Browsing Category

Healthcare

Healthcare, Pennsylvania,

Pennsylvania Medicaid, or Medical Assistance Program

no comment

What You Need To Know

Medicaid is a program is set up to provide health coverage to those who are unable to afford it. The children, pregnant women, seniors, parents and people with disabilities are catered to diligently. Millions of Americans enjoy these benefits which help to secure their health. This health safety is provided to all low-income adults in some states. Their earnings must be below a specific level. Pennsylvania Medicaid has been administered through CMS, also known as the Center for Medicare & Medicaid Services. For this reason, it follows the rules and regulations of the Federal Medicaid Law. Medicaid can go by a lot of names, it is, therefore, known as Medical Assistance in Pennsylvania as well.

Medicaid provides you with two kinds of care, including physical health options and mental health services options. The later also includes any substance abuse services options. With the help of the federal and state government, the program is aimed at making life easier for residents. Especially those who face financial struggles at various points in their lives.

Are You Eligible?

To enjoy the benefits offered by this program, it’s important to meet the criteria set by federal and state governments. The requirements in this benefits program include factors like the following:

  • The person must be a resident of the state of Pennsylvania
  • Their financial situation should consist of low or very low income
  • They must be a U.S. national, citizen, or legal alien.
  • They must be pregnant or a parent to a child under 18
  • They must have a disability or their household members must have a disability.
  • The annual household income of the family also comes into play. The amount before tax deduction is considered which should be either less than or equal to:
Size of Household Maximum Annual Income Level ($)
1 16,612
2 22,491
3 28,369
4 34,248
5 40,127
6 46,005
7 51,884
8 57,762

In instances where there are more than eight residents in a household, an additional amount of $5,878 is added. These guidelines may change therefore, it is vital to keep in touch with the managing agency. The one in your area may be able to provide you accurate guidance.

How To Apply?

If you wish to apply for this benefit program, there are different ways to do so. The variety allows people to easily go through the process. They can choose the best option for themselves and apply it accordingly.

  • The application for the Pennsylvania Medicaid program can be found through online portals. This includes their COMPASS application portal. In case any additional information is required, there are other websites available such as the Health Care page. On these pages, you can easily download an application.
  • In case you wish to apply by having direct contact with the center, you can simply call on their Telephone which is 1-866-550-4355.
  • Some people find it more comfortable to tackle these applications in person. Therefore, Pennsylvania has set up local county assistance offices throughout the state. Contacting them is a simple method.
  • Along with these ways, there is also a written method to apply. The application form is available on specific sites. Therefore, it can be downloaded, filled and mailed to the appropriate authority.

These applications require information and documentation that can be easily verified. With limited resources, the people that can be catered to are limited too. Therefore, the eligibility criteria are strictly followed in order to make sure the more needy families are catered to. So far, the Pennsylvania Medicaid program has helped around three million people. This is a huge amount which the program wishes to expand further. The decision for qualified individuals is taken by none other than the DHS.

For Further Information

To deal with the queries one has, they can also contact the appropriate authority. This can be done by visiting the Medicaid and CHIP page which has the policies stated. These policies can be found according to the state.

In-depth information about the Pennsylvania Medical Assistance is necessary for its residents. Especially those that are hoping to gain benefit from it. This knowledge is important for the residents as proper information can make them more likely to receive benefits.  Pennsylvania has also introduced other programs that can cover those applicants who don’t qualify for Medicaid. This includes the Children’s Health Insurance Program (CHIP) and Medical Assistance for Workers with Disabilities (MAWDs). These programs help to cater to a majority of the Pennsylvanian population. Thus, it helps the program to achieve the objective that it had set out for.

 

Healthcare, Pennsylvania,

Pennsylvania Children’s Health Insurance Program

no comment

What You Need To Know

Health coverage is provided to a vast number of people in Pennsylvania through the Children’s Health Insurance Program. It has been set up to cater to those families who fall in the middle ground. They are unable to qualify for Medicaid due to high income but cannot afford private insurance. The CHIP has certain changes according to its region of operation. In some states, it is known to provide for parents and pregnant women as well.

