This primer provides an overview of the basic components of Medicaid, the nation's largest health coverage program, which covers nearly 60 million low-income individuals, including children and families, people with disabilities and seniors who are also covered by Medicare..."
Managing Agency Alabama http://www.alabama.gov ..."
"...Medicaid in Alabama covers these groups:.."
...Each Medicaid program has its own requirements you must meet in order to qualify for benefits. All programs have income requirements. Some programs also have age requirements or are limited to certain groups such as pregnant women or people who also have Medicare...."
"...The poverty thresholds are the original version of the federal poverty measure... The poverty guidelines are the other version of the federal poverty measure.
Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.
...All current recipients who have declared they are United States citizens will have to provide Medicaid with proof of United States Citizenship and Identity at the time of their annual review of eligibility in order to remain eligible for Medicaid. Applicants and/or recipients who cannot provide such documentation after a good faith effort, may request further guidance from their Medicaid eligibility worker..."
Medicaid citizenship requirements Under federal law, all U.S. citizens and certain legal immigrants who meet Medicaid’s financial and non-financial eligibility criteria are entitled to Medicaid. The Medicaid program has long required states to establish that individuals applying for Medicaid are U.S. citizens or satisfy the immigration restrictions.... "
What has changed? In the Deficit Reduction Act of 2005, a new requirement was established with respect to citizenship verification of current and new Medicaid applicants. Citizen applicants were previously able to self-attest their citizenship and identity under penalty of perjury to qualify for Medicaid..... "
...This is the on-line application for free and low cost health care coverage programs for Alabama's families..."
What are these programs for?"
2. Who are these programs for?
3. How much do these programs cost?
4. If I have other insurance, would I still be eligible for these programs?
5. I was on Medicaid in another state, can I transfer my Medicaid?
6. How does the on-line application work?...
This application should take 30 - 45 minutes to complete. Once you've finished, you should have a good idea if you and/or your children may be eligible for any of the programs...."
"...click on your county to locate the district office serving your area..."
"More than 420,000 Alabamians currently participate in Patient 1st, a primary care case management (PCCM) program operated by the Alabama Medicaid Agency. "
Medicaid recipients on the Patient 1st program may change their personal doctor (also called a primary medical provider) at any time. ..."
"To find a Medicaid Patient 1st doctor or clinic in your area, click on the name of your county to see a list of Patient 1st doctors and/or clinics available to you. ..."
Recipient ID number requiredb>
"As soon as your child is enrolled in ALL Kids, choose a doctor and dentist... When your child needs medical and dental care, you must use a Blue Cross and Blue Shield of Alabama (BCBSAL) Preferred Provider Organization (PPO) provider. The PPO network is a group of doctors, dentists, pharmacies, hospitals and outpatient facilities enrolled as BCBSAL providers to offer services to ALL Kids enrollees at special, prearranged rates..."
ALL Kids shares an application with SOBRA Medicaid. The program(s) for which you and/or your children qualify will be determined by your family size and income..."
OVERVIEW OF THE ALL Kids HEALTH INSURANCE PLAN..."
...SOBRA Medicaid is a health care coverage program that helps pay medical bills. SOBRA Medicaid is for children and teens under age 19 and pregnant women..."
A low cost, health care coverage program for children and teens under age 19. .."
Medicaid for Low Income Families (MLIF) is a health care program for families with very low income who have children under the age of 19 living in their homes. There must be a relationship to the children, such as that of a parent or close relative, in order to qualify for MLIF. Non-related caretakers do not qualify for MLIF..."
...ALL Kids is a state program that provides health insurance to low-income families with children under the age of 18 who are not eligible for Medicaid and are uninsured..."
...ALL Kids provides low-cost healthcare coverage for Alabama's children and teens whose family incomes are above Medicaid eligibility, but below 300% of the Federal Poverty Level. ALL Kids comprehensive benefit package covers regular check-ups, immunizations, sick child doctor visits, prescriptions, dental and vision care, hospital and physician services and mental health and substance abuse services. Additional medical services may be available for children with special needs. ALL Kids is administered by The Alabama Department of Public Health..."
"General information about children’s health coverage... - State-based resources, including possible enrollment partners - Steps for enrolling a child in coverage program - Follow-up flyer for parents - Health resources, by county, for children who are not eligible for coverage...
Alabama has two programs that provide free and low-cost health coverage to children: If you are a family of four with income of ... or less, your child is eligible for Medicaid. If you make ... or less and your child is under 5 years old, they are also eligible for Medicaid. If you are a family of four with income of ... or less, your child is eligible for ALL Kids...."
How affordable is health coverage for Alabama’s Children?... CHIP and Medicaid Enrollment Procedures for Alabama’s Children... Despite difficult economic times, Alabama was one of 23 states that took steps to improve health coverage for children in the last year. In 2009, Alabama expanded CHIP eligibility from 200 to 300 percent of poverty."
HHow does Medicaid help children in Alabama? Children make up 50% of Alabama’s Medicaid population, but are of very low cost, accounting for only 24% of the state’s Medicaid spending....."
...The two major federal funding sources for low-income children’s public health insurance are Medicaid and the State Children’s Health Insurance Program (SCHIP). States enjoy some flexibility in their Medicaid programs for children,..."
