VNSNY CHOICE FIDA Complete (Medicare-Medicaid) 2019 Provider and Pharmacy Directory
The VNSNY CHOICE FIDA Complete Provider and Pharmacy Directory includes information about the provider and pharmacy types in VNSNY CHOICE FIDA Complete and listings of all the plan’s providers and pharmacies as of the date of this Directory. The listings contain provider and pharmacy address and contact information, as well as other details such as days and hours of operations, specialties, and skills. Key terms and their definitions appear in alphabetical order in the last chapter of the Participant Handbook.
- VNSNY CHOICE FIDA Complete is a managed care plan that contracts with both Medicare and New York State Department of Health (Medicaid) to provide benefits of both programs to Participants through the Fully Integrated Duals Advantage (FIDA) Demonstration.
- The VNSNY CHOICE FIDA Complete Directory lists health care professionals (such as doctors, nurse practitioners, and psychologists), facilities (such as hospitals or clinics), and support providers (such as Adult Day Health and Home Health providers) that you may see as a VNSNY CHOICE FIDA Complete Participant. We also list the pharmacies that you may use to get your prescription drugs.
- We will refer to these groups as “network providers” in this Directory. These providers signed a contract with us to provide you services. This is a list of VNSNY CHOICE FIDA Complete’s network providers. The service area for this plan includes the Bronx, Kings (Brooklyn), Nassau, New York (Manhattan), Queens, and Richmond (Staten Island).
- ATENCIÓN: Si habla español, tiene disponible los servicios de asistencia de idioma gratis. Llame al 1-866-783-1444, TTY es 711, 7 días a la semana, de 8 am – 8 pm. La llamada es gratuita.
You can get this document for free in other formats, such as large print, braille, or audio. Call 1-866-783-1444, TTY is 711, 7 days a week from 8 am – 8 pm. The call is free.
To request a preferred language or format and to keep or change this information for your future mailings and communications, please contact Participant Services at 1-866-783-1444, TTY is 711, 7 days a week from 8 am – 8 pm.
The State of New York has created a Participant ombudsman program called the Independent Consumer Advocacy Network (ICAN) to provide Participants free, confidential assistance on any services offered by VNSNY CHOICE FIDA Complete. ICAN may be reached toll-free at 1-844-614-8800 or online at icannys.org. (TTY users call 711, then follow the prompts to dial 844-614-8800.)
The list is up-to-date as of the date noted as “last date update” noted at the bottom of the web search tool page or on the left-hand column of the search tool. You need to know that:
- Some VNSNY CHOICE FIDA Complete providers in our network may no longer be accepting new Participants. If you are having trouble finding a provider who will accept new Participants, call Participant Services at 1-866-783-1444, TTY is 711, 7 days a week from 8 am – 8 pm and we will help you.
You can request a directory in hard copy by calling Participant Services at 1-866-783-1444, (TTY 711) during 8 am – 8 pm, 7 days a week. The call is free.
This section explains key terms you’ll see in our Provider and Pharmacy Directory.
- Providers are health care professionals and support providers such as doctors, nurses, pharmacists, therapists, and other people who provide care and services. Services include medical care, long-term services and supports (LTSS), supplies, prescription drugs, equipment, and other services.
- The term providers also includes facilities such as hospitals, clinics, and other places that provide medical services, medical equipment, and long-term services and supports.
- Providers that are a part of our plan's network are called network providers.
- Network providers are the providers that have contracted with us to provide services to Participants in our plan. The providers in our network may only bill us for the care they give you. When you see a network provider, you usually pay nothing for covered services.
If you are eligible to get services from Indian health providers, you may see these providers even if they are out of our plan’s network.
- A Primary Care Provider (PCP) is a is a Provider specialized in Family Practice, Internal Medicine, General Practice, OB/GYN, or Geriatrics who gives you routine health care. Your PCP will keep your medical records and get to know your health needs over time. If you ask and he/she is willing, your PCP may participate on your Interdisciplinary Team and help in planning your care and ensuring that you get necessary services.
- Specialists are doctors who provide health care services for a specific disease or part of the body. There are many kinds of specialists. Here are a few examples:
- Oncologists care for patients with cancer.
- Cardiologists care for patients with heart conditions.
- Orthopedists care for patients with certain bone, joint, or muscle conditions.
You also have access to a Care Manager and Interdisciplinary Team (IDT) that you help choose.
- A Care Manager works closely with you and your Interdisciplinary Team to develop a Person-Centered Service Plan that helps you manage your medical, behavioral health, long-term services and supports, and social and functional needs.