The CHIP coverage is decided through collaboration with the Medicaid program of the state. It runs in collaboration of leading health insurance companies. This allows offering a variety of choices with its own physician networks, specialists and care facilities. In some cases, the children can even stick to their current doctors, which help in easy availability of physician services. The Pennsylvania Children’s Health Insurance Program provides the following benefits to its members:

  • Emergency services
  • Laboratory and X-ray services
  • Inpatient and outpatient hospital care
  • Prescriptions
  • Routine check ups
  • Immunizations
  • Doctor visits
  • Dental and vision care

Along with these, there are many other benefits involved in this comprehensive health insurance as well. They can range from mental health care to substance abuse treatment. It is a flexible program that incorporates the health of children from the ages of 0 to 19.

The administration of this program has been carried out by the Centers for Medicare & Medicaid Services (CMS). It has been set up for kids without health insurance. The reason behind this can range from different factors such as parent’s loss of a job or no insurance at work. CHIP benefits help to reduce costs. Through proper implementation of the program, 90% of the CHIP families are able to get the satisfactory benefits. This helps in ensuring good health for the children. CHIP also ensures that all checkups and vaccinations are carried out on time to avoid any issues that may surface.

For qualified families, CHIP coverage is free. But in some cases, certain families have incomes above the free CHIP limits. These families, therefore, have to pay a small amount in order to avail the benefits.

Are You Eligible?

CHIP provides for families that have uninsured children below 19 years old. These families have incomes high enough that it makes them ineligible for Medicaid. To be eligible for this program, the child must be:

  • US national
  • Citizen
  • Legal alien
  • Permanent resident
  • Resident of Pennsylvania
  • Unable to have income that allows private coverage
  • Not eligible for Medicaid

The annual household income is also considered in this regard. The amount considered is before any tax deductions. It needs to be less than or equal to the following figures:

Size Of Household Maximum Annual Income Level ($)
1 37,470
2 50,730
3 63,990
4 77,250
5 90,510
6 103,770
7 117,030
8 130,290

Households that have more than eight residents must add $13260 extra per person. To keep up-to-date with the most recent guidelines, the managing agency must be approached. Therefore, one should stay in touch with the agency in their area to not miss out on any information.

In cases of pre-existing conditions, the eligibility is not affected. These conditions are covered by CHIP or through Medical Assistance. The latter depends on the seriousness of the medical condition.

Once the child is successfully enrolled, he or she is guaranteed with 12 months of health coverage. This is applicable in cases where the children meet the eligibility criteria discussed above. CHIP coverage is renewed on a yearly basis. To make sure the renewal process goes smoothly, the insurance companies involved sent renewal notices. These are received by the families before the 90-day expiry of their benefits. These forms must be completed on time if the families wish to continue their CHIP benefits.

How To Apply

The Pennsylvania CHIP program can be applied for through an online portal. You can find the appropriate application through their Pennsylvania COMPASS. In case any additional information is required concerning the application, you can find it on the website. It has also been made easier for applicants as the application can be downloaded directly from the site.

For Further Information

To approach the appropriate authority in cases of queries, the Pennsylvania CHIP page can be visited. The website has all the necessary information required by parents who might be interested in it. It even has a Frequently Asked Questions section which can be referred to tackle any confusion. The service center can also be easily found through the use of the County Coverage Map. For more detailed information, you can also consider the Medicaid & CHIP policies page. It outlines the information according to the state selected.

 

Healthcare, Ohio,

Ohio Healthy Start

no comment

What You Need To Know

The Children’s Health Insurance Program is known as Healthy Start in Ohio. The program wishes to help out families with children by providing them with health coverage. Ohio Healthy Start aims to cater to the healthcare needs of those families that are unable to qualify for Medicaid. The earning of these families is higher than those eligible for Medicaid but it is still lacking for private coverage. Therefore, Ohio Healthy Start caters to their needs, hoping to improve the health in the region.

Like the CHIP programs in other states, Ohio Healthy Start has been administered by the Centers for Medicare & Medicaid Services. The health coverage provided by healthy start includes, but is not limited to:

  • Doctor visits
  • Hospital care
  • Pregnancy services
  • Vision services
  • Dental Care
  • Mental health services
  • Immunizations
  • Substance abuse services

Healthy Start provides coverage to qualified pregnant women during their pregnancy. This coverage lasts till approximately 60 days after giving birth. The babies born are, therefore, eligible for the free medical services provided by Healthy Start. This coverage is for an entire year. The benefits enjoyed by eligible pregnant women of any age include the following aspects:

  • Pregnancy-related services
  • Comprehensive pregnancy-related care after birth
  • Aid with appointment setting and transportation
  • Nutritional information
  • Dental services
  • Vision care
  • Treatment in case of injury or illness
  • Comprehensive preventive health care services
  • Health check services for those below 21 years.

