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Medical
Assistance Programs and Services
The
Medical Assistance unit covers a number of programs that many people
refer to as " Medicaid". These health care programs
are for people who cannot pay for their medical care. There
are several ways that you can be eligible for Medicaid. Eligibility
depends on your age, income, health, sometimes your resources and
other requirements. The Medicaid Programs that are available include
programs for adults and special programs for children.
Community
Medicaid Program
There
are several types of
Community Medicaid:
1.
Medicare Savings program: This program assists qualifying
individuals with help in paying their Medicare premium, co-insurance
and deductible amount
2.
Child Health Plus A: medical coverage for children up to age
19
3.
SSI-related: for adults who are aged, certified blind or
certified disabled and can be either fully eligible or eligible with
a spend down.
4.
Adults: single/childless couples (ages 21 to 65) can only be
eligible for Medicaid if they would be eligible for Temporary
Assistance. Medicaid for adults living with their dependent
children can also be eligible for full Medicaid or with a spend
down.
5.
Family Health Plus: this is a health insuracne program whose
benefits are offered through Blue Cross/Blue Shield
Chronic
Care
This is a Medicaid program that may help pay for the costs for
someone who is in institutional care or a home and community-based
waiver services program. (There is a very extensive
interview and information gathering process that is required for
determining eligibility for this program.)
Third
Party Program
This
program investigates the availability of other insurance available
to an applicant/recipient to help defray medical costs.
General
Eligibility Guidelines
There are many factors and various
types of documentation requirements involved in making a determination of eligibility
for Medicaid programs. If you need health care coverage, contact your
local Department of Social Services.
If you do not qualify for some programs, a worker may be able to
assist you or know of another option to help you with your medical care
costs.
Link to Medicaid Income Levels
are here (for general information purposes only)
FAQ for Medicaid
Programs
If you get Temporary Assistance or SSI, can you get Medicaid?
Yes, you
can get Medicaid and cash assistance. You can also get Medicaid
without cash assistance. Citizens and aliens with satisfactory
immigration status can get Medicaid.
If
you stop getting cash assistance because you are working and earn too
much money, can you continue to get Medicaid?
Yes, if
you have children, are age 65 or older, or are certified disabled,
you may be eligible for Medicaid. If you have too much income
and/or resources, you may be eligible after you incur medical bills at
least equal to your excess income and /or excess resources. If you are
not eligible for Medicaid, you may be eligible for Family Health
Plus. You can qualify for Family Health Plus if you live
with a child(ren) and have income up to 150% of the Federal Poverty
level. If you do not live with a child, you can qualify for
Family Health Plus if you have income up to 100% of the Federal
Poverty Level. Your resources will not be counted for Family
Health Plus. Citizens and aliens with satisfactory immigration
status can get Family Health Plus.
If
you are pregnant, can you have more income to get Medicaid?
You can
have income up to 200% of the Federal Poverty level and get Medicaid.
Your resources are not counted. Pregnant women do not need to prove
citizenship or immigrations status.
What
if you do not quality for Medicaid or Family Health Plus? Is there any
other help?
Yes, Child
Health Plus A is for children under age 21. If you are under
age 19, you can have income as high as 133% of the Federal Poverty
Level, and your resources are not counted.
If you are
age 19 or 20, you can qualify if you have income and resources below
certain levels. If you have too much income and/or resources,
you may be eligible after you incur medical bills at least equal to
your excess income and/or excess resources. You may also be
eligible for Family Health Plus. You can quality for family health
plus if you live with a parent and have income up to 150 % of the
Federal Poverty level. If you do not live with a parent, you can
qualify with income up to 100% of the Federal Poverty Level.
Your resources will not be counted for Family Health Plus.
Child
Health Plus B is free or low cost health insurance for children
under age 19 who are not eligible for Child Health Plus A.
Can
my child get help finding a health care provider and getting regular
checkups?
Yes, the
Child/Teen Health Program covers medical and dental care, provides
regular checkups and helps you make sure your child is growing
right.
If you
need health care coverage, contact
the local Department of Social Services.
Link
to Blue Choice Options Grid
Want to
know more about the Blue Cross/Blue Shield provider that services Yates County? You can check
out the Rochester
Excellus website here.
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