- Your Interdisciplinary Team (IDT) helps to coordinate your care. This means that they make sure your providers know about care you get medicines you take, tests and labs are done once and the results are shared with the appropriate providers. You and your IDT will develop your Person-Centered Service Plan, which will list all of your needs and services, set goals to address those needs, and determine ways to monitor those needs. Your IDT will be in contact with you as often as needed. Your IDT includes:
- You and your designee(s) and
- Your Care Manager.
You may also choose to have any of the following people participate in any or all of your IDT meetings:
- Your Primary Care Provider (PCP), including a physician, nurse practitioner, physician assistant, or specialist who has agreed to serve as your PCP, or a designee from your PCP’s practice who has clinical experience (such as a registered nurse, nurse practitioner, or physician assistant) and knowledge of your needs;
- Your Behavioral Health (BH) Professional, if you have one, or a designee from your BH Professional’s office (or practice) who has clinical experience and who has knowledge of your needs;
- Your home care aide(s), or a designee with clinical experience from the home care agency who has knowledge of your needs, if you are getting home care;
- A clinical representative from your nursing facility, if getting nursing facility care;
- Additional individuals, including:
- Other providers either as asked for by you or your designee, or as recommended by the IDT members as necessary for care planning and approved by you or your designee; or
- The registered nurse (RN) who completed your assessment.
You can get services from any provider who is in our network and accepting new Participants.
First, you will need to choose a Primary Care Provider. You may be able to have a specialist act as your PCP. FIDA participants may select a specialist as a PCP or a PCP may refer participants to a specialist who will provide and coordinate the participant’s primary and specialty care if they determine there is a need. Another treating provider may identify the need as well. You may also select a home visiting physician as your PCP. Home visiting physicians are listed in this directory or you can call the number below for assistance.
To choose a PCP, go to the list of providers on page 1 and choose a provider:
- that you use now, or
- who has been recommended by someone you trust, or
- whose offices are easy for you to get to.
If you want help in choosing a PCP, please call Participant Services at 1-866-783-1444, TTY is 711, 7 days a week from 8 am – 8 pm. The call is free.
If you have questions about whether any service or care that you want or need is covered, talk to your Care Manager and Interdisciplinary Team or call Participant Services and ask before you get the service or care.
As a VNSNY CHOICE FIDA Complete Participant, you may be able to get long-term services and supports (LTSS), such as adult day healthcare services, AIDS adult day healthcare, Consumer Directed Person Assistance Services (CDPAS), environmental modifications, home and community support services, home delivered and congregate meals, home health agencies, home maintenance services, non-emergency transportation, independent living skills and training, medical social services, moving assistance, personal care services, Personal Emergency Response Services (PERS), private duty nursing, respite providers, social day care, social day care transportation and transportation. LTSS help people who need assistance to do everyday tasks like taking a bath, getting dressed, making food, and taking medicine. Most of these services are provided at your home or in your community but could be provided in a nursing facility or hospital. A full list of covered LTSS is available in Chapter 4 of your Participant Handbook.
Your Care Manager and Interdisciplinary Team (IDT) will help you manage all your providers and services, including long-term services and supports. They all work together to provide the care you need.
You must get all of your covered services from providers within our network. If you go to providers who are not in VNSNY CHOICE FIDA Complete’s network (without prior authorization* or approval from us), you will have to pay the bill.
The exceptions to this rule are when you need urgent or emergency care or dialysis and cannot get to a provider in the plan, such as when you are away from home. Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area, you must use plan providers for urgent care. When out of the service area, urgent care may be obtained from the first available provider. In addition, when out of the service area you can obtain dialysis treatment from any qualified dialysis provider. You can also go outside the plan for other non-emergency services if VNSNY CHOICE FIDA Complete or your IDT gives you permission first.
- You may change providers within the network at any time. If you have been going to one network provider, you do not have to keep going to that same provider. You may change your PCP at any time during your enrollment in the plan. You may only choose PCPs in the network. In order to change a PCP, you must notify us by calling the number below. If you have an out of network PCP when joining, we will contact them to join the network. If the provider does not join the network, we will inform you to choose an in-network PCP.
- VNSNY CHOICE FIDA Complete works with all the providers in our network to accommodate the needs of people with disabilities. As applicable, the list of network providers in this Directory includes information about the accommodations they provide. If you need to see a provider and are not sure if they offer the accommodations you need, VNSNY CHOICE FIDA Complete can help you. Talk to your Interdisciplinary Team and Care Manager for assistance.
*A prior authorization is an approval from VNSNY CHOICE FIDA Complete before you can get a specific service, drug, or see an out-of-network provider. VNSNY CHOICE FIDA Complete may not cover the service or drug if you don't get approval.
To find a provider near you, or that fits your specific need, select the type of provider you are looking for and filter by location.