Are You Eligible?

There are certain requirements outlined by the program. The fulfillment of these aspects is important if you wish to receive the benefits. The basic criteria, in this regard, are that the person must be:

  • A resident of the state of Ohio
  • Under the age of 19
  • Caregiver of a child under 19
  • Not covered by health insurance i.e. Medicaid
  • S. national, citizen, legal alien, or permanent resident

If the person fits the above-given criteria, then the annual household income of the family comes into play. The earning, before any tax deductions, is expected to either be less than or equal to the following figures:

Size Of Household Maximum Annual Income Level ($)
1 24,980
2 33,820
3 42,660
4 51,500
5 60,340
6 69,180
7 78,020
8 86,860

Some households may consist of more than eight residents. In such events, an additional amount of $8,840 is added per person. For the most recent and accurate guidelines, it is advised that the managing agency is approached.

There are different types of income which are important in this program. In some cases, a certain type of income is disregard or exempted. Therefore, an individual should still apply for the program if their earnings are more than the figures listed. This would give them a chance at gaining the benefits they need. The income level of an individual may also determine the kind of coverage they receive. There are certain differences as in some situations; a premium would be expected to be paid.

The program is focused upon children; therefore they may receive immediate insurance. On the other hand, the adult may have to gather certain verifications for qualifications. Especially if it’s the full twelve months of coverage they wish to receive.

How To Apply?

The application process requires certain information or documents to be submitted. This includes proof of:

  • Income
  • Pregnancy
  • Citizenship
  • Other health insurance.

This information will help to outline whether or not you are eligible without any requirement of a face-to-face interview.

Ohio Healthy Start has also set up an appropriate Consumer Hotline. This is available in cases of any information required as well as any assistance concerning the application. The hotline is active seven days a week to cater to the greatest amount of people.

1-800-324-8680

Families have two methods of acquiring the application. They can simply find them at the local office of job and family services or download them. The latter can be done with the Combined Programs Application (CPA) – JFS Form No. 07216 found online.

Once you have qualified for the program, you have twelve months’ full coverage. If you wish to maintain this coverage, it is important for children to reapply every twelve months. Similarly, families must reapply as well but their time duration if six months instead of twelve.

For Further Information

A website has been set up by the Ohio Department of Medicaid. It has the necessary information required to clear out any confusion that may occur. More frequently asked questions have also been addressed there. This helps the people to make appropriate decisions regarding Ohio Healthy Start.

 

Healthcare, Ohio,

Ohio Medicaid

no comment

What You Need To Know

Medicaid is managed by the U.S. Department of Health and Human Services. They aim to improve healthcare in different states of America including Ohio. The program provides a large number of Americans with health coverage. These low-income individuals are unable to provide such medical coverage for themselves. Amongst the people whose needs are catered to, there are children, pregnant women, parents, seniors and people with disabilities.

The individuals who receive Medicaid are then expected to join the Managed Care Plan (MCP). This is how they receive the benefits of the program. MCP allows them to gain the appropriate health coverage required. Ohio has selected plans that seem best to them, these provide:

  • Toll-free medical advice through the phone. This number is open 24 hours to help cater to its members in the best possible way.
  • Help coordinating care. This is especially for those who require special health care.
  • Annual physical exams for adults.

Other benefits depend upon your MCPs. Some of them provide services like:

  • This helps the individual to easily make it to their medical appointments. Not wasting any time for the patient as well as the physician.
  • None or lower co-payments. Certain medical services require the payment between the Medicaid and the patient to be divided. This takes place in dental services, routine eye examinations, eyeglasses, and non-emergency services.

Enrollment means that you will be the owner of a card until you’re on the plan. This card will help you to access the benefits you require. You will also receive a plan that will contain the expected information. This means data about doctors, providers, health services and other available services. A managed care plan will also remind you about preventative medical services. This includes screenings, tests, and immunizations. Therefore, the main aim of the program would be achieved by safeguarding the health of qualified individuals.

