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Medicaid Frequently Asked Questions

Frequently asked Medicaid questions

 

 

Is my Medicaid active?

 

I lost my Medicaid card. How do I get another one?

 

I can't get my prescription. Who can help me?

 

I am not sure if I should to go to the emergency room, who can I call?

 

How do I change my information or report the birth of my child?

 

I have both Medicare and Medicaid, why doesn't Medicaid pay for my prescriptions if I have Medicare?

 

Why was I enrolled in a Medicaid HMO?

 

How do I disenroll from a Medicaid HMO?

 

How can I get help in choosing a Medicaid PCP?

 

Where do I find the list of Medicaid Specialists?

 

I got a bill from a provider. What do I do?

 

I am going out-of-state. What do I do if I need medical care?

 


 

Q. Is my Medicaid active?


A. You can check if your Medicaid is active by going to the Colorado PEAK Web site and clicking on the "Check My Benefits" button.  You can also call your local County Department of Social/Human Services , or Medicaid Customer Service at 1-800-221-3943.

 

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Q. I lost my Medicaid card. How do I get another one?


A. Contact your local  County Department of Social/Human Services  to get a replacement Medical Identification Card (MIC). You can also contact Customer Service at 1-800-221-3943.

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Q. I can't get my prescription. Who can help me?


A. For assistance call Customer Service at 1-800-221-3943.

 

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Q. I am not sure if I should to go to the emergency room, who can I call?


A. Call the NURSE ADVICE LINE at 1-800-283-3221

 

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Q. How do I change my information or report the birth of my child?


A. Contact your local  County Department of Social/Human Services

 

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Q. I have both Medicare and Medicaid, why doesn't Medicaid pay for my prescriptions if I have Medicare?


A. Medicaid is the payer of last resort, which means Medicaid pays last. If you have other insurance such as Medicare Part D prescription drug benefit, in most cases Medicare will pay for your prescriptions. There are a very limited number of Medicare excluded drugs that are still covered by Medicaid.

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Q. Why was I enrolled in a Medicaid HMO?


A. Passive enrollment encourages client participation in a Medicaid managed care health plan and promotes selecting a primary care physician as the client's medical home. For more information call HealthColorado, the Medicaid enrollment broker at 303-839-2120 (within Metro Denver), or 1-888-367-6557 (outside Metro Denver).

 

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Q. How do I disenroll from a Medicaid HMO?


A. You can call HealthColorado, the Medicaid enrollment broker at 303-839-2120 (within Metro Denver), or 1-888-367-6557 (outside Metro Denver).

 

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Q. How can I get help in choosing a Medicaid PCP?


A. You can call HealthColorado, the Medicaid enrollment broker at 303-839-2120 (within Metro Denver), or 1-888-367-6557 (outside Metro Denver).

 

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Q. Where do I find the list of Medicaid Specialists?


A. You can use the Medicaid Provider Lookup, or contact Customer Service at 1-800-221-3943.

 

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Q. I got a bill from a provider. What do I do?


A. First, contact the provider that is billing you and get all the information as to why the provider is billing you. Then contact Customer Service at 1-800-221-3943.

 

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Q. I am going out-of-state. What do I do if I need medical care?


A. If you are temporarily out-of-state, but still are a resident of Colorado, you may receive some Medicaid benefits under certain conditions:

  1. It is a medical emergency that is life or limb threatening, as determined by the doctor.
  2. Your health would be endangered if you were required to return to Colorado for the medical care/treatment.
  3. The Out of State provider is only reimbursed if they are enrolled in or are willing to enroll in the Colorado Medicaid Program.

 

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