Hamaspik Medicaid
58 Route 59, Suite #1
Monsey, NY 10952
How to appeal
To appeal a decision about your health care services, please follow these guidelines:
- File an appeal within 60 business days of receiving our decision
- File the appeal yourself or ask someone you trust to file the complaint on your behalf
- Make sure the appeal is made in writing (even if you initially call, you must follow up in writing)
Your first appeal is reviewed by Hamaspik Medicaid. A person who was not involved in the decision to deny or limit your coverage will review your appeal. If we deny your appeal, you may ask for a Level 2 appeal, which is also known as a “Fair Hearing.” The Fair Hearing is reviewed by an independent third party. In some circumstances, other levels of appeal are also available.
Alternative Options
If you are not satisfied with the services you have received from Hamaspik, you (or someone on your behalf) may submit a complaint directly to the New York State Department of Health (DOH) by calling 1-800-206-8125.
If your complaint or appeal is about your long term care services or your behavioral health services, you can call the Independent Consumer Advocacy Network (ICAN) to get free, independent advice about your coverage, complaints, and appeal options. They can help you manage the appeal process.
Contact ICAN to learn more about their services:
- Phone: 1-844-614-8800 (TTY Relay Service: 711)
- Web: icannys.org
- Email: ican@cssny.org]
If your service request has been denied, we also encourage you to contact Member Services. Please call 1.888.426.2774 (TTY users, call 711); or send your request in writing to:
Hamaspik Medicaid
Attn: Care Management
58 Route 59, Suite #1
Monsey, NY 10952
Getting help
For assistance with filing a grievance, or a coverage decision or an appeal, please contact us. Your doctor, prescriber or lawyer can also submit a request on your behalf at any point in the appeals process. Alternatively, you may appoint a friend, relative or another representative to help you. If you request help from another individual, you will need to submit the Appointment or Representative form found on our resources page.
Notice of Non-Discrimination
Hamaspik Medicaid plan complies with Federal civil rights laws. Hamaspik, Inc. does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Hamaspik, Inc. provides the following:
- Free aids and services to people with disabilities to help you communicate with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Free language services to people whose first language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you believe that Hamaspik, Inc. has not given you these services or treated you differently because of race, color, national origin, age, disability, or sex, you can file a grievance with Hamaspik, Inc. by:
In person: at the address listed above
Phone: 1-833-426-2774 For TTY/TDD services, call 711
Fax: 1-845-503-0999
Email: quality@hamaspik.com
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights via:
Web: OCR Complaint Portal at
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
Mail: U.S. Department of Health and Human Services
200 Independence Avenue SW, Room 509F,
HHH Building
Washington, DC 20201
Complaint forms are available at
http://www.hhs.gov/ocr/office/file/index.html
Phone:
1-800-368-1019
For TTY/TDD, call 800-537-7697
Your prescription for better health
How Hamaspik makes getting your prescriptions a priority

Broad Formulary of Covered Medications
Each Hamaspik plan uses an established drug list (known as ‘The Formulary’) that has been approved by the New York State Department of Health (DOH). The drug list includes all of the drugs that are provided under your Medicaid benefits. Just speak with your doctor about the drugs you need, and show them the formulary for your plan.

Vast Pharmacy Network
You can get your medications at any of the thousands of pharmacies in our network, including all major drug store chains and many independent pharmacies. You can also order your medications to be delivered via mail.

Flexible Options
If you are taking a drug that is not included in the Hamaspik Medicaid formulary, we will cover a temporary supply of your drug during the first 90 days of your membership in the plan when you are a new member. This temporary supply will be for a maximum of 30 days. If your prescription is written for fewer days, we will allow multiple fills to provide up to a maximum of 30 days of medication. The prescription must be filled at a network pharmacy. This will ensure that your health needs are always met. Be sure to talk with your doctor during this time to prescribe a different drug or to file a request for a coverage decision.
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and your questions answered—all here on our site.