Frequently Asked Questions
Health Program Representatives
1. What is a Health Program Representative (HPR)?Health Plans
1. What is a health plan?2. Can the doctor charge me if Medicaid pays less than the amount charged?
3. How do I choose a health plan?
4. Can I change my health plan?
5. What is a PCP? (Primary Care Provider)
6. Do I have to select a health plan?
7. How do I switch from non-Traditional Medicaid to Traditional Medicaid?
8. What is open enrollment?
Benefits
1. How do I use my card?2. How many prescriptions can I get?
3. Am I covered out of the area?
4. What do I do with medical bills?
5. What is the difference between urgent care and emergency care?
6. Prior Approval, Referrals, & Speciaists
7. Can I keep my Medicaid drug benefit if I have Medicare?
8. What do the different color cards mean?
9. What if I have problems with my benefits?
10. What birth control services are covered?
11. What maternity and midwife services are covered?
Costs
1. What costs do I have to pay?2. What is a co-pay?
3. What is a co-insurance?
4. What is an "Out of Pocket" maximum?
5. Can I be exempted from paying a co-pay?
Glossary of Terms
1. What is an LHD?2. What is a TPL?
Rights & Responsibilities
1. What are my responsibiities as a Medicaid client?2. What are my rights?
Acronyms (Abbrevations)
1. What do these abbreviations mean?2. PMHP
Providers
1. Where can I find information about eligibility requirements for Medicaid?2. Can we bill patients for no-show appointments?
3. How do we bill for a pregnant woman who does not have the co-pay exemption?
4. Can we balance bill Medicaid clients?