Are You Eligible?

Certain basic requirements need to be fulfilled if one wishes to apply for this program. The applicant needs to be:

  • A resident of the state of Ohio
  • In need of health coverage
  • Someone who is facing a financial situation of low or very low income

It is also important to be a U.S. National, citizen, or legal alien. These are the basic criteria factors. In order to qualify, it is also important that you must be:

  • Above the age of 64
  • Pregnant or parent to a child under 18
  • Blind or disabled
  • In a household with a child, parent or spouse who is blind or disabled.

The annual household income is also considered for this program. The amount before tax deductions is considered. Therefore, it must either be less than or equal to the following figures:

Size Of Household Maximum Annual Income Level ($)
1 16,612
2 22,491
3 28,369
4 34,248
5 40,127
6 46,005
7 51,884
8 57,762

A household may have more than eight residents. If this is the case, then an additional amount of $5,878 is added per person. To ensure that the most accurate guidelines are being followed, the managing agency in the area must be contacted.

How To Apply

Application information is present on the Get Coverage page. This will help you to apply for Ohio Medicaid without any issues. Its accessibility allows the program to reach a large number of people. Especially, considering the online portals available.

Once your application is approved, you are expected to pick a plan. In case the selection is not made, automatic enrollment of the individual is done. They are notified regarding this and even provided with guidance about any changes they want. An individual has approximately 90 days after their initial selection to change their plan. If it’s not done during this duration then the person is expected to wait till the open enrollment period. Therefore, they get a chance to make the change on an annual basis. If the person has just cause for a change, they can consider it as well.

For Further Information

Queries and any confusion are addressed through the home page of the Ohio Department of Medicaid. There is even a Basic Health Program page available that may offer some in-depth information. This would clarify any questions that you may have.

In order to improve the Medicaid services of Ohio, a consumer Hotline has also been set up at 1-800-324-8680. This hotline can be called in case of any complaints a person may have. Moreover, complaints are also taken into account if you contact the member services department of your MCP.

 

Healthcare, New York,

New York Child Health Plus (CHIP)

no comment

What You Need To Know

A health insurance plan has been set up for children in New York. It is known as the Child Health Plus. It provides health coverage to the children belonging to low-income families. Child Health Plus is divided into two categories:

  • Child Health Plus A
  • Child Health Plus B

The former was known as Children’s Medicaid but now similar services are available under the new name. Both categories have proven helpful in safeguarding the healthcare of a large number of people. Providers present throughout the state make sure that healthcare services are available to A and B. Enrollment into this benefit program is a simple matter, undertaken by people without any major issues.

Administration of New York Child Health Plus has been carried out by CMS. They are more commonly known as Centers for Medicare and Medicaid Services. There are 18 Child Health Program that families can choose from. This is also dependent upon the county where the individual resides. The services that are covered by this benefit program include:

  • Well-child care
  • Immunizations
  • Treatment for illness or injury
  • Hospitalization
  • Radiation therapy
  • Mental health services
  • Substance abuse services
  • Emergency care
  • Prescriptions
  • Dental and vision care

However, the program does have certain limitations. The scarcity of resources of the program means that it works with a limited amount of funds. Therefore, it aims to make sure that these funds are properly allocated. It eliminates costs associated with some services by excluding them from the program. Amongst these, there is:

  • Experimental procedures or drugs.
  • Prescriptions:
  • Drugs bought without them
  • For drugs that treat erectile dysfunction
  • For drugs that may cause death, suicide, or mercy killing.
  • Private duty nursing or home health care
  • Cosmetic, plastic, or reconstructive surgery
  • Infertility services
  • Transportation
  • Comfort items such as Cervical pillows or back massager with heat.
  • Orthodontia Services
  • Any other services that are not medically necessary.

Are You Eligible?

The program requirements include a basic criterion that must be present as well as more specific details. These requirements can be listed as:

  • A resident of the state of New York
  • Under the age of 19; or a primary caregiver to a child under 19; or pregnant.
  • Uninsured in terms of healthcare which includes Medicaid
  • S. national, citizen, legal alien, or permanent resident.

