Medicaid Policy
Medicaid Policy
An individual is not eligible for the Medicaid Cancer Program if the individual is enrolled in or is eligible for certain health coverage. Applicants who provide necessary verifications, cooperate with medical support enforcement (if applicable-see 227), and are found eligible for other Medicaid programs are not eligible for the Medicaid Cancer Program. If the applicant does not submit all the necessary verifications to determine eligibility for other Medicaid programs, and they qualify for the Medicaid Cancer Program, approve the Medicaid Cancer Program.
Medicaid
Adults are not eligible for the Medicaid Cancer Program if the qualify for other programs. Some of the other Medicaid programs include:
Parent and Caretaker Relative;
Pregnant Woman; and
Adult Expansion.
If individuals are Medicaid Cancer Program eligible, do not put them on:
Targeted Adult Medicaid;
Medically Needy programs; or
Refugee Medical Assistance.
Armed Forces
An individual who is eligible for health coverage provided by the Armed Forces is not eligible for the Medicaid Cancer program.
Medicare
An individual who is enrolled in Part A or Part B Medicare is not eligible for the Medicaid Cancer program.
Health Insurance or Group Health Plan
An individual enrolled in any health insurance or a group health plan is not eligible for the Medicaid Cancer Program unless:
· The plan does not provide benefits for cancer treatment.
· The plan is limited coverage even if the plan covers the cancer treatment. Limited coverage plans are insurance plans that only provide medical care for a single type of service or specific disease, under special circumstances, or where the medical care is secondary to the primary purpose of the insurance (i.e., medical under automobile insurance.)
· The coverage is under the Indian Health Services.
There is no sanction or waiting period if an applicant terminates their health insurance coverage.
E. Co-Pays
Individuals on the Medicaid Cancer Program are not required to pay co-pays.