Program Eligibility
Who is eligible for Health Home services?
The New York State Department of Health defines the criteria for patients to be eligible for a Health Home as follows:
- Patients must be Medicaid eligible.
- Patients must have at least one single qualifying chronic condition:
- HIV/AIDS
- Serious mental illness
- Sickle cell disease
OR - At least two or more chronic conditions (e.g. substance use disorder, asthma, diabetes)
See full list of qualifying chronic conditions via this link: Click here
For Health Home Enrollment, patients must also demonstrate one of the following healthcare or social needs:
- Lack of adequate social, family, or housing support
- Lack of adequate connectivity with healthcare system
- Difficulty managing treatments or medications
- Probable risk for adverse events (e.g., death, disability, inpatient or nursing home admission)
- Recent release from incarceration
- Recent admission to a hospital
- Limitations in daily living activities (e.g. dressing, bathing, eating)
- Learning or cognition issues
Please refer to the following link if you need more information on Health Home criteria: Click here