Missed Or Canceled Appointments
When members do not show up for a scheduled appointment, it creates an unused appointment slot that could have been used for another member. It is very important to keep appointments and call the provider in advance if you cannot make it to a scheduled appointment. Medicaid providers cannot bill a member for no-show/missed appointments. However, a provider may discharge a member from their practice after so many no-show/missed appointments. The provider must have the same policy for Medicaid members as non-Medicaid members, and must notify Medicaid members that the policy exists.
For a full list of member rights and responsibilities, see the Member Rights and Responsibilities Section of the Member Guide
Medicaid Member Card Information
Medicaid members receive a wallet-sized plastic Medicaid card. The card will be used whenever the member is eligible for Medicaid. Each Medicaid member will get their own card. The card will have the members name, Medicaid ID number, and date of birth. The back of the card has helpful contact information and websites for both providers and members. Here is a sample of the Medicaid Member Card.
In addition to the Medicaid card, members will receive a Benefit Letter in the mail. The Letter has eligibility and plan information. When there are changes, Medicaid will send a new Benefit Letter. Please keep this letter for your records.
To check eligibility, Members can call the Medicaid Member Services hotline: 1-844-238-3091If lost or damaged, members can call the Department of Workforce Services to request a new card: 1-866-435-7414
What If I Have Questions About My Healthy Louisiana Plan
If you have questions about your Healthy Louisiana plan, contact your plans customer service department.
- Aetna Better Health 1-855-242-0802 TTY: 711 Available 24 hours a day, 7 days a week
- Healthy Blue 1-844-521-6941 Available Monday Friday, 7:00 a.m. – 7:00 p.m.
- AmeriHealth Caritas 1-888-756-0004 Available 24 hours a day, 7 days a week.
- Louisiana Healthcare Connections 1-866-595-8133 Available Monday Friday, 7:00 a.m. – 7:00 p.m.
- UnitedHealthcare Community 1-866-675-1607 Available Monday Friday, 7:00 a.m. 7:00 p.m
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Tips To Keep Your Medicare Number Safe
Even though your Medicare Number is no longer the same as your Social Security number, you can still be at risk for medical scams if it falls into the wrong hands. Follow these tips to keep yourself safe:
- If you think your Medicare Number or Medicare Card has been stolen, alert Medicare at 1-633-4227 .
- Be careful to only give your Medicare Number to people you trust, like your healthcare providers, insurers, and pharmacists. Be wary of people selling medical devices or tests who ask for your Medicare Number and tell you that you dont need to consult with your healthcare provider first.
- Dont give your Medicare Number to someone calling you and claiming to be from Medicare if you havent requested a call. If youre in doubt, you can always hang up and call Medicare at 1633-4227 to be sure youre speaking to someone from Medicare.
I Was Approved For Medicaid Whats Next
Congratulations! This is an important first step to better health and well-being. Coverage isnt only important when you are sick, its helpful when you dont feel sick. Now that you have Medicaid coverage, you can use your insurance to:
-Visit your doctor
-Get preventive care
-Get prescription medicines that you need
Follow the links on the right side of this page to learn what you need to do next, how to stay covered, and how to get the most out of your Medicaid coverage.
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Can I Change My Peach State Health Plan Pcp
Members may change their PCP if they are not satisfied. Members may change their PCP once a month during the first 90 days of enrollment in Peach State Health. After 90 days, members can change their PCP once every six months. They may also get services from any Peach State Health Plan participating Primary Care Provider at any time regardless of assignment.
What Is A Medicaid Provider Number
Whether you’re a physician or you have your own clinic, you want to provide patients with the best possible rates. That’s where Medicare can help. This national health insurance program enables Americans who meet certain criteria to receive discounted medical services. Generally, it covers about half of their health care costs.
In 2015, over 56 million people were enrolled in this program. California alone had more than 5.6 million beneficiaries. Physicians and other medical professionals who wish to participate in this program must apply for a Medicaid provider number. This unique identifier is issued by state health and human services agencies.
The application process is quick and can be completed online.Look up Medicare provider services enrollment on the official website, contact a representative or visit a regional office of the Centers for Medicare & Medicaid Services 2.
- Whether you’re a physician or you have your own clinic, you want to provide patients with the best possible rates.
- Look up Medicare provider services enrollment on the official website, contact a representative or visit a regional office of the Centers for Medicare & Medicaid Services 2.
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Who Qualifies For Lachip
LaCHIP provides health care coverage for the children of Louisiana’s working families with moderate and low incomes. Children must be under age 19 and not covered by health insurance. Family income cannot be more than 217 percent of the Federal Poverty Level for the no-cost LaCHIP program.
Number in Family 217% FPL Monthly Income
1 $2,196More than 8 For each additional person, add $782 to the monthly amount.
Do I Qualify?
