2014 Medicaid: Changes You May Need To Know

NY Connects provides helpful information to frequently asked questions about Medicaid to help you plan for the future.

Medicaid-funded transportation for medical appointments is changing in our county. Please be aware of the changes that will be in effect Aug. 1, 2014.

Medical Answering Services, LLC will be authorizing medical transportation for Medicaid clients in Chautauqua County. MAS is a New York state corporation located in Syracuse. They provide Medicaid Transportation Management and Prior Authorization Services for the New York State Department of Health as well as a number of counties. They have been involved in the industry since 2003.

To schedule trips on or after Aug. 1, call 1-855-733-9405, fax 315-299-2786 or visit medanswering.com.

Through July 31, please continue to call the medical transportation lines at : Jamestown 661-7718, Dunkirk 672-8837, Mayville 753-4718.

The following has been extracted from the New York state website of frequently asked questions:

Medicaid is a program for New Yorkers who can’t afford to pay for medical care.

Often times people needing home care and skilled nursing homes will need to apply. Frequently people ask: “How do I know if I qualify for Medicaid?” You may be covered by Medicaid if: You have high medical bills, you receive Supplemental Security Income, or you meet certain financial requirements.

“How do I apply for Medicaid?”

You may apply for Medicaid in the following ways: NY State of Health, The Official Health Plan Marketplace 855-355-5777, healthbenefitexchange.ny.gov; Managed Care Organization , healthbenefitexchange.ny.gov/IPANavigatorSiteSchedule; or the Medicaid Helpline at 800-541-2831.

“If I think I am eligible for Medicaid, should I cancel any other health insurance I might already have?”

No. If you currently pay for health insurance or Medicare coverage or have the option of getting that coverage, but cannot afford the payment, Medicaid can pay the premiums under certain circumstances.

Even if you are not eligible for Medicaid benefits, the premiums can still be paid, in some instances, if you lose your job or have your work hours reduced. If you need help with a COBRA premium, you must apply quickly, to determine if Medicaid can help pay the premium.

You may be eligible for the Medicare Savings Program. This program pays your Medicare premiums and deductibles.

“How do I know if my income and resources qualify me for Medicaid?”

There is a chart at health.ny.gov/health-care/medicaid/ that shows how much income you can receive in a month and the amount of resources (if applicable) you can retain and still qualify for Medicaid. The income and resource (if applicable) levels depend on the number of your family members who live with you. Income and resource levels are subject to yearly adjustments. You may also own a home, a car, and personal property and still be eligible. The income and resources (if applicable) of legally responsible relatives in the household will also be counted.

“Can I be eligible for Medicaid even if I make more money than the chart shows?”

Yes, some people can. Pregnant women, children, disabled persons, and others may be eligible for Medicaid if their income is above these levels and they have medical bills. Ask your Medicaid worker if you fit into one of these groups.

Individuals who are certified blind, certified disabled, or age 65 or older who have more resources may also be eligible. Ask your Medicaid worker if this applies to you.

If an adult has too much income and/or resources and is not eligible for Medicaid, that person may be eligible for the Family Planning Benefit Program.

“What health services are covered by Medicaid?”

In general, the following services are paid for by Medicaid, but some may not be covered for you because of your age, financial circumstances, family situation, transfer of resource requirements, or living arrangements. Some services have small co-payments. These services may be provided using your Medicaid card or through your managed care plan if you are enrolled in managed care. You will not have a co-pay if you are in a managed care plan, except for pharmacy services, where a small co-pay will be applied.

smoking cessation agents

treatment and preventive health and dental care (doctors and dentists)

hospital inpatient and outpatient services

laboratory and X-ray services

care in a nursing home

care through home health agencies and personal care

treatment in psychiatric hospitals (for persons under 21 or those 65 and older), mental health facilities, and facilities for the mentally retarded or the developmentally disabled

family planning services

early periodic screening, diagnosis and treatment for children under 21 years of age under the Child/Teen Health Program

medicine, supplies, medical equipment, and appliances (wheelchairs, etc.)

clinic services

transportation to medical appointments, including public transportation and car mileage

emergency ambulance transportation to a hospital

prenatal care

some insurance and Medicare premiums

other health services

If you are eligible for Medicaid, you will receive a Benefit Identification Card which must be used when you need medical services. There may be limitations on certain services.

For you to use your Benefit Identification Card for certain medical supplies, equipment, or services (e.g., wheelchair, orthopedic shoes, transportation), you or the person or facility that will provide the service must receive approval before the service can be provided.

Should you have further questions or would like to apply, please contact the Chautauqua County Department of Social Services at 661- 8147.

NY Connects is your one-stop call for information about services available to you in Chautauqua County. Call with your questions and we will provide you with local services and resources in an effort to meet your needs.

You can reach NY Connects by phone: Jamestown areas: 661-7582, Dunkirk/Fredonia areas: 363-4582 and Mayville areas/mid- county 753-4582, fax 753-4844, e-mailccnyc@co.chautauqua.ny.us. You can come and see us at 7 N. Erie St., Mayville. NY Connects is brought to you in cooperation from the Chautauqua County Office for the Aging and the Chautauqua County Department of Health and Human Services.