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Frequently Asked Questions
Beneficiary FAQ's  

 
1.  On Beneficiary Eligibility response page, what is 'lock-in information'?
     Lock-in indicates that the beneficiary can receive services only from certain providers or only with authorization from that provider.

2.  How far back does the web portal go for checking eligibility?
     Eligibility is never purged, therefore, it goes back many years.

3.  Is my Medicaid still open (active)?
     In order verify your eligibility; please call 1-800-421-2408 or 1-800-884-3222. Please have your Medicaid number or Social Security number available.

4.  Does Medicaid still pay for prescriptions?
     Medicaid will still cover your prescription if you are Medicaid eligible ONLY.

5.  My doctor told me I am out of office visits and that I should call to get more office visits. How do I get more office visits?
     Medicaid only pays for 12 office visits per fiscal year (July to June) for adults. For children under the age of 21 additional visits may be approved with a Plan of Care submitted by the doctor to DOM.

6.  I received a letter from Social Security that Medicaid will pay my Medicare premium for Part B. When will Medicaid start paying?
     If you are not currently on Medicaid, you must first apply for Medicaid and qualify, then Medicaid will pay your premium.
If you are currently on Medicaid, please report the start of your Medicare to your local Medicaid Regional Office to have your case updated.

7.  I have Family Planning Medicaid and Medicaid did not pay for my Emergency room visits or my prescription. Why?
     The Family Planning Medicaid Waiver only covers services relate to family planning visits, birth control and other limited family planning services.

8.  I am on Family Planning Medicaid and I am pregnant. How do I get on regular Medicaid?
     Please contact your local Medicaid Regional Office to apply.

9.  I take seven prescriptions and Medicaid will only pay for the first five. How can I get my other two prescriptions?
     Medicaid provides no additional coverage for more than five prescriptions. Please check with your physician concerning possible resources with Prescription Assistance Programs.

10.  How many doctor (office) visits have I used so far?
     Medicaid tracks the number of claims billed. It is the beneficiary's responsibility to keep track of the number of office visits made.

11.  I never got my Medicaid card. Will you send me a Medicaid card?
     You may order a Medicaid card by calling 1-800-884-3222.

12.  Why was my Medicaid terminated?
     Please contact your local Medicaid Regional Office to speak with your Medicaid Specialist.

13.  I received a bill and I had Medicaid. Why didn't Medicaid pay this bill?
     Please call Division of Medicaid - Beneficiary Relations at 1-800-421-2408. Please have your Medicaid number or social security number available when you call.

14.  I need my teeth cleaned and several fillings done. Will Medicaid pay for my dental services?
     Medicaid only covers tooth extractions, pain management and infection control for adults in specific eligibility categories. Most general dental services are covered for children, however some require prior authorization.

15.  What type of coverage do I have with Medicaid?
     For an explanation of your Medicaid coverage, please call Division of Medicaid - Beneficiary Relations at 1-800-421-2408. Please have your Medicaid number or social security number available when you call.

16.  Will Medicaid sell my house if I go on the Waiver Program or in a Nursing Home?
     There is a process called Estate Recovery for Beneficiaries that receive Nursing Home and Home and Community Based Waiver services. However, Medicaid does not sell your property to recoup money spent. For details on Estate recovery, you should speak with your Medicaid Specialist in the local Medicaid office. Also, you may read the policy on Estate Recovery on Medicaid's website at http://www.medicaid.ms.gov

17.  I was in a car accident and Medicaid paid all my medical bills, will Medicaid get my money if Issue the Automobile Insurance company?
     Medicaid will recover all money paid for medical services related to the accident and paid by Medicaid. When your claim against the Insurance Company is settled, a check in the amount paid by Medicaid should be sent to Medicaid as reimbursement for the money Medicaid spent.

18.  I never got a notice telling me my child's Medicaid had been cut off, now my child's doctor is billing me. Why didn't Medicaid send me a letter telling me my Medicaid was being cut off?
     Medicaid mails notice to the address of record. Mailings from the Division of Medicaid can not be forwarded by the postal services. All changes should be reported to your local Medicaid Regional Office.

19.  Will Medicaid transport me and my children to the doctor?
     Medicaid will provide non-emergency transportation services to Medicaid eligible beneficiaries that have appointments with Medicaid providers. You must contact Logisticare (1-866-331-6004) 72 hours in advance of your scheduled appointment to arrange transportation to your medical appointment.

20.  I have lost my prescription drug card and I don't remember what Plan I had. Can you tell me what Drug Plan Medicaid put me in?
     Medicaid did not assign you to a drug plan, this is a Medicare program. However, you can contact the Medicare Plan Line at 1-866-835-7595 for assistance.

21.  I was told by the pharmacist that Medicaid will not pay for my child's prescriptions. Why?
     The prescription that you were unable to purchase may need a prior authorization number and this must be requested in writing by your physician.

22.  What is TPL?
     TPL stands for Third Pary Liability. This means that a person or entity is repsonsible for medical expenses other than Medicaid.

23.  Medicaid says I (a beneficiary) have insurance. My bills are being denied and the doctor's office is calling me.
     Contact Jean Trim in the Bureau of Recovery with the name of the provider, contact number and dates of services. A staff member will assist the provider in resolving the matter.

24.  How can I get my medicine from my pharmacy when they say I have other insurance?
     Contact Jean Nickson in the Bureau of Recovery. A Medicaid Investigator will contact the pharmacist to assist with filing your claim to expedite filling your prescription.

25.  When someone dies on Medicaid in a nursing home does Medicaid automatically take the property?
     No. Medicaid determines the value of the property and the amount paid for applicable medical services. The family is notified of the amount to reimburse Medicaid.

26.  What is a Medicaid Lien and how much is the percentage?
     Mississippi is not a lien state for Estate Recovery purposes. Medicaid uses the amount paid on nursing home related claims and the value of the estate to determine the amount the family owes the state. The family is expected to pay 100%.

27.  Estate Recovery?
     Estate Recovery is collecting Medicaid payments from deceased Medicaid recipients' estates who receive services at the age of 55 or older in long term care.

28.  Do I owe Medicaid any money from a check that I received from my private insurance company?
     You may if Medicaid paid for the same dates of service as the insurance company.

29.  Where do I send the check to reimburse Medicaid?
     Send the check and explanation of benefit from the insurance company or a letter with your Medicaid identification number and date of service explaining the nature of the overpayment to:

Division of Medicaid
Accounting Department
Suite 1000 Sillers Bldg
500 High Street
Jackson, MS 39201,


30.  How will Medicaid know how to credit my account?
     Medicaid will compare its payment for services with the explanation of benefit from the third party. If Medicaid paid for the same service, the third party payment will be collected as reimbursement. A notice will be sent to the beneficiary showing the credit on the account.

31.  What is needed from an attorney or claim adjuster to release the amount medicaid paid for medical treatment to a beneficiary who was involved in a vehicular accident?
     Medicaid needs a letter of representation from the attorney. The claim adjuster may send a written request. Requestors must also send authorization signed by the beneficiary, or parent or legal guardian, if a minor, permitting the release of information. These statements may be faxed to Barbara Rhodes at (601) 359-6632