If your income is more than these amounts, you may qualify for the LaCHIP Affordable Plan, which is available to uninsured Louisiana children in families up to the age of 19 whose families have an annual income up to 250 percent of the Federal Poverty Level . Families of children enrolled in the LaCHIP Affordable Plan, however, will pay a $50 monthly premium. To learn more about the LaCHIP affordable plan, click here.
How Does Medicaid Work
The Medicaid program does not provide health care services for everyone. Your application will be reviewed for all Medicaid programs. If you are found eligible for Medicaid, you will get:
- A letter in the mail from Medicaid telling you about your coverage
- A Medicaid ID card
- A Healthy Louisiana plan ID card, if you enroll in a plan.
Each time you go to your health care provider or pharmacy, take your Medicaid ID and Healthy LA plan ID cards with you. Show them at all medical visits before you receive any service. The health care provider or pharmacy will tell you if they accept your Medicaid benefits. You should also ask your health care provider or pharmacy if the service or prescription is covered by Medicaid before receiving the service or filling a prescription.
Medicaid does not pay money to you instead, it sends payments directly to your health care provider or pharmacy.
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If You Qualify Under A Non
- If you are a U.S. citizen and provide a valid Social Security Number , a match with the Social Security Administration will verify your SSN, date of birth and U.S. citizenship. If SSA verifies this information, no further proof is needed. The SSA match cannot verify birth information for a naturalized citizen. You will need to submit proof of naturalization or a U.S. passport.
- Proof of citizenship or immigration status*
- Proof of age , like a birth certificate
- Four weeks of recent paycheck stubs
- Proof of your income from sources like Social Security, Veteran´s Benefits , retirement benefits, Unemployment Insurance Benefits , Child Support payments
- If you are age 65 or older, or certified blind or disabled, and applying for nursing home care waivered services, or other community based long term care services, you need to provide information on bank accounts, insurance policies and other resources
- Proof of where you live, such as a rent receipt, landlord statement, mortgage statement, or envelope from mail you received recently
- Insurance benefit card or the policy
- Medicare Benefit Card **
Proof of Medicare application can be:
- Your award or denial letter from the Social Security Administration, OR
- Your on-line confirmation letter stating that you have applied for Medicare with the Social Security Administration.
The following are exempt from all Medicaid co-payments:
How Can I Find My Medicare Number Without My Card
Need your Medicare Number but dont have your Medicare card? No need to worry you have a few options for retrieving your Medicare Number.
If you forget to bring your card to an appointment with your doctor or healthcare provider, they may be able to look it up for you.
Lost or damaged Medicare cards can be easily replaced. Give Medicare a call at 1-800-633-4227 or log into your Medicare.gov account.
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Find And View Providers And Health Plans
This website has new tools to help you find and view primary care providers and health plans.
Medicaid and NC Health Choice Provider and Health Plan Lookup ToolYou can use the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool to find a PCP. Our new provider search will help you find the best PCP for you and your family.
To search for a provider, go to .
Health Care Option GuideYou can use the Health Care Option Guide to view health plans. It will help you choose the best health plan to meet your health care needs.
To view health plans, go to .
Mandatory Waiver Provider Training
This notice is to inform all providers of services to individuals on an Ohio Department of Medicaid home and community-based services waiver of mandatory training on incident management. An incident is an alleged, suspected or actual event that is not consistent with the routine care of, and/or service delivery to, an individual enrolled on an ODM waiver.
The mandatory training can be viewed at In addition, upon entering into a Medicaid provider agreement, and annually thereafter, all providers must acknowledge in writing they have reviewed Ohio Administrative Code Rule 5160-45-05 Ohio department of Medicaid -administered waiver program: incident management system, which can be found at
Questions may be directed to ODMs contracted Provider Oversight Contractor, Public Consulting Group at 1-877-908-1746.
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When To Contact Your State Medicaid Or Chip Agency
Issues to take to your state Medicaid or CHIP agency include:
- You didnt get an enrollment card and arent sure youre covered
- You cant find a doctor who accepts Medicaid or CHIP, or you cant get an appointment
- You want to know if a service or product is covered
- You have a life change that may affect if youre eligible for Medicaid or CHIP like getting a job that increases your income, your dependent reaching an age where they no longer qualify, or getting married or divorced.
FILLING PRESCRIPTIONS IF YOU DON’T HAVE A CARD: If you need to fill a prescription and havent received your enrollment card yet, check if your pharmacy accepts Medicaid, CHIP, or your health plan. If they do, take your eligibility letter and prescription to the pharmacy. Theyll try to fill it using the information in the letter.
If they dont have enough information, most pharmacies can give you enough medicine for 3 days. Call your Medicaid or CHIP agency or health plan for help getting the rest of your medicine.
If your pharmacy doesnt accept Medicaid, CHIP, or your health plan, call the number in your eligibility letter to find a pharmacy you can use. You can usually find this information on the state Medicaid or CHIP agency website too.
