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

The South Shore runs from Great Kills through Eltingville, Annadale, Huguenot, and Prince’s Bay to Tottenville at the far end of the Staten Island Railway. It is mostly single-family houses, and Medicare and Medicaid together are less common here than on the North Shore. When they do come together, often after a long illness or years on disability, the paperwork is new to everyone in the house.

This page is for South Shore residents who received a letter from a Medicaid managed care plan about a Medicare D-SNP, for anyone with both programs who wants IB-Dual and Medicaid Advantage Plus explained plainly, and for the family members driving them to appointments. It is educational only. It does not enroll anyone and does not decide eligibility.

Every part of the South Shore is in Richmond County for Medicare and Medicaid. Tottenville is closer to New Jersey than to Manhattan, but it is still Richmond County; write that in the county box. Medicaid is run by HRA citywide. ZIP 10307 covers Tottenville, 10308 Great Kills, 10309 Prince’s Bay and Charleston, and 10312 Eltingville, Annadale, and Huguenot (approximate; verify with USPS).

Staten Island University Hospital’s South campus, on Seguine Avenue in Prince’s Bay, is the South Shore hospital, with practices along Hylan Boulevard and Amboy Road. Some households drive over the Outerbridge Crossing to a New Jersey specialist; a D-SNP’s Medicare network is a specific list, so an out-of-state practice is something to confirm, not assume. The Staten Island Railway stops at Great Kills, Eltingville, Annadale, Prince’s Bay, and Tottenville and runs straight to St. George and the island’s one in-person HIICAP site.

A South Shore household often has one person on Medicare for years and another whose Medicare is just beginning, and the default enrollment letter is about the second person. It arrives from the Medicaid plan at least 60 days before that person’s Medicare start date, with an effective date and a last day to opt out; confirm both on the letter. Not every plan sends one, so a neighbor’s experience in Eltingville is not a prediction of yours.

The South Shore-specific step is the New Jersey question. If you cross the Outerbridge for a specialist, look that practice up in the D-SNP’s Medicare directory before the effective date, along with Staten Island University Hospital South and your pharmacy. If anything is missing, call HIICAP that week.