The annual household income is also considered for qualification. This is because Child Health Plus is set up for those who have low or very low income. Therefore, the annual earnings before any tax deductions must be less than or equal to the following figures:

Size Of Household Maximum Annual Income Level ($)
1 49,960
2 67,640
3 85,320
4 103,000
5 120,680
6 138,360
7 156,040
8 173,720

The size of the household may be greater than eight. In such instances, add $17,680 extra per person. It is advised that you check with the managing agency in your area. Keeping in touch will allow you to stay up-to-date with accurate guidelines.

Your income level determines the health coverage you receive. Therefore, it is possible that some families may have to pay a premium for the coverage. This is done in order to make sure that a high number of families are catered to. The most deserving of them received the full coverage whilst the rest are helped to the greatest extent possible.

How To Apply?

An eligible individual can apply for this program by approaching the local community organization. They will provide them with the necessary forms as well as any guidance that helps to eliminate their confusions.

Enrollers are also present in various communities to help provide assistance with the application. They make the process simpler and collect the appropriate documents required. Their responsibility includes the selection of health plan choice as well. With their help, one can select the plan that best suits their needs. Assistance is usually available during the evening or on weekends. The enrollment is this program is open year-round. Therefore, one can apply for it whenever it seems suitable.

For Further Information?

Information regarding the benefits program can be found on the online website. This makes it easier for a larger number of people to gain access to it. Similarly, the following toll-free number has also been set up where you can pose any questions you may have.

1-800-698-4543

Child Health Plus has also made sure to include people with disabilities in this program. To make it more possible for them to apply with ease, a toll-free number specifically for them has been set up:

1-877-898-5849

 

Healthcare, New York,

New York Medicaid

no comment

What You Need To Know

Medicaid has been established with the aim to cater to the medical needs of people in states. It is especially for those people who are unable to provide for their healthcare. Medicaid is designed to pay for the appropriate services required by the person. This includes a variety of treatments but still has its limitations. It is dependent upon various factors such as

  • Age
  • Financial circumstance
  • Family situation
  • Transfer of resource requirements
  • Living arrangements.

Medicaid tries to provide all its qualified members with fully funded services. However, due to limited resources, some services require co-payment. This means that a portion of the bill is undertaken by Medicaid whilst the rest is paid by the patient. The administration of this benefit program has been carried out by the Centers for Medicare & Medicaid Services (CMS). Medicaid provides its services through the help of a Medicaid card or a managed care plan. You have to be enrolled in the latter.

Are You Eligible?

The New York Medicaid program has a certain list of requirements. The basic aspects that need to be fulfilled include:

  • A resident of the state of New York
  • Someone in need of health coverage
  • Someone with low or very low income
  • A U.S. national, citizen, or legal alien.

These are a requirement for most of the benefits program. However, the other more specific criteria outline that the person must

  • Be over 64 years of age, or
  • Be pregnant or a parent of a child under 18, or
  • Be blind or disabled, or
  • Be related to someone who is blind or disabled. The relative can be a child, parent or spouse.

To ensure that the financial situation of the applicant is low enough to qualify for Medicaid, the income is considered. The annual household income is taken into account before any tax deductions take place. The income amount is compared to see whether it is less than or equal to the listed amounts.

Size Of Household Maximum Annual Income Level ($)
1 16,612
2 22,491
3 28,369
4 34,248
5 40,127
6 46,005
7 51,884
8 57,762

If a household has more than eight residents, then an additional amount of $5,878 should be added per person. It is advised to stay in touch with the managing agency of the area. This would help you to remain up-to-date with the latest and more accurate guidelines.

How to Apply

To start the application process, different methods can be used. An eligible person can choose to call the consumer service number for information related to it. This would also allow the person to gain guidance concerning the form. Moreover, they can also approach the local department of social services. With the help of the internet, they can find the nearest agency and choose to go through the procedure in person. Furthermore, the internet can be used for the whole application process. This would help the people to easily access all information from the comfort of their home. The application can be found on the website of the New York State of Health.