What If I Think A Decision You Make Is Unfair Incorrect Or Made Too Late
You have the right to appeal the Medicaid decision. There are several ways to request an appeal. You can write the reason you disagree with the decision on the back of the decision letter and then mail or fax it to Medicaid as directed on the letter. You can also fax the decision letter to the Division of Administrative Law at 225-219-9823 or mail it to the Division of Administrative Law, Department of Health Section, P. O. Box 4189, Baton Rouge, LA 70821-4183. You can request an appeal by phone by calling Medicaid Customer Service at 1-888-342-6207 or the Division of Administrative Law at 225-342-5800.
Faq For Unitedhealthcare Community Plan Members
Are UnitedHealthcare Community Plan members eligible for this new benefit?
Coverage of COVID-19 testing is determined by each State Medicaid program, and specifics regarding coverage vary by state. For those that are dually eligible for Medicaid and Medicare, the administrator of their Medicaid benefits should provide guidance on their coverage. Members should call the number on the back of their card if they have questions.
New Requirement For Medicaid Effective November 2017
If you are turning age 65 within the next three months or you are age 65 or older, you may be entitled to additional medical benefits through the Medicare program. You may be required to apply for Medicare as a condition of eligibility for Medicaid.
Medicare is a federal health insurance program for people age 65 and for certain people with disabilities, regardless of income. When a person has both Medicare and Medicaid, Medicare pays first and Medicaid pays second.
You are required to apply for Medicare if:
- You have Chronic Renal Failure or Amyotrophic Lateral Sclerosis OR
- You are turning age 65 in the next three months or are already age 65 or older AND your income is below 120% of the Federal Poverty Level , or is at or below the applicable Medicaid Standard, then the Medicaid program will pay or reimburse you the cost of your Medicare premiums. If the Medicaid program can pay your premiums, you will be required to apply for Medicare as a condition of Medicaid eligibility.
If you have Medicaid and appear to be eligible for Medicare based on any of the criteria above, you must apply and show proof of Medicare application, or risk losing your Medicaid coverage.
When you apply for MEDICARE:
If you go to your local SSA office, you should bring:
- Proof of date of birth and
- Proof of U.S. citizenship or lawful residence and
- A copy of your Social Security card and your Medicaid card.
Proof of Medicare application can be:
- Social Security Administration 1-800-772-1213
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Will Medicaid Provide Payment For A Family Member Who Needs Nursing Home Care
Louisiana’s Medicaid Program provides payment for special long term care support services, as well as full Medicaid health coverage, to eligible people who, because of their medical condition, require assistance with activities of daily living . Long-term care supports may be provided either in a facility or in an individual’s own home or in the community. Visit Medicaid Long-Term Care.
Submit Your Application Online
If you wish to apply online, access the CMS.gov website. Check the Medicare enrollment resources for providers and then head over to the PECOS section 2. Before filling out your application, it’s necessary to register for a national provider identifier. All health care providers based in the U.S. are required to have this unique identification number.
If you already have a national provider identifier, you can apply for a Medicaid provider number right away. Simply create a user account and fill out the enrollment form. You will need to provide an email address, enter a password and confirm your identity. Your application will be approved or declined within 45 days. Paper-based enrollment, on the other hand, takes about 60 days.
- If you wish to apply online, access the CMS.gov website.
- Before filling out your application, it’s necessary to register for a national provider identifier.
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How Do I Replace My Medicaid Id Card
Call Medicaid Customer Service at 1-888-342-6207 to request a new card or visit the online Medicaid Self-Service Portal. You can create an online account at any time. Until you receive your new card you should call your health care provider before your appointment to make sure they can verify your coverage.
If you need a new Healthy Louisiana plan ID card, call the member services department for a replacement card.
How Do I Report An Address Change
Call Medicaid Customer Service toll free at 1-888-342-6207 or go online by visiting the Medicaid Self-Service Portal to update your address.
If you do not have an online account, you can create an account at any time. Creating an online account allows you to check the status of your application, report any household changes, report an address change, request a replacement Medicaid ID card, and renew your Medicaid benefits.
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How Do I Get A New Medicare Card If My Card Is Lost Stolen Or Damaged How Do I Change My Contact Information
If your Medicare card was lost, stolen, or destroyed, you can ask for a replacement by using your online my Social Security account, even if you don’t yet receive Social Security benefits. If dont already have a Social Security on-line account, you can create one online. Go to .
Once you are logged in to your account, select the “Replacement Documents” tab. Then select Mail my replacement Medicare Card.Your Medicare card will arrive in the mail in about 30 days at the address on file with Social Security.If you cant or prefer not to use the online service:
- Call us at 1-800-772-1213 , Monday through Friday, from 7 a.m. to 7 p.m. or