The Medicaid Program provides medical benefits to groups of low-income people, some who may have no medical insurance or inadequate medical insurance. Although the Federal government establishes general guidelines for the program, the Medicaid program requirements are actually established by each State..."
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..."
In order to qualify for this benefit program, you must be a resident of the state of Delaware, a US national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income..."
You can have a car, bank account, and a home and still qualify for Medicaid. DMMA does not look at any of your resources when determining your eligibility for Medicaid... You can work and still qualify for Medicaid. Some persons can have other insurance and still receive Medical Assistance....
"Your children may qualify if they... Do not have comprehensive health insurance, Are under the age of 19 and reside in the State of Delaware, Are U.S. citizens or legally-residing noncitizens..."
"Financial eligibility criteria vary from program to program. However, the two most common benchmarks by which DMMA sets income criteria are the..."
"...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.
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..... "
ASSIST is the State of Delaware's Application for Social Service Programs. Here is how ASSIST can help you. The self-screening questionnaire can tell you which Social Service Programs you and the members of your household may be eligible to receive. The application lets you apply online for Social Service Programs offered by the State of Delaware..."
Hours of Operation for all office locations are 8:00 a.m. to 4:30 p.m. Monday through Friday, except State holidays. Choose the name of any office for driving directions and more information about the services provided..."
...The majority of people receiving Medicaid must choose a family doctor who, along with a managed care organization (MCO), will provide or arrange for all your preventive care and medical needs. The following individuals are not enrolled with a MCO..."
Medicaid Managed Care Enrollees... Medicaid Enrollment in Comprehensive Managed Care Plans... Medicaid Managed Care Enrollees as a Percent of State Medicaid Enrollees"
YYour children may qualify if they... Do not have comprehensive health insurance, Are under the age of 19 and reside in the State of Delaware, Are U.S. citizens or legally-residing noncitizens...
"It's easy and convenient. Parents or caregivers can fill out and mail an application form on paper, or complete and submit an application on the internet. A paper application form may be obtained either by calling the Delaware Healthy Children Program (DHCP) at..."
"The Delaware Healthy Children Program covers everything from routine checkups to eye exams to doctor and hospital services. Families covered by the Delaware Healthy Children Program enjoy an extensive list of services for a single low monthly rate and no co-payments. Services covered include..."
This program is operated by the Division of Medicaid & Medical Assistance. It provides Medicaid coverage to severely disabled children who do not qualify for Supplemental Security Income (SSI) or other Medicaid qualifying programs because of their parents' income and/or resources..."
...The Delaware Healthy Children Program (Healthy Children) is a Medicaid expansion program that provides health coverage to low-income children under the age of 19 who are not eligible for Medicaid and who have no health insurance and pregnant women ineligible for Medicaid..."
"Health Coverage for Delaware’s Children:... How affordable is health coverage for Delaware’s children? ... How simple are enrollment procedures in CHIP and Medicaid for Delaware’s children..."
How does Medicaid help children in Delaware? Children make up 47% of Delaware’s Medicaid population, but are of very low cost, accounting for only 27% of the state’s Medicaid spending. In general, Delaware children who..."
...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 Delaware, there are 120,797 families, with 204,004 children.
Low-Income Children: 33% (68,226) of children live in low-income families (National: 41%), defined as income below 200% of the federal poverty level...."
Individual state profiles..."
...The Delaware Healthy Children Program (DHCP) is targeted to children under age 19 whose family income is at or below 200% of the Federal Poverty Level (FPL) and who do not qualify for Medicaid. Eligible children receive hospital services, physicians services, lab, x-ray, prescription drugs, and mental health and substance abuse services..."
Nearly one in ten women in Delaware receives health care coverage through Medicaid.. Medicaid is the most important source of coverage for low-income women. In 2006-07..."
Medicaid benefits: Online database"
As of July 2003, 125,397 people were covered under Delaware’s Medicaid and SCHIP programs. There were 120,239 enrolled in the Medicaid program, and 5,158 enrolled in the separate SCHIP program. In federal fiscal year 2001, Delaware spent $601 million to provide Medicaid services....."
The goal of the Delaware Prescription Assistance Program (DPAP) is to help pay for prescription medications for elderly and/or disabled individuals who cannot afford the full cost of filling their doctor's prescriptions. The program is designed to aid eligible individuals who have no prescription insurance other than Medicare Part D, and whose income is at or below 200% of the Federal Poverty Level (FPL), or whose prescription costs exceed 40% of their income..."
Under the Medicaid State Plan dental benefits are provided to eligible individuals under the age of 21 in compliance with the requirements of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services..."
"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 or someone you care about is one of the more than 105,000 uninsured Delawareans, you know that sometimes access to the healthcare system seems complicated. But, healthcare should never be beyond the reach of those who need it. This resource guide was created to...
"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..."
"Delaware 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..."
"...hand-held guide available that outlines your state’s (Delaware) 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 a Delaware resident, you have rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance, even if you have a serious health condition....."
Nursing Facility Program ..."
Many people know virtually nothing about Medicaid policy for nursing home care until the need arises. This guide is a good starting point to become knowledgeable about Medicaid policy and program requirements. It should be used in conjunction with visits to nursing homes and, where necessary, consultations with a qualified attorney..."
These are Delaware Nursing Homes in cities A - Z." In addition to the state directory described above, there are nursing home directories for principal Delaware cities. A few examples:
A consumer's guide to information and help about assisted living in Delaware, with a directory of assisted living facilities..."
If you are entitled to Medicare benefits and have a low income, DMMA may pay your Medicare premiums and, in some cases, other "out-of-pocket" expenses such as deductibles and coinsurance. Individuals must be entitled to Medicare Part A to qualify for any of these programs..."
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..."
This home and community based waiver program is administered by the Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) . Services offered include all regularly covered Medicaid services (hospital, physician, lab, prescriptions) plus the following special waiver services..."
Adult Day Services provides activities and assistance for people with physical and/or mental impairments. This service is for people who cannot be left alone for long periods of time. ..."
Under the Medicaid Waiver for the Elderly and Disabled individuals can choose to receive agency-based personal care services or self-directed personal care services. Agency-based personal care services are provided by aides from home health or personal assistance services agencies..."
...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 State of Delaware and the Federal Government have designated the Medicaid Fraud Control Unit (MFCU) to investigate and prosecute illegal acts relating to Medicaid funds. Created in 1980, the MFCU, which is housed within the Delaware Department of Justice, is designed to protect the Delaware residents who receive Medicaid and the taxpayers who support the program..."
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