You may also deduct from your income:
- Medical bill that
have been paid in the last 90 days and any unpaid medical bills
- Ongoing medical
bills, such as prescriptions you must pay each month
- $90 plus transportation
and child care expenses for any income earned through employment
- In some cases only
half of your wages count
You must have minor
children in your household for the whole family to qualify for
full MA unless you:
- are physically or
mentally disabled, and the disability prevents you from working;
- are in a drug or
alcohol treatment program that prevents you from working (only
9 months in a lifetime)
- care for a child
under 18 (not your own), or care for an ill or disabled adult;
- are a victim of
domestic violence (only eligible for 9 months in a lifetime);
- are pregnant, or
have a young child (see Healthy Beginnings section);
- are a two-parent
household, with a child under 13, that does not qualify for
TANF;
- are a full-time
student 18--20 in high school or vocational school and will
graduate before you reach 21.
Resource
Limitations
The resource
limit for full Medical Assistance is $1,000, regardless of family
size and $250 for an individual. Resources consist of cash on
hand or things that can be easily cashed out, such as stocks or
bonds, insurance policies, IRAs, etc. Many things do not count
as resources, including:
- one car of any value
- your home and home
furnishings
- retroactive Welfare
payments
- basic items needed
for essential "day-to-day" living
- life insurance policy
(less any cash value that it has)
- an Educational Savings
Account (funds to be used specifically for educational expenses)
Full
MA Basic Coverage
Full MA
provides a managed care (HMO) program for those who are eligible.
Each HMO will provide a comprehensive benefit package to Health
Choices members. Even though each HMO package will not be exactly
the same, all HMO's should offer the following basic services:
- visits to your doctor
- visits to your doctor
while you are pregnant
- baby and child
care, including regular checkups and immunizations (baby shots)
- visits to a specialist
when referred by your primary care doctor
- basic dental care
- family planning
- prescribed drugs
(with some exceptions)
- vitamins
- emergency transportation
(ambulance)
- hospitalization
- laboratory tests
and diagnostic tools (x-rays, cardiograms, etc.)
- surgery
- physical therapy
- speech therapy
- nursing care (limited
to the first 30 days)
- items such as hearing
aids, nebulizers, apnea monitors, and wheel chairs
- transportation
services (contact your HMO or County Assistance Office for more
information)
- EPSDT services
covering all medically necessary services for children under
21 including dental, vision, and hearing problems.
Mental health and
substance abuse
Important things
to remember:
- Choosing an HMO.
Choosing the right HMO is extremely important because each HMO
provides slightly different services and has a different network
of doctors. Certain doctors are only members of a specific HMO.
It may make sense to choose a doctor (Primary Care Physician
- PCP) and then enroll in the HMO where your doctor is a member.
Call the Benova Hotline at (800) 440-3989 for help in choosing
your HMO.
- In addition to
the Health Choices program described here, you may be eligible
for Healthy Horizons and Healthy Beginnings. They are described
in their own sections below.
Primary Care Physicians
(PCP).
This is the doctor,
or in some cases where permitted, the certified nurse practitioner,
whom you will see for care. A PCP is responsible for providing
primary and preventive care; recommending and arranging for care;
maintaining continuity of your health care; and making referrals
for specialty care and other medically necessary services both
in and out of plan.
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