- County on forms
- New York County (Manhattan)
- Medicaid run by
- NYC HRA, citywide
- ZIP codes (approx.)
- 10021, 10028, 10065, 10075, 10128
ZIP codes are orientation only. Verify yours with USPS.
Who this page helps
The Upper East Side is often pictured as Park Avenue, but Yorkville east of Third Avenue holds many older adults in walk-ups, rent-regulated buildings, and public housing along York and East End Avenues. Some have Medicaid with Medicare, and some are opening a letter from their Medicaid plan about being moved into its Medicare D-SNP unless they opt out.
This page is for those residents and for the family members, building aides, and neighbors who help them. It explains the letter in plain language, what changes under each choice, and how to reach a free, unbiased counselor. It does not tell you which plan to pick and cannot enroll anyone.
What “local” means for Medicare and Medicaid in Upper East Side
For Medicare and Medicaid records the Upper East Side is in New York County, and Medicaid is run citywide by the NYC Human Resources Administration (HRA), not a county office. The neighborhood’s ZIPs are 10065 (the 60s), 10021 (the 70s), 10075 (the upper 70s), 10028 (the 80s and Yorkville), and 10128 (the 90s and Carnegie Hill). They are approximate; blocks near 96th Street may carry an East Harlem ZIP.
All New York City integrated dual plans on the state’s 2026 IB-Dual chart include New York County, so the plan on an Upper East Side letter covers your address. What differs is the D-SNP’s Medicare network. This is the most hospital-dense stretch of Manhattan, with NewYork-Presbyterian / Weill Cornell on East 68th Street, Lenox Hill Hospital on East 77th Street, and Mount Sinai Hospital at Madison Avenue and 100th Street, and each is either in a given D-SNP or not.
The 4/5/6 on Lexington Avenue and the Q on Second Avenue reach Midtown and downtown counseling sites, and the M15 and M31 buses cover the York Avenue side.
The Upper East Side is mostly English-speaking, with many older long-time residents in Yorkville and large Spanish-speaking communities on the East Harlem edge; interpreters are available on every number here.
How to get free help from Upper East Side
- Call HIICAP at 1-800-701-0501 and answer “New York” when asked for your county. Ask the counselor to look up your doctors, especially any at Weill Cornell, Lenox Hill, or Mount Sinai, in the D-SNP’s directory and to check your prescriptions against its drug list.
- The nearest NYC Aging HIICAP sites are the Stavros Niarchos Foundation Library (Thomas Yoseloff Business Center), 455 Fifth Avenue, 5th Floor, 212-340-0863, Fridays 1:00–5:00 p.m., online appointments only, near Grand Central on the 4/5/6; and the NYC Aging HIICAP Unit, 2 Lafayette Street, 212-244-6469 (ask for HIICAP), Monday–Friday 9–4, by appointment.
- Questions about the Medicaid plan itself, opting out, or the long-term-services version of the notice go to New York Medicaid Choice at 1-800-505-5678 (TTY 1-888-329-1541). If you already get home care hours, ask about Medicaid Advantage Plus on the long-term care line, 1-888-401-6582.
- For Medicaid renewals or a coverage gap, call the HRA Medicaid Helpline at 1-888-692-6116. For Medicare itself, call 1-800-MEDICARE (1-800-633-4227). NY Connects at 1-800-342-9871 can point you toward long-term supports.
What to ask, in one sentence each
- HIICAP“I have Medicare and Medicaid and got a default enrollment letter. Can you compare the D-SNP with Original Medicare plus a drug plan for my prescriptions and doctors?”
- New York Medicaid Choice“If I opt out of the D-SNP, what happens to my Medicaid managed care plan and my home care? How do I opt out, and by when?”
- Your plan (number on the letter)“Are my doctors and my pharmacy in the D-SNP’s Medicare network, not just the Medicaid network?”
- HRA Medicaid Helpline“Is my Medicaid active and is my address correct?” (Only if your case, not your plan, is the problem.)
Free public help from Manhattan
These lines are run by New York State, New York City, or Medicare. None of them sells plans. When the HIICAP recording asks for your county, say “Manhattan.”
- HIICAP (free Medicare counseling)Mon–Fri, 8:30 a.m.–5:00 p.m.1-800-701-0501
- NYC Aging ConnectAsk for HIICAP; in-person appointments. Also 212-AGING-NYC212-244-6469
- New York Medicaid ChoiceMedicaid plan enrollment and opt-out help. TTY 1-888-329-1541. Mon–Fri, 8:30 a.m.–8:00 p.m.; Sat, 10:00 a.m.–6:00 p.m.1-800-505-5678
- NY Medicaid Choice long-term care lineMAP, MLTC, PACE1-888-401-6582
- NY ConnectsLong-term services and supports, any age1-800-342-9871
- NYC HRA Medicaid HelplineYour Medicaid case, renewals, address1-888-692-6116
- MedicareTTY 1-877-486-2048. 24 hours a day1-800-MEDICARE (1-800-633-4227)
Numbers checked against official sources on September 10, 2026. Hours and phone menus change; the official sites are aging.ny.gov, nyc.gov/aging, nymedicaidchoice.com, nyconnects.ny.gov, and nyc.gov/hra.
Default enrollment letter tip for Upper East Side
Upper East Side residents often have a specialist at a hospital within walking distance and assume the hospital’s name on a plan brochure means every doctor there is covered. It does not. A Weill Cornell or Lenox Hill practice may take one company’s Medicaid plan and not its D-SNP. Confirm your key doctors before the effective date on the letter.
In Yorkville’s public housing or a rent-regulated building near 96th Street, do not assume a neighbor’s letter tells you what yours will say. Default enrollment depends on your Medicaid plan, not your block, and not every plan sends a notice. Opt out by calling or writing your plan; the deadline is generally the day before the effective date, so check the letter.
Not sure which letter you have? Read the default enrollment letter decoder or the blog post what to do in the first 7 days.
Common mistakes in Upper East Side
- Writing “Manhattan” or “NYC” as the county because the hospital paperwork from East 68th Street says New York, NY. The county for every Upper East Side address is New York County.
- Opting out to keep a Madison Avenue or York Avenue doctor without first checking whether that doctor is in the D-SNP. Opting out also ends your Medicaid managed care plan and moves Medicaid to fee-for-service.
- Trying to walk into the Fifth Avenue library site on a weekday. HIICAP counseling there is Fridays only and is booked online, not at the desk.
Orientation: places people in Upper East Side mention
Orientation only. Listing a hospital or center here is not a recommendation and says nothing about which plans it accepts. Always check the plan’s own provider directory.
- NewYork-Presbyterian / Weill Cornell · East 68th Street at York Avenue
- Lenox Hill Hospital · East 77th Street between Park and Lexington
- New York Public Library, Yorkville branch · East 79th Street; free internet for Medicare.gov comparisons
Want your next steps in writing?
Answer five short questions about your coverage and your letter. We will email you a plain-language summary of what to ask and who to call from Upper East Side. Optional callback. This tool does not enroll you in any plan, does not decide eligibility, and is not from the government. Free HIICAP counseling is always available first.
Prefer to talk with a person right now? HIICAP is free at 1-800-701-0501.