Most family plans are funded through Medicaid, but a handful of states have waivers to use State Children’s Health Insurance Program (SCHIP) funds to cover parents. ..."
"In Alabama, there are 615,883 families, with 1,112,429 children..."
Individual state profiles..."
...Below is a partial listing of some goods and services that are not covered by Medicaid in Alabama. Medicaid will NOT pay for:... ..."
...Plan First is a program for women ages 19 - 55 for family planning (birth control) services only..."
Nearly one in ten women in Alabama receives health care coverage through Medicaid. Medicaid is the most important source of coverage for low-income women...."
In Alabama, low-income children may be enrolled in the Medicaid program or a separate SCHIP program, based on the child’s age and the family’s income...."
The Alabama Medicaid Agency pays for most medicines legally prescribed by a doctor or authorized health professional when dispensed by a licensed doctor or pharmacist in accordance with state and federal laws. In FY 2007, Medicaid paid for approximately 7 million prescriptions for qualifying Alabama recipients..."
Preferred Drug List – Alphabetical - Effective 10-1-10..."
The Alabama Medicaid Dental Program covers certain routine preventive and restorative services for children under age 21 who have full Medicaid eligibility. Medicaid does not cover any type of dental care for adults..."
Medicaid pays for routine dental care for children under 21 years of age with full Medicaid eligibility through the EPSDT Program when provided by licensed dentists who are enrolled as Medicaid dental providers. Adults 21 years of age and older are not eligible for dental coverage through Medicaid..."
"The Guide is intended to serve as a resource of current information on clinical practice, evolving technologies and recommendations in dental care. The guide is not intended to change current Medicaid policies, nor is it intended to impose any new requirements on states..."
Dental services under Title XIX of the Social Security Act, the Medicaid program, are an optional service for the adult population, individuals age 21 and older. However, dental services are a required service for most Medicaid-eligible individuals under the age of 21, as a required component of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit..."
...If you cannot afford health care or insurance... there are programs that provide health insurance to some people who cannot afford to buy it on their own. You or your family members may qualify, even if you work. However, these programs have income and asset limits. In Alabama, the main programs are Medicaid and ALL Kids..."
"Federally-funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income. Health centers provide •checkups when you're well •treatment when you're sick •complete care when you're pregnant •immunizations and checkups for your children •dental care and prescription drugs for your family •mental health and substance abuse care if you need it..."
"Alabama Federally-Supported Health Centers, 2008..."
If you need affordable health care, a Community Health Center may be what you're looking for... Click here to find the health center closest to your address or to see a list of health centers in your state or county/parish..."
If you currently do not have health insurance because you are unemployed or are employed but cannot afford your employer’s health insurance plan, you may qualify for one or more of the following health insurance assistance programs. ..."
"...hand-held guide available that outlines your state’s (Alabama) public and private health care choices for individuals and groups in almost every demographic profile, as well as offers a reference list of phone numbers and Web sites..."
...As an Alabama resident, you have rights under federal and state law that will protect youwhen you seek to buy, keep, or switch your health insurance, even if you have a serious healthcondition.This guide describes your protections as an Alabama resident....."
The Alabama Medicaid Agency has a number of programs for the elderly and disabled. Medicaid for Institutional care is for people in nursing homes, hospitals, and ICF-MR facilities. Home and Community Based Waivers are for people who are elderly, disabled, homebound, mentally retarded, or who have certain diagnoses and who live in the community..."
...Since 1982, options for home and community choices have been available for individuals applying for long term care services. Individuals with special health care needs at risk for nursing home placement may choose available services in the home and community..."
These are Alabama Nursing Homes in cities A - Z." In addition to the state directory described above, there are nursing home directories for principal Alabama cities. A few examples:
A consumer's guide to information and help about assisted living in Alabama, with a directory of assisted living facilities..."
A consumer's guide to information and help about Home Health Care agencies and services in Alabama, with a directory ..."
Alabama has programs for people with limited income and resources that pay some or all of Medicare's premiums. Some programs may also pay Medicare deductibles and coinsurance. To be eligible for the Medicare Savings Programs, you must..."
Individuals who are entitled to Medicare Part A and/or Part B and are eligible for some form of Medicaid benefit are often referred to as “dual eligibles.” These benefits are sometimes referred to as Medicare Savings Programs (MSPs). Dual eligibles are eligible for some form of Medicaid benefit, whether that Medicaid coverage is limited to certain costs, such as Medicare premiums, or the full benefits covered under the State Medicaid plan..."
Nearly 8.8 million Medicaid beneficiaries are “dual eligibles” – low-income seniors and younger persons with disabilities who are enrolled in both the Medicare and Medicaid programs. Dual eligibles are among the sickest and poorest individuals covered by either the Medicaid or Medicare programs..."
...Home and community-based waiver programs are available to eligible Medicaid recipients who are at risk of needing care in a nursing home, hospital or other institution. Clients must meet financial, medical and program requirements ..."
"The following is a list of all Alabama 1915(c) Waivers by name - complete with a description, contact information and web link..."
...This list contains information about state-specific Medicaid waiver and demonstration programs. Users can access fact sheets, copies of proposals, approval letters, and other documents related to specific programs..."
" The Alabama Medicaid Agency is committed to detecting, preventing and/or eliminating all forms of fraud and abuse to ensure that all available funds go to provide health care to those in need..."
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