There are certain documents required in case one wishes to apply for Medicaid. The documents are dependent on the two kinds of categories that take place in this program. These two are labeled as Modified Adjusted Gross Income (MAGI) guidelines and non-MAGI guidelines. The MAGI Group includes the following eligible people:

  • Pregnant women
  • Children in Foster Care
  • Parents or Caretaker Relatives
  • Infants and children under 19
  • Family planning benefit program
  • Childless adults who are:
  • Not pregnant
  • Aged between 19 and 64
  • Not on Medicare
  • Certified Disabled

On the other hand, Non-MAGI Group includes:

  • Individuals aged 65 or above
  • Individuals who are blind or disabled who do not meet the MAGI group criteria.
  • COBRA
  • Medicare Savings Program – MSP
  • AIDS Health Insurance Program – AHIP
  • Medicaid Buy-In for Working People with Disabilities
  • Medicaid Cancer Treatment Program
  • Residents of Adult Home run by LDSS, OMH Residential Care Centers.

New York Medicaid has made sure to provide the groups with necessary application accessibility options. This makes it more possible for them to acquire and complete it on time. The presence of the form in different languages also helps to cater to a larger audience.

The waiting period between application submission and acceptance or denial is 45 days. In case of pregnancy or children, the period decreases to 30 days instead. However, if the applicant has a disability, this time duration can increase up to 90 days. This is done in order to properly determine the eligibility.

For Further Information

Queries and confusions of the interested individuals can be addressed on the New York Medicaid website. It would allow them to get more in-depth information about the benefits program.

Healthcare, Iowa,

Iowa – IA Health Link

no comment

What You Need To Know

IA Health Link helps people in paying for medical and healthcare costs. The Iowa Medicaid program is managed with the help of the Iowa Department of Human Services. The program is funded by the Federal and state government to support eligible residents of Iowa. Medicaid program is known to provide a variety of medical and healthcare services that are covered in cases of necessity. The members of the Medicaid program are provided through Managed Care Organizations (MCO). Those who are enrolled with MCO they can avail available services. However, sometimes the member is required to pay a small co-payment due to certain exceptions.

Centers for Medicare & Medicaid Services (CMS) has administered the Iowa Medicaid Program. The new Medicaid program in Iowa, known as the IA Health link brings with it, new plans and new services. With the help of Amerigroup MCO, the members of this program can enjoy benefits that include:

  • Management of all health care needs through the primary care provider (PCP).
  • Vision care for adults and children
  • Behavioral health services
  • Disease management
  • Physician services
  • Immunizations
  • Prescriptions

Along with these, the MCO also provides extra help such as free dental suppliers, video chats, and free health programs.

Are You Eligible?

There are specific requirements necessary for the member to have if they wish to qualify for this program. Amongst these requirements is:

  • Resident of Iowa
  • S. National
  • Citizen
  • Permanent resident
  • In need of healthcare assistance
  • Low or very low income in terms of financial situation
Household Size Maximum Income Level (Per Year)
1 $16612
2 $22491
3 $28369
4 $34248
5 $40127
6 $46005
7 $51884
8 $57762

The annual household income must also be either less than or equal to the following amounts if one wishes to qualify.

In case the household has more than eight residents, an extra amount of $5878 per person would be added. To keep up-to-date with the most recent guidelines, it is vital to stay in contact with the managing agency.

How to Apply

The application for IA Health Link can be found through the online DHS benefits portal. You can even discuss the case of another person through the forms available to you.

Once you become a member of an MCO such as Amerigroup through this, you’re given a handbook that outlines the:

  • Benefits you enjoy
  • Special programs you can avail
  • Rights and responsibilities you have
  • How to choose a PCP
  • How to get help in case the office is closed
  • Renewal of coverage
  • Consumer choice options
  • Contact Information in case of questions

The Consumer Choices Options is a program for aging or disabled members of Medicaid. In order to cater to your unique needs, it lets you choose service providers. This can prove to be very helpful for certain members. One can choose to exercise such freedom if their Medicaid funding is done through an HCBS waiver (Home- and Community-based Services). It is also vital to get a reference from your case manager.

Amerigroup also provides Consumer Choice Option members with My Support tools. It is an online tool that helps to find personal attendants. This can prove helpful in connecting a patient with workers who have similar values. Thus, making the experience a positive one for them.

