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What happens after the decision is made about Medicaid eligibility?

Once Medicaid Eligibility is determined you should receive a card in the mail and you should become a part of a managed care plan.

Once eligibility is established for Medicaid, it can take up to 2 weeks to receive a Medicaid card. If the individual needs to see a physician right away they can use the temporary Medicaid number that is issued to them on their decision letter. The individual needs to make sure that the physician they are going to see is a provider that accepts Medicaid or the fees will be paid out of pocket by the individual.

Eligibility

It can take up to 45 days for an individual to find out if they are eligible for Medicaid. Once a decision is made a notification of the decision is sent in the mail. The Department of Human Services are the ones that make the final decision. In the letter it will have eligibility or denial, and why. It will also have the case number, Medicaid number, and the coverage period, which is usually 6-9 months at a time.

Health Care Plan

Once Medicaid eligibility is determined the individual is placed in a fee for service plan until they can be placed in a Medicare Managed Care Plan. In most cases the individual is able to wait for the paperwork to be received by the managed care plan, a primary care physician is sometimes chosen at during the application process. The individual is assigned a case worker, the caseworker’s information can also be found on the original decision letter, with the caseworker’s phone number and name.

Conclusion

Once Medicaid eligibility is determined it takes a few weeks to get a card and to be assigned to a managed care plan, once there it is up to the individual to make sure that the doctors they choose accept the Medicaid plan.

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What happens after the decision is made about Medicaid eligibility?

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