Two or more ongoing conditions on Medicaid means your child can have a free care manager who keeps every specialist, refill, school form and appointment on track. Sickle cell disease qualifies on its own.
Three quick questions. Based on New York State's Health Home rules for children.
This is a guide, not a decision. Eligibility is confirmed by our care management team using your child's records and New York's appropriateness criteria.
Endocrinology, cardiology, pulmonology, hematology, the pediatrician, the school nurse, the pharmacy and Medicaid transportation do not talk to each other. Your care manager does. We build one plan of care, remind you of what is next, arrange rides, and step in after an ER visit or hospital stay so nothing falls through.
Tell us your child's age, Medicaid plan and diagnoses. Parents can refer their own child. Takes about ten minutes.
Referral, consent form (DOH-5201) and the intake assessment. You choose The Children's Circle as your agency.
Your dedicated care manager visits your home, builds one plan of care, and starts coordinating within days.
Two or more of these qualify. Sickle cell disease or HIV qualifies on its own, and so does a serious emotional disturbance or complex trauma confirmed by a licensed clinician.
Children and young adults from birth to 21 who have NY Medicaid and two or more ongoing health conditions from the state's list, such as autism and ADHD, asthma and anxiety, or diabetes and a developmental delay. Sickle cell disease, HIV, a serious emotional disturbance, or complex trauma qualifies on its own. Call us and we will check together.
All of them. Care management is a Medicaid benefit, so it does not matter whether your child is on Healthfirst, Fidelis, MetroPlus, UnitedHealthcare, Anthem, EmblemHealth, Molina or fee-for-service Medicaid.
No. The program is paid for by Medicaid. There are no copays, no fees and no bill, ever. It is voluntary and you can stop at any time.
Yes. New York State rules say the parent's choice of care management agency comes first. If a plan or a hospital offers you a list, you can ask for The Children's Circle. Families already with another agency can ask to transfer.
Yes. Your care manager meets your family at home and can go with you to appointments. We serve the Bronx, Brooklyn, Queens, Manhattan and Staten Island.
If autism is the only diagnosis, New York routes care coordination through OPWDD, and we will point you to the OPWDD Front Door. If your child has autism plus another condition, like ADHD, asthma, epilepsy, or a speech or developmental delay, and you are not enrolled in OPWDD services, your child can get a Medicaid care manager through us.
Call now or send the enrollment form. Free with Medicaid, home visits in all five boroughs, Hablamos Español.