2. What is a restricted plan under Medicaid ? 3. How is Medicaid – eligible patients...

2. What is a restricted plan under Medicaid ?

3. How is Medicaid – eligible patients identity verified

Expert Solution

ANSWER 2:

RESTRICTED PLAN UNDER MEDICAID:

LIMITS THE UNWANTED AND INAPPROPRIATE USE OF MEDICAID SERVICES.
THE SELECTED PERSONS UNDER THIS PROGRAMME ARE PROVIDED WITH RESTRICTION PROGRAMME CARD.
THEY ARE ELIGIBLE ONLY FOR ONE PRIMARY CARE PROVIDER AND ONE PHARMACY.
THE PRIMARY CARE PROVIDERS AND THE PROVIDERS TO WHOM THEY ARE REFERRED SHOULD BE AMONG THOSE ENLISTED IN THIS PROGRAMME EXCEPT FOR EMERGENCY CASES.

ANSWER 3:

PROCESS OF IDENTITY VERIFICATION OF MEDICAID -ELIGIBLE PATIENTS:

ELIGIBILITY IS DETERMINED BY TWO MAIN FACTORS: FINANCIAL AND NON-FINANCIAL

1. FINANCIAL ELIGIBILITY CRITERIA:

INCOME ELIGIBILITY BASED ON MODIFIED ADJUSTED GROSS INCOME(MAGI)
RELATED TO THE TAXABLE INCOME AND TAX-FILING RELATIONSHIPS
ELIGIBLE FOR CHILDREN, ADULTS, PREGNANT WOMEN AND ALSO FOR BLIND AND DISABLED .
CHILDREN WITH ADOPTION ASSISTANCE AGREEMENT, YOUNG ADULTS WHO ARE FORMER FOSTER CARE RECIPIENT ARE ELIGIBLE.

2. NON-FINANCIAL ELIGIBILITY CRITERIA:

CITIZEN OF THE UNITED STATES, CERTAIN QUALIFIED PERMANENT RESIDENTS
CERTAIN OTHERS ARE CATEGORIZED BY AGE, PREGNANCY OR POSITION OF CERTAIN PARENTS.

Nightingale answered 2 years ago

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