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Medical Assistance for Families Program MA4F. Carrie Daniels Events/Publications Coordinator. Medical Assistance for Families. Working Families and Small Business Health Coverage Act – Senate Bill 6 Medicaid Expansion. Medical Assistance for Families (MA4F)
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Medical Assistance for Families ProgramMA4F Carrie Daniels Events/Publications Coordinator
Working Families and Small Business Health Coverage Act – Senate Bill 6 Medicaid Expansion Medical Assistance for Families (MA4F) • Expands full Medical Assistance coverage to parents and caretaker relatives of children covered by MCHP. Families with income levels less than 116% FPL • $16,900 for a family of 2 (previous income levels for MA were 30% or about $5,280)
Who is Covered? • Parents and relative caregivers of children • Must be taking care of children in their household • Relative caregiver by blood relation, marriage, or adoption • Adults aged 19 and up • Adults on Medicare or other Employee Based Program are also eligible. • MA4F will be considered a secondary health insurance • Will not cover prescriptions for recipients of Medicare Part D
What Does This Mean for Families? • Changed Eligibility requirements • Families can have higher income and be eligible for medical assistance. • Ability for the entire family to be enrolled in the same MCO • MCHP is still available for children under 19 and Pregnant women of any age There have been no changes to previous Medical Assistance coverage categories. This is an expansion to what already exists.
What Does This Mean for Families?Continued… • Easier enrollment process • No face-to-face interview required • Local Health Department can process your application • Income and childcare are declaratory • More streamlined enrollment process- • One main application/program for parents and children • Same benefits for entire family • Pays for any unpaid medical bills 3 months prior to activation
When Should a MA4F Application Be Used? A person should use the MA4F application if they are: • A parent or child applying for MA4F • A relative caregiver and child applying for MA4F • A child applying for MCHP • A pregnant woman applying for MCHP
Who Should Not Use a MA4F Application? • Appling for Medicaid as well as additional programs such as TCA, Food Stamps, etc. • Still apply at Social Services • Applying for PAC • use the PAC application
How Do I Apply? • Call BHCA at 410-649-0512 to get an application • Apply on-line through the SAIL service at www.marylandSAIL.org • Eligibility Processing Time • BHCA has 10 working days from the date of application • DSS has 30 calendar days from the date of application
What Information is Needed to Apply? • Information about all family members considered a household (even those not applying) such as names and birth dates • Determines family size! • If children are already on MCHP, list social security numbers but check no for “applying for” • A data-match is completed to combine the family
What Information is Needed to Apply? Continued… • Information about all members applying • Proof of Citizenship and Identity • Listed in the new MA4F Application • For a list of ways to prove citizenship and identity, see: http://www.dhmh.state.md.us/html/hotissues_citizen.htm • Social Security numbers • Information on any other health insurance coverage that you or your family might have • A person can have health insurance and still apply
What Information is Needed to Apply?Continued… ***Declaritory*** • Sources and amounts of income • Child care/day care expenses • 3 months of unpaid medical bills if applicable ***Proof of this documentation is not needed but may be requested.
What is a Family Unit? • In a three generation family, the grandparent and minor parent should be included in the family unit • Both parent and minor parent must sign • Sign anywhere on the signature page • Children may be excluded from the family unit as long as at least one child remains in the unit with the parent
What is a Family Unit?Continued… • Married persons are a separate family unit • Children living alone may apply as a family of one (if they do not have any children) • If they live with their parents they are considered part of the family unit and all incomes will be counted • Unmarried parents/relative caregivers living together and are jointly taking care of a child can get MA4F benefits
MA4F Benefits are the Same as MA/MCHP • No premiums or co-pays • Free visits to a PCP • Free visits to a mental health provider • Lower-priced and no-cost prescription drugs (Birth Control Rx are FREE) • Family Planning Services (including Tubal Ligation) • Specialty care • X-ray and lab services • Hospital services • Emergency Services
MA4F Benefits are the Same as MA/MCHPContinued… • Physical Therapy • OB/GYN care for women • Outpatient treatment for drug and alcohol abuse • Targeted case management for HIV-infected individuals • Home health services • Hospice services • Transportation services • Eye exams (Eye Glasses for beneficiaries under 21) • Dental services for beneficiaries under 21
What About Women on the Family Planning Program? • FP recipients must apply for MA4F (no automatic transfer will occur) • Family Planning Renewal is renewed yearly • There is no initial two year eligibility period • Maximum eligibility is now 5 years • Women can not be on FP and MA4F • Women can be cancelled prior to the five year period by: • Exceeding the qualifying family income level (250%) • If a women becomes pregnant while on FP, she must re-apply for MCHP – income limits for pregnant women are still up to 250% of FPL
Questions? • If you need further information or if you have a policy question related to the expansion, go to: MAexpansion@DHMH.state.md.us • Call the Medical Assistance Hotline: (800) 456-8900 or TDD for the Disabled: (800) 735-2258 • For access to outreach and other materials related to the expansion, go to: www.dhmh.state.md.us/ma4families Or Call Baltimore HealthCare Access at 410-649-0500 and ask for our Hotline Staff, or visit our website at www.bhca.org CALL 311!!!