For Further Information

To apply for IA Health Link, you can simply find the appropriate application online. The portal makes it easy for people to apply from home. You can also find them in your local phone book in the State or County Government section. To make it even simpler, the contact numbers are:

1-800-972-2017

1-855-889-7985

In case of queries or confusions, the country DHS office will cater to your needs. They will even be able to provide you with the application form you require to become a member of Medicaid.  You can easily find the nearest office to you through the help of their online portal.

http://dhs.iowa.gov/dhs_office_locator

If there is a requirement for further information, you can even go through the resources provided on the DHS website. It outlines the member materials and includes different resources that can help in your decision. This includes Frequently Asked Questions, MCO Plan Summary and even a flow chart for MCO Enrollment Processes.

Along with member materials, you will also find the appropriate MCO Resources. These would prove helpful in the selection of the appropriate MCO which mainly includes Amerigroup Iowa, Inc. and Iowa Total Care. The latter is a new service but it is possible to find a provider in both MCO’s networks.

Healthcare, Iowa,

Iowa – Healthy and Well Kids in Iowa (Hawk-I)

no comment

What You Need To Know

Hawk-I, also known as Healthy and Well Kids in Iowa is the state-specific name of a federally funded program. It is commonly known as the Children’s Health Insurance Program or CHIP. The program is aimed to provide people with health coverage and other related benefits. It has been specifically set up for people who are stuck between Medicaid and private coverage. They have high incomes that make them ineligible for Medicaid. On the other hand, their earnings are not high enough to allow them with private coverage. This is where Hawk-I comes in.

CHIP benefits are available in almost all states. However, it does not cater to the same benefits. Through the help of each state Medical program, CHIP has been set up. In certain states, it tends to offer health coverage to parents and pregnant women. This cannot be said for every state. In terms of Iowa, the CHIP program includes the following benefits:

  • Emergency services
  • Laboratory and X-ray services
  • Dental and vision care
  • Doctor visits
  • Immunizations
  • Inpatient and outpatient hospital care
  • Routine check-ups
  • Prescriptions

Eighty million children and families have been provided with health coverage through CHIP benefits. The health insurance is provided through a Managed Care Organization (MCO). In Iowa, there are two MCOs you can choose between, including:

  • Amerigroup Iowa, Inc.
  • Iowa Total Care – health coverage by this MCO has recently begun on July 1, 2019
  • Delta Dental of Iowa – For dental benefits provided by Hawk-i

Hawk-I has recently introduced an Open Choice Period. This means that the members can change their MCOs from July 1, 2019, to September 30, 2019, for any reason. In instances where they wish to change their MCO after this date, they must have reasons of “Good Cause”.

Both the MCOs provide the benefits stated above. However, there are certain terms and conditions attached to some benefits:

  • Amerigroup and Iowa Total Care both provide Emergency Rooms but in cases of non-emergent conditions, there is an exception. It will be provided with a copay of $25 in cases of families that pay a premium for the program.
  • Similarly, routine eye exams will be carried out but a limit has been imposed on eyeglasses of $100.

Are You Eligible?

Hawk-I is aimed at providing health coverage to children below 19. These uninsured children must belong to families that have incomes which makes them unable to qualify for Medicaid.

To avail Hawk-I, it is vital for the child to be:

  • S. National
  • Citizen
  • Legal alien
  • Permanent resident
  • Resident of Iowa
  • Have low income
People Present In A Household Maximum Earnings Per Year ($)
1 37,720
2 51,069
3 64,417
4 77,765
5 91,114
6 104,462
7 117,811
8 131,159

 

In cases where the people living in a household are greater than eight, an additional $13348 is considered. It is essential to make sure that you are aware of the up-to-date guidelines. To ensure this, you can consider checking in with managing agencies present in your areas.

How to Apply

The application process for hawk-I is carried out online. This makes it easier to access. You can simply visit the Iowa Department of Human Services website. Here you’ll find a tab “Apply for benefits” which will allow you to partake in the process without any issues.

In case of queries or any confusion, you can also access the additional application information. This is available on the hawk-I ‘How to apply’ page. This site will also allow you to access and download the appropriate application forms.

For Further Information

The Hawk-I page will prove to be helpful in case additional information is required. It will also allow you to go through other resources that increase your understanding of the program. Such information will help you to determine your eligibility as well as provide you with guidance concerning the application process.

Some resources that you will be able to find on their website include:

  • Hawk-I income guideline
  • MCO Enrollment Form
  • Delta Dental Benefits Summary Sheet
  • Hawk-I MCO Health Plan Comparison

You will also be able to find the appropriate Hawk-I e-News through the portal along with other resources.

