D-SNPs and default enrollment letters in Queens

Queens has one of the largest populations of people with both Medicare and Medicaid in New York State, spread across neighborhoods that speak dozens of languages. That mix shows up in the mail: a person in Flushing, a person in Jamaica, and a person in Rego Park can each get a “default enrollment” letter from the same kind of Medicaid managed care plan, but the questions they need answered are different. This hub explains what stays the same across the borough and where the neighborhood pages go deeper.

For Medicare and Medicaid paperwork, Queens is Queens County. Every integrated dual plan listed on the New York State Department of Health’s 2026 IB-Dual chart that serves New York City includes Queens in its service area, so most Queens residents who get a default enrollment letter are being offered a plan that covers the whole borough, not just their neighborhood. What differs by neighborhood is which doctors, pharmacies, and clinics are in the plan’s network, which is exactly what a HIICAP counselor can help you check.

Nothing on this page decides anything about your coverage. Your letter, your plan, Medicare, and New York Medicaid are the only ones who can do that. Use this hub to understand the letter, gather questions, and find free help.

In New York City, Medicaid is run by the city’s Human Resources Administration (HRA), not by a county Department of Social Services the way it is in Nassau or Westchester. There is no separate “Queens Medicaid office” phone line to hunt for. Queens residents call the same HRA Medicaid Helpline as everyone else in the five boroughs, and HRA’s Medicaid offices in Queens are listed on nyc.gov/hra.

Free Medicare counseling in Queens comes through HIICAP, New York’s State Health Insurance Assistance Program. The statewide line asks which county you are in, so say “Queens.” Inside the city, NYC Aging (the Department for the Aging) runs HIICAP, and you can also reach a counselor by calling Aging Connect and asking for HIICAP. NYC Aging’s citywide listing shows community counseling sites in Jamaica, Corona, Astoria, and Sunnyside, all by appointment.

For anything about your Medicaid managed care plan, opting out of default enrollment, or Managed Long Term Care (including Medicaid Advantage Plus), New York Medicaid Choice is the state’s official enrollment broker. They cannot pick a Medicare plan for you, but they can connect you with your plan and explain what happens to your Medicaid plan when your Medicare starts.

Queens residents often get their default enrollment letter while they are still going to the same clinic they have used for years, whether that is in Elmhurst, Jamaica, or Flushing. Before the effective date on the letter, ask the plan (or a HIICAP counselor) whether that clinic and your pharmacy are in the D-SNP’s Medicare network, not just the Medicaid network. Same company does not always mean the same doctor list.