Medicaid is a state health insurance program that is partially funded by and must meet guidelines set forth by the federal government. Doctors typically run Medicaid eligibility checks before seeing patients on Medicaid to ensure that Medicaid is still active.
Contact your state Medicaid office to ask about Medicaid eligibility tools. Many states offer online benefit-checking tools that require entering an individual's name and either a Social Security number or Medicaid number.
Enter in all requested information in the forms on the benefit eligibility screening tool. If a tool is not available, give the patient's information to the phone operator at the number on the back of the Medicaid card so the phone operator can run an eligibility check.
Review information provided by the phone operator or benefit screening tool. If this information is for yourself and you disagree with it, contact your local Medicaid office. If the information is regarding a patient of yours, suggest that the patient contact the Medicaid office to resolve the issue.
Warnings
A common reason for losing Medicaid is failure to attend the annual recertification appointment. You must attend these appointments. If you move, you should update your contact information within 10 days so you'll receive notices for the appointments.
References
- Center for Medicare and Medicaid Services
- U.S. Centers for Medicare & Medicaid Services. "Financial Management." Accessed Aug. 27, 2020.
- U.S. Centers for Medicare & Medicaid Services. "Medicaid - Eligibility." Accessed Aug. 27, 2020.
- U.S. Centers for Medicare & Medicaid Services. "Medicaid." Accessed Aug. 27, 2020.
- U.S. Centers for Medicare & Medicaid Services. "NHE Fact Sheet." Accessed Aug. 27, 2020.
- U.S. Centers for Medicare & Medicaid Services. "Federal Poverty Level (FPL)." Accessed Aug. 27, 2020.
- Lyndon B. Johnson Presidential Library. "Medicare and Medicaid." Accessed Aug. 27, 2020.
- Kaiser Family Foundation. "Federal and State Share of Medicaid Spending." Accessed Aug. 27, 2020.
- Congressional Research Service. "Medicaid’s Federal Medical Assistance Percentage (FMAP)," pages 2, 16 and 17. Accessed Aug. 27, 2020,
- U.S. Centers for Medicare & Medicaid Services. "How Much Do States Spend Per Medicaid Enrollee?" Accessed Aug. 27, 2020.
- Kaiser Family Foundation. "Medicaid Enrollees by Enrollment Group." Accessed Aug. 27, 2020.
- Kaiser Family Foundation. "Medicaid Spending by Enrollment Group." Accessed Aug. 27, 2020.
- U.S. Centers for Medicare & Medicaid Services. "Medicaid, Children's Health Insurance Program, & Basic Health Program Eligibility Levels." Accessed Aug. 27, 2020.
- U.S. Centers for Medicare & Medicaid Services. "What to include as income." Accessed Aug. 27, 2020.
- U.S. Centers for Medicare & Medicaid Services. "RE: Opportunities to Promote Work and Community Engagement Among Medicaid Beneficiaries," pages 1-10. Accessed Aug. 27, 2020.
- U.S. District Court of Appeals in the District of Columbia. "Charles Gresham v. Alex Azar, II, 19-5094 (D.C. Cir. 2020)," pages 16-19. Accessed Aug. 27, 2020.
- U.S. Centers for Medicare & Medicaid Services. "Read the Affordable Care Act." Accessed Aug. 27, 2020.
- U.S. Supreme Court. "National Federation of Independent Business v. Sebelius, 567 U.S. 519 (2012)," pages 522-524 and 575-588. Accessed Aug. 27, 2020.
- Kaiser Family Foundation. "The Uninsured and the ACA: A Primer," page 7. Accessed Aug. 27, 2020.
Writer Bio
Matt Knouff is a mental health professional, programmer and freelance writer from Lafayette, Ind. His educational background includes a bachelor's degree in psychology and anthropology from Purdue University and undergraduate certificates in computer science and music production. He has been writing professionally for three years and currently writes for TopTenReviews.com and other online publications.