Help Off-Exchange Members Renew Their Coverage

Posted Mar 21, 2025

This year, New York State will resume standard annual recertification procedures for off-exchange Medicaid, Personal Wellness Plan (HARP), Life Improvement Plan (LIP), CompleteCare, and Senior Health Partners (SHP) members whose coverage is managed by the Local Department of Social Services (LDSS) or Human Resource Agency (HRA).

A printable PDF is available here.

Starting with cohorts up for recertification in May 2025, off-exchange members must renew their Medicaid eligibility annually or they will lose their coverage.

Here are ways you can help your patients avoid a lapse in health coverage.

How do members know when to renew?

When it’s time to recertify, off-exchange members will receive a paper renewal application typically three months in advance of their recertification date. The applications will include a submission due date, which is typically 50 days prior to the member’s recertification date.

Members must submit or mail their paper renewal application to their LDSS or HRA or risk coverage loss.

A sample copy of the member's renewal notice can be viewed here.

How to help your patients renew their health plan

Log in to Healthfirst’s Provider Portal through Availity Essentials^TM to access the Member Renewal Roster. Off-exchange members are notated with a LDSS/HRA tag.
Patients whose renewal deadline is approaching should be directed to visit healthfirst.org/renew-your-coverage for more information.
If your patients who are Healthfirst members have not come in for an office visit in the past 12 months, contact them today and schedule an appointment for them. Ask if they know their plan renewal deadline. If not, contact Healthfirst for assistance (see below chart, When it’s time to renew).
You can refer Healthfirst members to the Healthfirst representative with whom you work or to our Community Offices for help renewing their Healthfirst coverage. See our list of Healthfirst Community Offices.

When it’s time to renew

Members who need support completing their renewal packets can contact Healthfirst’s dedicated support teams below. Healthfirst will work with our members to check their plan eligibility and make sure they are enrolled in the right plan with the right benefits.

Member Plan(s)	Healthfirst Support Information
Medicaid Personal Wellness Plan (HARP)	Members who do not receive public assistance can schedule an appointment for in-person support at 1-844-500-9820 or visit a Healthfirst Community Office.
Medicaid Personal Wellness Plan (HARP)	Members who receive public assistance must renew with their case manager at HRA. Direct them to the HRA Medicaid Helpline at 1-888-692-6116.
Life Improvement Plan (LIP)	Members can call Senior Planning Services (SPS) at 1-844-559-4219 (Monday to Friday 9am-5pm)
CompleteCare Senior Health Partners (SHP)	Members can call 1-844-450-5701 (TTY: 1-888-542-3281 for English and 1-888-867-4132 for Spanish), Monday to Friday, 8:30am – 5:30pm for support.

Additional Resources

Healthfirst Community Offices
Healthfirst.org/renew-your-coverage
Healthfirst Provider Toolkit: Patient Recertification

Questions?

If you have any questions, please contact your Network Account Manager, or call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am-5:30pm.