Direct Complete Plan (H5989)

Direct Complete Plan is an Institutional Special Needs Plan (I-SNP) with a Medicare contract designed to meet your medical and prescription drug needs. If you are a resident in a nursing home that is contracted with us you may enroll in the Direct plan.

INFORMATION FOR MEMBERS

INFORMATION FOR PROVIDERS

Back to Health Pointe Direct Complete Plan

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Low Premiums and $0 Co-pays

Low monthly premiums
No premium if you have Medicaid Prescription Drug Coverage Benefits. (If you receive Low Income Subsidy (LIS), you are eligible to receive assistance with your Part D Prescription Drugs.
If you have full Medicaid, your co-payments and co-insurance rates will be covered by the Medicaid program.
$0 co-pay for primary care physician visits

An Additional Level of Quality Care

Quality medical care from an extensive network of physicians, specialists and hospitals
Vision care
Acupuncture services
Emergency room coverage worldwide
Free health screenings for a wide range of conditions

Prescription Drug Coverage

No deductible for prescription drugs
Covers both Medicare Part B prescription drugs and Medicare Part D prescription drugs from pharmacies in our network.

SUPPORT

We are here to help. Call us at 1-888-201-4342, Monday-Friday, 8 a.m. to 8 p.m. EST. TTY users should call 711.

You may also request a callback by filling in the form below.

Direct Complete also Provides a nurse practitioner who works with the Primary Care Physician (PCP) who’s role is to:

Provide care management services to enhance continuity and coordination of care
Decrease unnecessary hospitalizations by identifying early changes in condition initiating rapid interventions and assuring appropriate and timely use of services
Improve member health outcomes by facilitating preventative health screenings
Serve as liaison to you and the Health Plan

You may qualify for Direct Complete Plan if you:

Are entitled to Part A of Medicare and are also enrolled in Part B of Medicare and continue to pay your Medicare Part B premium
Are entitled to Medicaid and Part A of Medicare and are also enrolled in Part B of Medicare and continue to maintain your Medicaid benefits and pay your Medicare Part B premium
Live in one of our contracted nursing homes in our service area: Bronx, Kings (Brooklyn), New York (Manhattan), Queens, Richmond (Staten Island), Nassau, Suffolk and Westchester counties

HOW TO ENROLL

To enroll in the Direct Complete Plan, please call us at 1-888-201-4342 (TTY: 711) From October 1 to March 31, we are open 7 days a week, from 8 a.m. to 8 p.m. EST. From April 1 to September 30, we are open Monday through Friday, from 8 a.m. to 8 p.m. EST. We can have one of our representatives visit you. We’ll explain in detail how our plan works and what services we provide, and will begin enrollment if eligible. We will also discuss any special needs and concerns and answer any questions you may have.

Contact Us:

Toll-Free: 1.888.201.4342

TTY: 711

Mailing Address:

Health Pointe of New York

810 Seventh Avenue – Suite 801

New York, New York 10019

Please contact our Member Services number at 1-888-201-4342 for additional information. (TTY users should call 711.) From October 1 to March 31, we are open 7 days a week, from 8 a.m. to 8 p.m. EST. From April 1 to September 30, we are open Monday through Friday, from 8 a.m. to 8 p.m. EST.

We do not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, sex, gender identity, age or disability in our health programs and activities.

ATENCION: Si habla español, tiene a su diposicion servicios gratuitos de assistencia linguistica. Llame a 1.888.201.4342 / TTY: 711

Health Pointe Direct Complete Plan (HMO I-SNP) is a Health Plan with a Medicare Contract. Enrollment in Health Pointe HMO I-SNP depends on contract renewal.

CMS Material ID: H5989_HPweb2019 | Last updated 12/10/2019