Frequently Asked Questions For Current Medicaid Beneficiaries
What is a Community Spouse?
A community spouse is someone whose husband/wife is currently institutionalized or living in a nursing home. The community spouse is not currently living in a nursing home and usually resides at the couple´s home.
I am a community spouse. Will I be allowed to keep any income or resources?
If your spouse is institutionalized or living in a nursing home, you will be permitted to keep some income known as a minimum monthly maintenance needs allowance . If you are currently receiving income in excess of the minimum monthly maintenance needs allowance, you may be asked to contribute twenty-five percent of the excess income to the cost of care for the institution
How do I find my local Medicaid office?
The Medicaid office is located in your local department of social services. A listing of offices can be located here:
If you live in the five boroughs of New York City, your offices are run by the Human Resources Administration . A listing of offices can be found here:
How do I order a new benefit card?
If your Medicaid is with your LDSS, to order a new Medicaid Benefit Identification Card, please call or visit your
If your Medicaid is with the and you need to order a new benefit card please call the call center at 1-855-355-5777.
Members residing in the five boroughs of NYC can call the HRA Infoline at 1 557-1399 or the HRA Medicaid Helpline at 1 692-6116.
How often do I have to renew?
Pregnant Women And Infants
Healthy Connections provides coverage to pregnant women with low income. This coverage for the mother continues for 60 days after the baby’s birth. The infant is covered up to age one.
A woman who may qualify for this program must:
- Be pregnant
- Be a South Carolina resident
- Be a U.S. citizen or Lawful Permanent Resident Alien
- Have a Social Security number or verify an application for one
Individuals who are eligible will receive all Medicaid covered services.
Apply online or complete the following form and submit it electronically to , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101 or to your .
The Omnibus Budget Reconciliation Act of 1986 gave states the option to provide Medicaid coverage to pregnant women with low income.
Will A Marketplace Health Plan Also Cover A Newborn
Yes. The ACAs EHB requirement mandates coverage of maternity and newborn care. Newborn care covers childbirth and immediate care for the baby after birth. The specifics of this coverage will vary by state and by each individual plan, but all women in Marketplace coverage must also enroll their baby in coverage soon after birth.
If the newborn is eligible for Marketplace coverage, then the parents can choose to add the baby to the familys existing Marketplace plan or choose a new Marketplace plan for the baby. If they opt for the latter, they can enroll the baby into a new Marketplace plan at any metal tier. However, when enrolling a newborn into Marketplace coverage, other members of the household are generally not permitted to change their existing Marketplace coverage.
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What Changes When A Woman Already Enrolled In Medicaid Becomes Pregnant
Generally, nothing. A woman who was previously eligible and enrolled in full-scope Medicaid who becomes pregnant continues to be eligible, and will be able to access pregnancy services. A woman who becomes pregnant while enrolled in Medicaid Expansion can stay in that coverage, at least until redetermination. The state must inform the woman of the benefits afforded to pregnant women under other coverage categories, such as pregnancy-related Medicaid, and provide the option to switch categories if the woman is eligible.
Provider Inquiry Newborn Spreadsheet
If you know the mother is pregnant, Medicaid eligible, and her unborn child does not have a number, you may have the baby added by emailing a password protected Master Unborn Provider Spreadsheet to the statewide DCF email address identified on the spreadsheet. This spreadsheet can also be used to contact DCF to request assistance regarding missing eligibility for newborns or issues concerning incorrect demographics such as discrepancies in dates of birth.
Please review the Provider Unborn Update Spreadsheet Completion Guide for further instructions on completing and submitting inquiries to DCF.
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Can Uninsured Immigrant Women Receive Medicaid Or Chip Services
Maybe. Immigrants with qualified non-citizen status are eligible to enroll in Medicaid if they otherwise meet state Medicaid eligibility requirements, but are subject to a five-year waiting period from the time they receive their qualifying immigration status before becoming eligible. Some categories of qualified non-citizens are exempt from the five-year ban because they are considered lawfully residing immigrants. For lawfully residing immigrants, the five-year waiting period was waived in 2010, giving states the option to provide lawfully residing immigrant women with pregnancy-related Medicaid regardless of the length of time they have been in the U.S. Twenty-three states provide pregnancy-related Medicaid to lawfully residing immigrants without waiting periods. For undocumented and DACA-eligible immigrants, states may provide undocumented immigrant women with federally funded prenatal services through CHIP. Some states may also provide prenatal care entirely using state funds.
