Tag: long-term care

New York State’s Independent Consumer Advocacy Network (ICAN) program helps New Yorkers with disabilities with their health insurance and long-term care problems. Long-term care includes care in a nursing home or in your own home with help from an aide. Personal care aides can help with activities like getting dressed, walking, and going to the bathroom.

The way the long-term care system works can be hard to figure out, which is why ICAN is here to help.

ICAN is a group of advocates and lawyers from different organizations across New York State, including CIDNY. ICAN’s staff at CIDNY are experts in the long-term care system and handle a wide range of cases from all five boroughs of New York City. Our staff provides services ranging from simple advice to representing people at appeals, free of charge.

In 2015, New York State created both the Independent Consumer Advocacy Network (ICAN) and the new Fully Integrated Dual Advantage (FIDA) insurance plans. FIDA was intended to make it easier for people with both Medicaid and Medicare to get health care. 

When people with Medicaid become eligible for Medicare, they usually have to change their Medicaid plan. Then they have to figure out how to use their separate Medicaid and Medicare insurance on their own to get health care. These “dual-eligibles” generally need more care than most people with only Medicaid. The State hoped that setting them up with a single plan that combines their Medicaid and Medicare would make it easier for them to get services. 

Many people were confused by the changes.

Luckily, ICAN was created to help people navigate the new long-term care system at the same time as the new FIDA program. ICAN helps people who need long term care services with any kind of Medicaid managed care: FIDA, FIDA-IDD, MLTC, MMC, PACE, MAP, and HARP. ICAN’s services include answering people’s questions, giving advice, advocating with plans or agencies, and representing people in formal appeals.

If your managed care plan denies coverage for services you need, ICAN can help you fight to keep your services.

Here are some real examples of how CIDNY’s ICAN advocates have helped consumers:

Fran* fell and hurt herself and had to go to the hospital. After she recovered, her family wanted to bring her home, but her insurance plan refused. They said she needed more help than they were providing, but did not want to pay for more. With ICAN’s help, she was able to get the plan to pay for 24-hour help, which let her live at home.

Carolyn* was stuck on the second floor of her family home and couldn’t get out on her own. The insurance company had promised to send people to carry her wheelchair down the stairs whenever she needed to go out, but they never actually did. ICAN helped her get a stairlift so that she could go out whenever she wanted.

CIDNY’s ICAN staff understand how difficult it can be for New Yorkers with disabilities to get the help they need. If you are confused about the long-term care system or a notice you received, you can call ICAN’s toll-free telephone help line at (844) 614-8800. ICAN’s staff will answer your questions and will try to help you solve your problems. See how ICAN has helped other New Yorkers with disabilities on ICAN’s website.

(*Names changed for confidentiality.)