St. George and the North Shore: D-SNPs, IB-Dual, and the “default enrollment” letter

The North Shore, from St. George and Tompkinsville through Stapleton, Clifton, and West Brighton, is the part of Staten Island where Medicaid managed care is most common and where people most often hold Medicare and Medicaid together. It is also the island’s most diverse stretch, with families from many countries in the apartment buildings along Victory Boulevard and Bay Street and the NYCHA developments near Stapleton.

This page is for North Shore residents who got a letter from their Medicaid plan about the plan’s Medicare D-SNP, for people with both programs who want IB-Dual and Medicaid Advantage Plus explained plainly, and for the relatives and neighbors reading the mail for them. It is educational. It does not decide anything and does not enroll anyone.

On every Medicare and Medicaid form, Staten Island is Richmond County. The county line should read “Richmond,” not “Staten Island” and not “New York.” Medicaid is run citywide by HRA. ZIP 10301 covers St. George, Tompkinsville, and part of Silver Lake; 10304 covers Stapleton and Grymes Hill; 10310 covers West Brighton and Port Richmond (approximate; verify with USPS).

Richmond University Medical Center, on Bard Avenue in West Brighton, is the North Shore hospital, and many residents also ride the ferry to a Manhattan specialist. Every New York City integrated dual plan on the state’s 2026 chart lists Richmond County, so a Manhattan doctor is not out of the service area; whether that doctor is in the D-SNP’s Medicare network is the separate question. The ferry terminal, Borough Hall, the northern end of the Staten Island Railway, and the island’s one NYC Aging HIICAP site on Stuyvesant Place all sit within a few blocks in St. George.

The letter here is like anywhere in the city: sent by the Medicaid plan at least 60 days before the Medicare start date, with an effective date and a last day to opt out. Confirm both dates on the letter. Not every plan sends one; if a neighbor on Bay Street got a letter and you did not, the likely explanation is different plans, not lost mail.

The North Shore-specific check is the ferry. If your cardiologist or oncologist is in lower Manhattan, look them up in the D-SNP’s Medicare directory before the effective date, and do the same for Richmond University Medical Center if that is your hospital. A counselor at CASC can walk through the directory with you.