Mott Haven: D-SNPs, IB-Dual, and the “default enrollment” letter

Mott Haven is the southern tip of the Bronx, and much of its housing is in NYCHA developments and older walk-ups along Brook Avenue and St. Ann’s Avenue. A large share of residents are under 65 and got Medicare after two years on Social Security disability, and many are in HARP plans, the Medicaid managed care plans with extra behavioral health services. Those are exactly the people who get default enrollment letters, often well before 65.

This page is for Mott Haven residents holding one of those letters, for people with both Medicare and Medicaid who want to know whether they are in IB-Dual, and for the family members, case managers, and tenant association volunteers who help with paperwork. It explains and points to free help. It does not determine anyone’s eligibility.

Mott Haven is in Bronx County, and Medicaid here is administered by HRA for the whole city. ZIP 10451 covers the blocks around 149th Street and the Grand Concourse, 10454 the area near Third Avenue and 138th Street, and 10455 the eastern side toward St. Mary’s Park (approximate; verify with USPS). If a form asks for county, write “Bronx.”

NYC Health + Hospitals / Lincoln, on East 149th Street, is the hospital most people in Mott Haven use, and many residents see their primary care doctor in its clinics. BronxCare Health System on the Grand Concourse is the other large option nearby. Both are worth looking up in any D-SNP’s Medicare directory; an aligned plan still has its own Medicare provider list. The 6 train at Third Avenue–138th Street and the 2, 4, and 5 trains at 149th Street–Grand Concourse put both Bronx HIICAP sites within a short trip.

For someone in Mott Haven whose Medicare is starting because of disability, the letter should arrive at least 60 days before the 25th month of disability benefits, and it comes from the Medicaid or HARP plan, not from Social Security and not from HRA. Look for the effective date and the last day to opt out, and confirm both on the letter.

The HARP question is the one to settle before that date. Under IB-Dual, staying in the aligned D-SNP generally keeps your HARP services in place. Opting out does the opposite of what many people expect: you are generally moved to Medicaid fee-for-service. If your care depends on a behavioral health program tied to your plan, ask HIICAP and New York Medicaid Choice about continuity before deciding.