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What You Need to Enroll

Different programs require different documentation for enrollment.  Please check the column below your program to determine what documents you must provide at the time of your appointment. You must provide all of the documentation necessary for your application before you can use your coverage.

Required Documents

Family Planning Benefit Program

Medicaid

Proof of Identity

X

X

Proof of Residency (Must be a NYS resident)

X

X

Social Security Number (Must be a US citizen or Legal Immigrant)

X

      NA

Proof of individual income (for the past 4 weeks)

X

X

Proof of household income (for the past 4 weeks)

X

X


College students may not use mail sent to a dorm or other university address to prove residence. Recent mail (from the last six months) from your permanent home address must be provided instead. Other forms of proof of residency are: postmarked mail sent to you within the last six months (envelopes must not have a clear window; magazines must have lasered address, not a sticker), utility bills (gas, electric, cable or water), recent bank statements, or a driver's license issued within the last three months.

 Acceptable Documents:

  • one recent month's worth of consecutive paycheck stubs OR a letter from your employer on company letterhead, signed and dated, stating how much you make per hour and how many hours you work each week
  • unemployment award letter/benefit check
  • workers comp. award letter/benefit check
  • signed and dated statement from friend/family member stating that they support you

Please note: 

  • If married, proof of spouse income MUST be documented.
  • If you were recently pregnant, and had Medicaid when your pregnancy ended, you may qualify for the Family Planning Extension Program (FPEP). Call (518) 434-5678 for more information.

Services Covered

Each program covers a specific range of services. See the chart below to determine what services are covered under your program.

Services

Family Planning Benefit Program

Medicaid

Birth Control

X

X

Annual Exam

X

X

Emergency Contraception

X

NA

Pap Test 

X

X

Cancer Screening, Colposcopy, Cryotherapy and LEEP

X

X

Abortion (surgical and medication)

NA

X

Some other services, including STI testing and treatment, may also be covered depending on the details of your visit. Call (518) 434-5678 for more information. 

Some services are only covered by FPBP if they are administered in the course of a visit where family planning is discussed.

Colposcopy, Cryotherapy and LEEP procedures are only covered by FPBP if the pap test that came back abnormal was taken at a visit where family planning was also discussed.

Questions?

Please visit ourĀ FAQ page, or call 518.434.5678 to speak with our staff.