HARP stands for Health and Recovery Plan, a specialized type of Medicaid managed care plan in New York State designed for adults with significant behavioral health needs. It covers all the standard Medicaid benefits you’d get through a regular managed care plan, plus additional recovery-oriented services that help people with serious mental health conditions or substance use disorders live more independently in their communities.
How HARP Differs From Standard Medicaid
A regular Medicaid managed care plan covers your medical, hospital, and pharmacy needs, along with some behavioral health services. HARP includes all of that but adds a layer of support specifically built around behavioral health recovery. The two biggest additions are Home and Community-Based Services (HCBS) and dedicated care management through a state-designated Health Home.
Think of HARP as a Medicaid plan that treats behavioral health as a central priority rather than an add-on. Where standard managed care might cover therapy and medication, HARP goes further by connecting members with services designed to build life skills, maintain stable housing, find employment, and strengthen social connections. These aren’t clinical treatments in the traditional sense. They’re practical supports that help people stay out of hospitals and crisis situations.
Who Is Eligible
HARP is available to adults on Medicaid who have serious mental health conditions, substance use disorders, or both. New York State identifies eligible individuals based on factors like their past Medicaid service use, including hospitalizations, emergency room visits, and history of behavioral health treatment. You don’t apply for HARP the way you’d apply for Medicaid itself. Instead, the state reviews claims data and flags people who meet the criteria.
The program is limited to adults. Children and adolescents with behavioral health needs are served through separate programs. To qualify, your behavioral health conditions generally need to be significant enough that they affect your ability to function day to day, whether that means holding a job, managing a household, maintaining relationships, or staying safe.
How Enrollment Works
If the state determines you’re HARP-eligible, what happens next depends on which Medicaid managed care plan you’re already in. Some managed care plans in New York offer a HARP product. If your current plan is one of them, you don’t need to do anything. You’ll receive a notice from the state about your HARP enrollment and have 30 days to opt out or switch to a different HARP if you prefer.
If your current managed care plan doesn’t offer a HARP, you’ll need to take action. The state will send you a notice explaining how to join one. People enrolled in an HIV Special Needs Plan will also be notified of their eligibility separately. The key point is that HARP enrollment is not mandatory. You can opt out if you’d rather stay in your current plan, though doing so means you won’t have access to the additional HCBS benefits.
Home and Community-Based Services
The services that set HARP apart from regular Medicaid fall under the umbrella of Home and Community-Based Services. These are organized into two tiers, and which tier you qualify for depends on the results of an assessment called the New York State Community Mental Health Assessment. This evaluation looks at several areas of your life: employment and education status, your ability to handle daily tasks like cooking and managing finances, cognitive skills, social relationships, experiences with stress and trauma, co-occurring medical conditions, engagement with services, substance use, and risk of harm.
Based on the results, you’ll be placed into either Tier 1 or Tier 2. Tier 2 members have access to a broader set of services and can also participate in Tier 1 offerings. The assessment is typically conducted by your care manager, ideally on the same day as the initial screening.
The types of HCBS available through HARP are focused on practical recovery goals. They include services like peer support (working with someone who has their own lived experience with mental health or substance use challenges), supported employment to help you find and keep a job, psychosocial rehabilitation to build coping and social skills, community-based crisis intervention, and support for developing skills needed for independent living. These services are delivered in your community, not in a hospital or clinical facility, which is the whole point. The goal is keeping people connected to their lives rather than cycling through institutional care.
The Role of Care Management
Every person enrolled in a HARP is assigned care management through a Health Home designated by New York State. Health Homes aren’t physical buildings. They’re networks of providers that coordinate all aspects of your care, from behavioral health treatment to primary medical care to social services like housing assistance. Your care manager is the person who ties it all together.
In practice, your care manager helps you figure out which behavioral health services, including the HCBS options, are the right fit for your situation. They can walk you through what you’re eligible for, help you access those services, and coordinate between different providers so you’re not managing it all alone. For people dealing with complex needs across multiple systems (mental health, substance use, physical health, housing), having a single point of contact can make a real difference in whether services actually get used.
Quality Measures and Oversight
New York State actively monitors how well HARP plans are serving their members. For the 2025 measurement year, there are 30 quality measures that HARP plans are evaluated against. The state also requires that health plans and providers incorporate race and ethnicity data into their quality reporting, a requirement that has been phased in since 2022 for new contracts and since April 2023 for existing ones. This stratification is meant to identify and address disparities in care, making sure that HARP services work equitably across different populations.
How to Get Started
If you’re on Medicaid in New York and think you might qualify for HARP, the most direct path is to contact your current managed care plan and ask whether they offer a HARP product. You can also reach out to a Health Home in your area, as they can help determine eligibility and connect you with the right plan. If you’ve already received a notice from the state about HARP eligibility, the letter will include instructions for your specific situation, whether that means you’re automatically enrolled or need to choose a plan.
It’s worth noting that HARP is specific to New York State. Other states have their own specialized behavioral health Medicaid programs, but the HARP name and structure are a New York creation. If you’re searching from outside New York, your state’s Medicaid office can point you toward equivalent programs for people with serious behavioral health conditions.