Icons in the Provider listings will indicate additional information such as if a provider is wheelchair accessible, speaks other languages, accepts Medicaid and more. To see the full detailed information for a provider, click the View Full Profile button on the listing. The Map button will provide you with access to ways you may be able to get to the provider’s office.
If you have questions or need help finding a provider, please call Participant Services at 1-866-783-1444, (TTY 711), 7 days a week from 8 am – 8 pm. The call is free.
The VNSNY CHOICE FIDA Complete Directory of network providers contains:
Health care professionals and support providers including primary care providers, specialists, behavioral health providers, adult day services, social day care, consumer-directed personal assistance services, home-delivered and congregate meals, home health agencies, environmental modifications, home maintenance services, non-emergency transportation, independent living skills and training, moving assistance, personal care services, personal emergency response services, private duty nursing, respite services and home and community support services;
Facilities including hospitals, nursing facilities and mental health facilities.
Providers are listed in alphabetical order by last name. You can also find the provider’s name and the page where the provider’s additional contact information is in the Index at the end of the Directory. Providers are also listed in alphabetical order by last name in the Index. In addition to contact information, provider listings also include specialties and skills, for example, such as languages spoken or completion of cultural competence training.
Cultural competence training is additional instruction for our health care providers that help them better understand your background, values, and beliefs to adapt services to your social, cultural, and language needs.
If a provider has this symbol — ADA+ — next to its name, it means that the provider meets the FIDA Program accessibility standards. This means that the provider meets all of the following 25 requirements, except for any that would not apply to that type of provider.
These are the requirements providers have met if they have an “ADA+” symbol next to their names:
- The office has at least one wheelchair-accessible path from an entrance to an exam room.
- Exam tables and all equipment are accessible to people with disabilities.
- Where parking is provided, spaces are reserved for people with disabilities. There are also pedestrian ramps at sidewalks and drop-off zones.
- Where parking is provided, there are an adequate number of accessible parking spaces (8 feet wide for a car and 5 foot access aisle).
- For a provider with a disability-accessible parking space, there is a stable, firm, and slip resistant path from the disability-accessible parking space to the facility entrance. The path does not require the use of stairs. Except for curb cuts, the path is at least 36 inches wide.
- There is a method for people using wheelchairs or that require other mobility assistance to enter as freely as everyone else. That route of travel is safe and accessible for everyone, including people with disabilities.
- The main exterior entrance door used by people with mobility disabilities to access public spaces meets accessibility standards. This includes a clear opening, low doorstep, and accessible door handle.
- There are ramps for wheelchair access. The slopes of the ramp are accessible for wheelchair access, the railings are sturdy and high enough for wheelchair access, the width between railings is wide enough to accommodate a wheelchair, and the ramps are nonslip and free from any obstruction (cracks).
- Where there are stairs at the main entrance, there is also a ramp or lift, or is there an alternative accessible entrance
- Any inaccessible entrances have signs indicating the location of the nearest accessible entrance.
- The accessible entrance can be used independently and without assistance.
- Doormats are half-inch high or less with beveled or secured edges.
- Waiting rooms and exam rooms are accessible to people with disabilities.
- The interior layout of the building allows people with disabilities to get materials and services without assistance.
- The interior doors comply with the criteria listed above for the exterior door.
- The accessible routes to all public spaces in the facility are 31 inches wide.
- In public areas where services are provided, there is a 5 foot circle or a T-shaped space for a person using a wheelchair to reverse direction.
- All buttons or other controls in the hallway are no higher than 42 inches.
- All elevators in the facility have raised and braille lettering on signs next to the door and on the controls inside the cab. The elevators also have call buttons in the hallway that are not higher than 42 inches.
- Sign language interpreters and other auxiliary aids and services are provided when needed.
- The public lavatory is wheelchair-accessible.
- The public restroom’s exterior door and interior stall doors comply with the standards listed above for exterior doors.
- There is at least one wheelchair accessible stall in the public restroom that has an area of at least 5 feet by 5 feet, clear of the door swing. Or, there is at least one stall that provides greater access than a typical stall (either 36 by 69 inches, or 48 by 69 inches).
- In the accessible stall of the public restroom there are grab bars behind and on the side wall nearest the toilet.
- There is one lavatory in the public restroom that meets accessibility standards, such as an accessible toilet, faucets, and soap dispensers.
This part of the Directory provides a list of pharmacies in VNSNY CHOICE FIDA Complete’s network. These network pharmacies are pharmacies that have agreed to provide prescription drugs to you as a Participant of the plan.