Do Marketplace Health Plans Provide Women With Comprehensive Coverage Including Maternity Care
Yes. All Marketplace plans must include the ten Essential Health Benefits , one of which is maternity and newborn care. HHS has not specified what must be covered under this category, delegating that authority to the states. Thus, specific benefits covered under maternity care vary by state.
2. What changes when a woman enrolled in a Marketplace plan becomes pregnant?
Nothing, unless she wants it to. The woman may choose to remain in a Marketplace plan or, if eligible, to enroll in Medicaid or CHIP. The woman will not lose eligibility for the APTCs as a result of access to MEC through full-scope or pregnancy-related Medicaid, but cannot be enrolled in both simultaneously and thus must choose. In deciding which coverage to select, overall cost, access to preferred providers, impact of transitioning across plans, and effect on family coverage influence preference.
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See If Your Children Qualify And Apply For Chip
Each state program has its own rules about who qualifies for CHIP. You can apply right now, any time of year, and find out if you qualify. If you apply for Medicaid coverage to your state agency, youll also find out if your children qualify for CHIP. If they qualify, you won’t have to buy an insurance plan to cover them.
Ways To Apply For Chip:
- Fill out an application through the Health Insurance Marketplace®. If it looks like anyone in your household qualifies for Medicaid or CHIP, well send your information to your state agency. Theyll contact you about enrollment. When you submit your Marketplace application, youll also find out if you qualify for an individual insurance plan with savings based on your income instead. Create an account or log in to an existing account to get started.
FYI: Apply any time
You can apply for and enroll in Medicaid or CHIP any time of year. Theres no limited enrollment period for either Medicaid or CHIP. If you qualify, your coverage can start immediately.
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I Am A Health First Colorado Or Child Health Plan Plus Member And I Just Had A Baby How Do I Get Health Care Coverage For My Newborn
If you are a woman enrolled in Health First Colorado or Child Health Plan Plus when your baby is born, you can add your newborn to your case online by reporting a change through your PEAK account at Colorado.gov/PEAK, or using the Health First Colorado mobile app. Your baby will then be automatically enrolled in health coverage until his or her first birthday.
You also have the option to report the birth of your baby to your county of residence human services office or a Medical Assistance site case worker near you. Once your baby is added to your case and you have their State ID, you are able to take your baby to the doctor.
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If You Qualify Under A Non
- If you are a U.S. citizen and provide a valid Social Security Number , a match with the Social Security Administration will verify your SSN, date of birth and U.S. citizenship. If SSA verifies this information, no further proof is needed. The SSA match cannot verify birth information for a naturalized citizen. You will need to submit proof of naturalization or a U.S. passport.
- Proof of citizenship or immigration status*
- Proof of age , like a birth certificate
- Four weeks of recent paycheck stubs
- Proof of your income from sources like Social Security, Veteran´s Benefits , retirement benefits, Unemployment Insurance Benefits , Child Support payments
- If you are age 65 or older, or certified blind or disabled, and applying for nursing home care waivered services, or other community based long term care services, you need to provide information on bank accounts, insurance policies and other resources
- Proof of where you live, such as a rent receipt, landlord statement, mortgage statement, or envelope from mail you received recently
- Insurance benefit card or the policy
- Medicare Benefit Card **
Proof of Medicare application can be:
- Your award or denial letter from the Social Security Administration, OR
- Your on-line confirmation letter stating that you have applied for Medicare with the Social Security Administration.
Apply Now:
The following are exempt from all Medicaid co-payments:
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Date Of Birth By Using The Web Portal Mevs Faxback Or Avrs
How to activate medicaid for newborn ga. If you qualify for the program, to activate your medicaid each month, you must either pay medicaid or accumulate medical bills equal to the amount your income exceeds the medicaid income limit. We give you all of your medicaid benefits. When you make an appointment, be sure to tell your provider that youre enrolled in medicaid or chip, or give them the name of your health plan.
