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* If unfamiliar with Managed Care, ask your caseworker or Case Manager in the Special Needs Unit. To contact a Special Needs Unit in your area:

AmeriHealth Mercy Health Plan . . . . . .1(888)991-7200 . . . TTY 1(888)987-5704

Gateway Health Plan . . . .. . . . . . . 1(800)642-3550 . . . TTY 1(800)654-5988

Unison Health Plan/MedPLUS+ . . . . . . .1(877)844-8844 . . . TTY 1(800)473-0989

AmeriChoice of Pennsylvania, Inc. . . . .1(800)321-4462 . . . TTY 1(800)654-5984

Health Partners of Philadelphia, Inc. . .1(866)500-4571 . . . TTY 1(877)454-8477

UPMC for You . . . . .  . . . . . . . . .1(800)286-4242 . . . TTY 1(800)361-2629

Keystone Mercy Health Plan .  . . . . . .1(800)521-6860 . . . TTY 1(800)684-5505

Access Plus . . . . . . . . . . . . . . .1(800)657-7925 . . . www.accessplus.org  

Medical Assistance for Workers with Disabilities - MAWD

* Full Medicaid coverage is available for those:

* Age 16 years to 64 years

* Who are considered disabled by meeting social security criteria and are employed or self employed

* Who meet income and resource criteria

- Is more generous than traditional Medicaid

- There are deductions that may apply

* Participants pay a monthly premium based on their income

* For more information visit www.dpw.state.pa.us   

Children’s Health Insurance Plan - CHIP

CHIP General Information and Tips

* Free and Low-Cost coverage for uninsured children up to age 19

* Must be a PA resident

* Child must be a US citizen or be in lawful status

* Eligibility determination considers age of child and household income

* Determination considers child for either CHIP or Medicaid

* Pre-existing conditions and assets are not a consideration

* Enrollment is for 12 consecutive months; renewals occur yearly

* Benefits are a comprehensive package; no deductibles

* No co-pays with Free CHIP. There are co-pays with Low-cost and Full-cost programs

* Identification cards are from insurance carrier and are not unique to CHIP

* Notices are sent to advise of changes

* An Eligibility Review Process (ERP) exists to allow for a review of an eligibility decision

* A single application can be used to apply for CHIP or Medicaid

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Appendix G: Medicaid/MAWD/CHIP/adultBasic continued

adultBasic Insurance Plan-adultBasic General Information and Tips

* Low-cost coverage for uninsured adults, age 19 through age 64

* Must be a resident of PA for 90 days, a US citizen, or be in lawful status

* Must have had no health insurance coverage in last 90 days, except for a person or their spouse who lost health insurance coverage because they are no longer employed

* Pre-existing conditions and assets are not a consideration

* Eligibility determination considers household income, age, and number of persons in the household

* Determination considers adult for either adultBasic or Medicaid

* If enrolled, a low monthly premium payment is required as well as co-pays; no grace period if premium payment not made

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