What is a Certified Application Counselor?

Certified Application Counselors (CACs) are individuals or organizations trained and certified to help people apply for and navigate health insurance programs, especially those available through the Health Insurance Marketplace established under the Affordable Care Act (ACA). The primary role of Certified Application Counselors is to assist individuals and families in understanding their health insurance options and to aid them in completing the application process.

Here are some key points about Certified Application Counselors:

• Training and Certification: CACs undergo training and certification to become knowledgeable about the various health insurance programs and the application process. They are required to pass exams and meet certain educational standards.
• Assistance with Enrollment: CACs help people enroll in health insurance plans through the Health Insurance Marketplace, which includes plans offered by private insurance companies as well as Medicaid and the Children’s Health Insurance Program (CHIP).
• Information and Education: They provide information about different health insurance plans, including details about costs, coverage, and benefits. They can explain the terms and options to help individuals make informed choices.
• Application Support: CACs assist individuals in completing and submitting their applications for health coverage. They can also help with any necessary documentation and verification processes.
• Special Populations: CACs are often trained to assist special populations, such as immigrants, refugees, and individuals with limited English proficiency, to ensure they can access health coverage.
• Privacy and Confidentiality: CACs are trained to maintain the privacy and confidentiality of individuals’ personal and health information. They follow strict guidelines to protect sensitive data.
• No Cost to the Consumer: CAC services are typically provided at no cost to the individuals seeking assistance. CACs are funded through government programs and grants.
• Community-Based: CACs are often found in community organizations, healthcare facilities, and social service agencies. They are strategically located to serve and reach underserved and vulnerable populations.
• Assistance Beyond Enrollment: In addition to helping with initial enrollment, CACs may also assist with reporting changes in circumstances, renewing coverage, and understanding how to use health insurance effectively.

How does a Certified Application Counselor help?

CACs play a crucial role in making health insurance more accessible and understandable for individuals and families. They help people make informed decisions about their health coverage options and can be especially helpful during the annual open enrollment period for the Health Insurance Marketplace. If you need assistance with health insurance enrollment or have questions about your coverage options, you can contact a Certified Application Counselor or use the services offered through the Health Insurance Marketplace.

Medicaid Offices in New York with Certified Application Counselors

Bronx

Rider Community: 
Address: 305 Rider Ave.
4th Floor
Bronx, NY 10451

Phone: 718-585-7872
Monday – Friday 8:30am to 5:00pm

Brooklyn

Coney Island: 
Address: 1912 Mermaid Ave.
Brooklyn, NY 11224
Phone: 929-221-3790
Monday – Friday 9:00am to 5:00pm

Brooklyn South: 
Address: 785 Atlantic Ave.
1st Floor
Brooklyn, NY 11238
Phone: 929-221-3502
Monday – Friday 8:30am to 5:00pm

Manhattan

Chinatown: 
Address: 115 Chrystie St.
5th Floor
New York, NY 10002
Phone: 212-334-6114
Monday – Friday 9:00am to 5:00pm

Dyckman Community: 
Address: 4055 10th Avenue
Lower Level
New York, NY  10034
Phone: 929-221-3244
Monday – Friday 8:30am to 5:00pm

Queens

Queens Community: 
Address: 32-20 Northern Boulevard
3rd Floor
Queens, NY 11101
Phone: 718-784-6729
Monday – Friday 8:30am to 5:00pm

Suffolk County

Staten Island: 
Address:215 Bay St.
Staten Island, NY 10301
Phone: 929-221-8823/8824
Monday – Friday 9:00am to 5:00pm

What Services does Medicaid Offer?

Medicaid provides comprehensive healthcare coverage, including doctor visits, hospital care, prescription drugs, preventive services, and more. States have some flexibility in determining the specific services covered under their Medicaid programs. For some pregnant women, services may be limited to perinatal care if their incomes are too high to qualify for full Medicaid coverage.

Medicaid offers a full range of health services for eligible persons including:

• All regular medical checkups and needed follow-up care.
• Immunizations.
• Doctor and clinic visits.
• Medicine.
• Medical supplies.
• Medical equipment and appliances (wheelchairs, etc.).
• Lab tests and x-rays.
• Eye care and eye glasses.
• Emergency care.
• Dental care.
• Nursing home care.
• Emergency ambulance transportation to a hospital.
• Hospital stays.

For children birth to 21 years old, Medicaid offers the Child/Teen Health Program (C/THP), which provides the services listed above for all Medicaid recipients. C/THP places an emphasis on preventive care and treatment. For example, Medicaid requires that all children be screened with a blood lead test at one and two years of age. C/THP is available from fee-for-service healthcare providers. Also, all managed care plans must offer C/THP to Medicaid recipients under 21 years of age who are enrolled in their plan.

Child Health Plus and Family Health Plus provide services to eligible children and adults, respectively, through managed care plans.