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

Astoria stretches from the East River waterfront and the Astoria Houses, across the brick houses and walk-ups off 30th Avenue and Ditmars Boulevard, to the apartment blocks along Steinway Street. Many long-time residents have both Medicare and Medicaid, or have Medicaid managed care now and will get Medicare soon. Astoria is also one of only four neighborhoods in the borough with an NYC Aging HIICAP counseling site on the citywide list.

This page is for Astoria residents who received a default enrollment letter from a Medicaid plan, who already have a D-SNP and are unsure what IB-Dual or Medicaid Advantage Plus means, or who are helping an older parent in a NYCHA building sort out the paperwork. It explains what the letter is asking and how to get a counselor in person or by phone. It does not enroll you in anything.

Astoria is in Queens County, and Medicaid is administered citywide by the NYC Human Resources Administration (HRA). The ZIP codes usually associated with the neighborhood are 11102 (west, toward the river), 11103 (central, around Steinway Street), 11105 (Ditmars and the north), and 11106 (south, toward Long Island City); all approximate, verify with USPS. Any county box gets “Queens.”

Mount Sinai Queens on 30th Avenue is the hospital most Astoria residents know. Whether it and its affiliated practices are in a specific D-SNP’s Medicare network is a plan-by-plan question, and it is separate from whether they accept your Medicaid plan today. The same goes for the pharmacies along Steinway Street and 31st Street.

The N and W trains run above 31st Street from Ditmars Boulevard to Queensboro Plaza, and several bus routes cover the waterfront and 21st Street. The HIICAP site on 30th Drive is a few blocks from the 30th Avenue station.

Because a counseling site is in the neighborhood, Astoria residents have a choice most of Queens does not: you can bring the letter to 30th Drive and have someone read it with you. Do that before the effective date on the letter. The plan must mail the notice at least 60 days ahead, and the opt-out window generally closes the day before the D-SNP would start (confirm on your letter), so booking soon after the letter arrives leaves room.

If you live in Astoria Houses or another NYCHA development on the waterfront, ask the counselor about transportation and pharmacy coverage specifically. The distance from 8th Street to the nearest subway makes a plan’s ride benefit and mail-order pharmacy rules matter more here than in most of the neighborhood.