805            MEDICAID RECIPIENT IDENTIFICATION CARD

805 A.         ISSUING MEDICAID TO ELIGIBLE RECIPIENTS

There are four ways that DPADivision of Public Assistance issues written documentation that a recipient is eligible for Medicaid coverage in a given month. These documents inform the recipient and their health care provider of the recipient’s Medicaid identification number, which the provider needs to submit a claim to Medicaid. Many medical providers require written proof of Medicaid eligibility before they will provide service to an individual. Any of the following documents will serve as proof of Medicaid eligibility:

1.  STANDARD SYSTEM ISSUED RECIPIENT IDENTIFICATION CARD

Each person approved for Medicaid will receive a Medicaid Recipient Identification (ID) card. Children enrolled in Medicaid will receive a Denali KidCare card while adults will receive a Denali Care card. This card can be used for health care and certain medically related services only for the person named on the card. The coverage period is generally twelve months and is valid for the period shown on the front of the card as long as the recipient remains eligible. Although the cards display coverage dates, it is not a guarantee of coverage or eligibility.

1. Standard cards are mailed to recipients for the following circumstances:

• One card per recipient per authorized application

• One card per individual per authorized month of retroactive Medicaid

• One card per new member add-on

• One card per recipient per authorized renewal

2. Cards should also be reissued for the following changes in circumstances:

• Name

• Client identification number

• Date of birth

• Eligibility code

• Coverage effective dates or resource code

• Lost, stolen, or client request

3. Cards are not issued to recipients eligible for SLMBSpecial Low-Income Medicare Beneficiary coverage.

2.  NON-STANDARD SYSTEM ISSUED RECIPIENT IDENTIFICATION CARD

A non-standard Recipient Identification card (traditional Medicaid coupon) has similar recipient and medical resource information as the standard Denali Care or Denali KidCare card but is used for a recipient whose Medicaid coverage is restricted to certain services, such as an exam for a blindness or disability determination or waiver screening. This ID card contains a statement of the service limitation. A provider may photocopy this card and submit it with their claim for reimbursement.

3.  FIELD BENEFIT ISSUANCE

Once Medicaid coverage has been authorized, a Field Benefit Issuance can be printed at any DPADivision of Public Assistance office. A Field Benefit Issuance contains similar recipient and medical resource information as a standard system issued Denali Care or Denali KidCare ID card. A Field Benefit Issuance is provided when the Denali Care or Denali KidCare card is needed immediately and the recipient cannot wait for mail delivery.

4.  MANUAL BENEFIT ISSUANCE

A Manual Benefit Issuance is the only form of documentation that can be printed for Emergency Treatment for Aliens because coverage for this special category is not considered regular Medicaid. It is also used for HPEHospital Presumptive Eligibility determinations. Although similar to a Field Benefit Issuance, additional instructions must be entered in the Special Information field on the Manual Benefit Issuance to specify the covered dates of services.

A Manual Benefit Issuance for a recipient eligible for any category of Medicaid that is assigned for the Care Management Program (CMP) can only be printed by Health Management Systems (HMS). A Manual Benefit Issuance can be requested on behalf of the recipient by contacting the HMSHealth Management Systems at 907-644-6842.

5.  ISSUANCE TO HOMELESS INDIVIDUALS 

A permanent address is not required. Recipients are allowed to choose the method of receiving their Medicaid cards:

• Mailing to General Delivery at a post office of their choice;

• Picking up their card at their local DPADivision of Public Assistance office; or

• An alternate mailing address with assurance of receipt of mail.

805 B.      AUTHORIZED REPRESENTATIVE

If an authorized representative (e.g., a public guardian) requests the Recipient Identification Card to be sent to him or her, the caseworker must also enter the authorized representative's address in the system.

805 C.       USING THE IDENTIFICATION CARD OR MANUAL COUPON

The recipient must be advised that it is their responsibility to:

• Present a current Recipient ID Card when each medical service is received;

• Ensure that the medical provide they choose is an enrolled provider in the Alaska Medicaid Health Enterprise;

• Ensure that the service they are receiving is covered by Medicaid;

• Be prepared to present proof of their identity;

• Guard their Recipient ID Card to prevent use by unauthorized persons; and

• Pay for any medical services for which a Recipient ID Card was not properly presented.