We also list pharmacies that are in our network but are outside the counties of the Bronx, Kings (Brooklyn), Nassau, New York (Manhattan), Queens and Richmond (Staten Island) in which you live. You may also fill your prescriptions at these pharmacies. Please contact VNSNY CHOICE FIDA Complete at 1-866-783-1444, TTY is 711, 7 days a week from 8 am – 8 pm, for additional information.
- VNSNY CHOICE FIDA Complete Participants must use network pharmacies to get prescription drugs.
You must use network pharmacies except in emergency or urgent care situations.
If you go to an out-of-network pharmacy for prescriptions when it is not an emergency, you will have to pay out of pocket for the service. Read the VNSNY CHOICE FIDA Complete Participant Handbook for more information.
- Some network pharmacies may not be listed in this Directory.
Some network pharmacies may have been added or removed from our plan after this Directory was published.
To get a complete description of your prescription coverage, including how to fill your prescriptions, please read the Participant Handbook and VNSNY CHOICE FIDA Complete’s List of Covered Drugs. You can also find the List of Covered Drugs, also called a Formulary on the Member Materials Page or by calling Participant Services at the number below to request a copy.
Along with retail pharmacies, your plan’s network of pharmacies includes:
- Mail-order pharmacies send covered prescription drugs to Participants through the mail or shipping companies.
- Home infusion pharmacies prepare prescription drugs that are given through a vein, within a muscle, or in another non-oral way by a trained provider in your home.
- Long-term care (LTC) pharmacies serve residents of long-term care facilities, such as nursing homes.
- Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) pharmacies
You are not required to continue going to the same pharmacy to fill your prescriptions.
Mail-Order Programs. We offer a mail-order program that allows you to get up to a 90-day supply of your prescription drugs sent directly to your home. Just as there is no copay for a one-month supply, there is no copay for a 90-day supply.
90-Day Retail Pharmacy Programs. Some retail pharmacies may also offer up to a 90-day supply of covered prescription drugs. Just as there is no copay for a one-month supply, there is no copay for a 90-day supply.
The “ADA+” Symbol
If a pharmacy has this symbol — ADA+ — next to its name, it means that the pharmacy meets the FIDA Program accessibility standards. This means that the pharmacy meets all 25 requirements that are listed on page xi, except for any requirements that would not apply to pharmacies. For example, a pharmacy would not have an exam room, so the requirements about an exam room do not apply to a pharmacy.
Retail and chain pharmacies
You can go to any of the pharmacies in our network.
Mail order pharmacies
You can get prescription drugs shipped to your home through our network mail order delivery program which is called Postal Prescription Services. Mail order pharmacies will obtain consent before shipping or delivering any prescriptions not requested by the Participant. To enroll in this service, please call Member Services or visit our Member Services page and download the prescription mail order form.
Typically, you should expect to get your prescription drugs within 14 days from the time that the mail order pharmacy gets the order. If you do not get your prescription drug(s) within this time, please contact us at 1-866-783-1444, TTY is 711. To learn more about mail order pharmacies, see Chapter 5 of the Participant Handbook.
Home infusion pharmacies
VNSNY CHOICE FIDA Complete will cover home infusion therapy if:
- Your prescription drug is on our plan’s formulary or a formulary exception has been granted for your prescription drug.
- Our plan has approved your prescription for home infusion therapy.
- Your prescription is written by an authorized prescriber.
Home infusion pharmacies service all counties in the plan’s service area, you can get more information by calling VNSNY CHOICE FIDA Complete at
1-866-783-1444, TTY is 711, 7 days a week from 8 am – 8 pm.
Long-term care pharmacies
Residents of a long-term care facility, such as a nursing facility, may access their prescription drugs covered under VNSNY CHOICE FIDA Complete through the facility’s pharmacy or another network pharmacy. To learn more about drug coverage in special cases, see Chapter 5 of the Participant Handbook.
Long-term care pharmacies service all counties in the plan’s service area, you can get more information by calling VNSNY CHOICE FIDA Complete at 1-866-783-1444, TTY is 711, 7 days a week from 8 am – 8 pm.
Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) pharmacies
Only Native Americans and Alaska Natives have access to Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies through VNSNY CHOICE FIDA Complete’s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to go to these pharmacies under limited circumstances (e.g., emergencies).
Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) pharmacies service all counties in the plan’s service area, you can get more information by calling VNSNY CHOICE FIDA Complete at 1-866-783-1444, TTY is 711, 7 days a week from 8 am – 8 pm.
VNSNY CHOICE FIDA Complete is a managed care plan that contracts with both Medicare and the New York State Department of Health (Medicaid) to provide benefits of both programs to Participants through the Fully Integrated Duals Advantage (FIDA) Demonstration.
Enrollment in VNSNY CHOICE FIDA Complete depends on contract renewal.
Last updated 4/25/2019