Four ways to choose peach state health plan: Complete an unborn activation form. Tell them you want to choose peach state health plan.
To continue coverage beyond this time, you must enroll the child within those 31 days and pay any applicable premium. If you qualify, you will be able to start receiving benefits right away. No action is required by medicaid members at this time.
711 or relaync.com) hours of operation: To 5 p.m., monday through saturday. For example, in north carolina cards typically are sent out once per year, but you can request a new one if you change your name or physician, or if you lose your card.
Outbreaks of novel virus infections among people are always of public health concern. They keep using the same card even after renewal. Fill out an application through the health insurance marketplace.
You have two ways to apply for chip: If you are unable to reach someone, your doctor or pharmacy can verify whether your medicaid is active. Special provisions may apply to a legally adopted child or a.
In much of rural maternal healthcare is
Can I Request A Replacement Medicaid Card
The Medicaid card should be presented to medical providers when medical care is being requested. To request a replacement card, call 850-300-4323. Those on Medicaid can print a temporary Medicaid card from their MyACCESS Account. Further information on Medicaid services is available from the Agency for Health Care Administration.
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Medicaid In New York State
- COVID-19 News and Updates:
- COVID Information for Medicaid Consumers:
- Medicaid Coverage through Your Local Department of Social Services during the Coronavirus Emergency –
- Medicaid Telehealth Services During the Coronavirus Emergency –
- IRS Form 1095-B Update:
- The 1095-B form for Tax Year 2020 is no longer being mailed automatically.If you need a copy of your 1095-B for Tax Year 2020, you can request it:
- By e-mail – or
What Is Medicaid For Pregnant Women
With Medicaid for pregnant women, you get full health care benefits during your pregnancy and for two months after your babys birth. Medicaid may also cover your medical bills for the three months before you enroll. You also get dental benefits during your pregnancy. Dental services are through the Smiles for Children program. For help finding a dentist or to learn more, call Smiles For Children at 1-888-912-3456. Also read the Guide to Dental Coverage.
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How Do I Get Medicaid For My Child
Fill out an application through the Health Insurance Marketplace. If your income is too high for Medicaid, your child may still qualify for the Childrens Health Insurance Program . It covers medical and dental care for uninsured children and teens up to age 19. Is my child eligible for CHIP? CHIP qualifications are different in every state.
Can An Uninsured Woman Enroll In A Public Health Insurance Plan Upon Becoming Pregnant
Yes, women who meet the eligibility criteria for Medicaid or Childrens Health Insurance Program can enroll in one of these public programs at any point during pregnancy:
Full-Scope Medicaid
A pregnant woman is eligible for full-scope Medicaid coverage at any point during pregnancy if eligible under state requirements. Eligibility factors include household size, income, residency in the state of application, and immigration status. An uninsured woman who is already pregnant at the time of application is not eligible for enrollment in expansion Medicaid.
Pregnancy-Related Medicaid
If household income exceeds the income limits for full-scope Medicaid coverage, but is at or below the states income cutoff for pregnancy-related Medicaid, a woman is entitled to Medicaid under the coverage category for pregnancy-related services and conditions that might complicate the pregnancy. The income limits for pregnancy-related Medicaid vary, but states cannot drop eligibility for this coverage below a legal floor that ranges from an income of 133% to 185% of FPL , depending on the state. States are permitted to set a higher income cutoff.
Childrens Health Insurance Program
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Checking Your Baby’s Hearing
Your baby’s ability to hear your voice and other sounds clearly may be affected for a variety of reasons. Doctors can test a baby’s full range of hearing to detect problems.
To help detect any hearing problems:
- Pay attention to your baby’s response to sound.
- If you have concerns, ask your doctor to refer you to someone who can test young infants for hearing impairment.
The sooner hearing loss is detected and treated, the better your child’s language development will be. Some hospitals even test babies’ hearing in the hospital before they are discharged!