Hawk-I also offers Member services five days a week. They are available from 8 a.m. to 5 p.m. This means that you can easily approach them if any issue arises. Along with an online portal, hawk-I also have a toll free contact number as well as an email address:

1-800-257-8563

Hawki@dhs.state.ia.us

Hawk-i services are mindful of their members with disabilities. To effectively cater to their needs, Hawk-I instructs them to call Relay Iowa TTY at 1-800-735-2942.

 

 

Florida, Healthcare,

Florida Medicaid

no comment

What You Need To Know

Medicaid helps to cater to the healthcare needs of people with low incomes. Its health coverage helps to provide for those people who are unable to take medical care of themselves. This helps to improve the health of the residents of the state. It is a program that has been administered by the Centers for Medicare & Medicaid Services.

The average amount of people that are eligible for Medicaid can be estimated at 3.8 million. Therefore, they are further broken into categories. Amongst these there is

  • Age by Assistance Category
  • Age by County
  • Age by Gender

Medicaid covers services according to the age of the beneficiary as well as the type of the program. The services may include:

  • Doctor
  • Hospital
  • Family planning i.e. birth control, pregnancy, and birth care.
  • Home health care
  • Nursing home
  • Hospice
  • Transportation
  • Dental and visual
  • Prescriptions
  • Community behavioral health
  • Any other similar services.

In case the individual who wishes to apply has both Medicare and Medicaid, the program covers:

  • Medicare deductible. This is the amount a person pays before Medicare starts to pay.
  • A portion of Medicare co-payment and co-insurance. This is the cost a person shares with Medicare.
  • Premiums paid for Medicare coverage
  • Some services that Medicare does not cover.

There are certain other programs that eligible applicants can consider too. These include Qualified Medicare Beneficiaries (QMB), Qualifying Individuals 1 (QI-1) and Special Low-Income Medicare Beneficiaries (SLMB).

Are You Eligible?

There are certain requirements involving this program. Amongst these, the applicant must make sure that he or she is:

  • A resident of the state of Florida
  • In need of health coverage
  • Has a financial situation which can be described as low income or very low income.
  • A U.S. national, citizen or has a satisfactory immigration status

These are basic requirements for the applicant who wishes to benefit from this program. Along with this, there are certain factors including the fact that the person must:

  • Be above the age of 64
  • Be pregnant or a parent of a child under 18
  • Be blind or disabled
  • Have a family member who is blind or disabled. This can be a child, parent or spouse in the household.
  • Recipients of Supplemental Security Income

Once these requirements are met, then the income and asset requirements of the person are considered. The household income of the applicant is also taken into account. Their earnings before tax deductions are considered. The amount is either be less than or equal to:

Size Of Household Maximum Annual Income Level ($)
1 16,612
2 22,491
3 28,369
4 34,248
5 40,127
6 46,005
7 51,884
8 57,762

Some houses may have more than eight residents. In these instances, an additional amount of $5,878 s added per person. To ensure that you are in line with the most recent and accurate guidelines, a managing agency must be approached.

How To Apply

The application process for Medicaid can begin with the help of the Department of Children and Families. A toll-free number is also available:

(866)762-2237

Certain people move from other states to Florida. In these cases, if the person had Medicaid in their previous state, they must apply for it in Florida. If they receive SSI then they should contact the appropriate Social Security through their toll-free number

(8000772-1213

Medicaid is also available for children. Families who wish to apply for it must submit a Florida KidCare application. There is a toll-free number available for such purposes as well. It is:

(888)540-5437

The qualified candidates receive all health care services except long-term care from a managed care plan. This helps you to choose among the various plans of your area. It is dependent on the providers of the individual’s plan. There is a choice counselor present who helps to make sure that the best plan is selected. It suits the needs of the person completely.

For Further Information?

A Florida Medicaid website has been set up to cater to the queries of potential applicants. This helps people to easily access the information they require.

There also Medicaid offices set up to help out the residents of the state. A local office can be found through the website which can be visited whenever it is possible. In case further information is required by the applicant concerning eligibility, there is a page available too.

In case the application has been denied or terminated. The person can also request a hearing through telephone. This includes any information you require if your benefits have been reduced or terminated. The DCF is available to answer such questions.