- Do What You Need To Do To Keep Medicaid
- When You Apply For Medicaid, Submit Prior Unpaid Medical Bills
- Notify Medicaid of Changes
- If You Receive Medicaid Because You Qualify For Supplemental Security Income (SSI), You Don't Have To Lose Medicaid Even If You Lose SSI Because Of An Increase in SSDI Due To Inflation
- Find A Medicaid Provider Who Meets Your Criteria And Who Knows The Medicaid System
- Get Your Prescriptions Through A Medicaid Participating Pharmacy
- Take Advantage Of Dental Coverage
- If You Can, Get Medicaid To Pay Health Insurance Premiums.
- If Necessary, Learn How To Survive In A Medicaid HMO
- Notify Medicaid If You Obtain Or Become Eligible For Health Insurance While Receiving Medicaid
- If You Receive Home Care, Work With The Agency In Charge Of Your Care To Maximize The Services You Receive.
Medicaid: How To Maximize Use
Getting Medicaid is one thing. Keeping it, and maximizing use of it, is another.
To maximize chances of keeping Medicaid, it is advisable to:
- Know your worker, or case manager, or representative, or whatever the person's title is in your state.
- You should have received, through the application process, the name and phone number of a contact at Medicaid to call with questions and changes. It is important that you know who this is. It doesn't hurt to periodically stay in touch with the person as well. See Make a Friend At The Insurance Company. The same advise applies to Medicaid.
- Read your mail.
- It is important to open and read all of the correspondence that Medicaid sends. The primary reason people lose their Medicaid coverage is that they ignore requests for information or fail to respond to correspondence sent to them.
- Medicaid sends a lot of correspondence, including:
- Questionnaires to be completed.
- Advice about changes.
- Once a year, Medicaid re-screens people for financial eligibility.
- If you don't understand a particular letter or document, ask someone who does. Call your Medicaid Worker, or ask someone knowledgeable at your local disease specific nonprofit organization.
- If you think Medicaid has stopped covering you, call immediately to find out why. For some reason, in many states Medicaid has an ugly habit of just stopping. While it may seem like it stops for no reason, there usually is something that triggered your loss of eligibility. Whatever the reason, odds are that if this happens, Medicaid will notify you in a letter.
- If you receive Medicaid because you qualify for Supplemental Security Income (SSI), even if you lose SSI you don't necessarily have to lose Medicaid particularly if the loss would be because of an increase in income from Social Security Disability Insurance (SSDI) due to inflation.
To maximize use of Medicaid:
- When you apply for Medicaid, submit prior unpaid medical bills.
- Find a Medicaid provider who meets your criteria -- and who knows the Medicaid system. Top quality doctors at teaching hospitals generally take at least some Medicaid patients.
- Get your prescriptions from a Medicaid Participating Pharmacy.
- Take advantage of dental coverage if offered.
- Find out if Medicaid in your area will pay for private health insurance premiums. If so, you are likely to find better doctors willing to take your health coverage because private policies pay more than Medicaid.
- Learn how to survive a Medicaid HMO if necessary.
- You can return to work and still receive Medicaid. Thanks to federal laws known as TWWIIA and Section 1619, if you've been receiving Medicaid and not working because of your health, states can permit you to return to work without losing your Medicaid coverage until you start to earn an income well above ordinary Medicaid levels. TWWIIA also permits states to authorize the purchase of Medicaid for very low premiums by people who are working but who have a health condition that could later become, or formerly was, fully disabling.
- If you are receiving home care, work with the agency in charge of your care to maximize the services you receive.
To avoid penalties for fraud:
- Notify Medicaid of changes in your resources and/or income.
- Notify Medicaid if you obtain or become eligible for health insurance while receiving Medicaid.
NOTE: It is worth checking to see if Medicaid in your state covers the cost of transportation to and from treatment.
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