Medicaid Member Card Information
Medicaid and Primary Care Network (PCN) members receive a wallet-sized plastic Medicaid card. The card will be used whenever the member is eligible for Medicaid. Each Medicaid member will get their own card. The card will have the member’s name, Medicaid ID number, and date of birth. The back of the card has helpful contact information and websites for both providers and members. Here is a sample of the Medicaid Member Card.
In addition to the Medicaid card, members will receive a Benefit Letter in the mail. The Letter has eligibility and plan information. When there are changes, Medicaid will send a new Benefit Letter. Please keep this letter for your records.
To check eligibility, Members can call the Medicaid Member Services hotline: 1-844-238-3091
If lost or damaged, members can call the Department of Workforce Services to request a new card: 1-866-435-7414
Using My Medicaid Card
It is important to show each health care provider your Medicaid Member Card BEFORE you receive any services. To avoid problems, carry the cards listed below with you each time you seek health care services.
Medicaid Member Card: Show your Medicaid Member Card BEFORE each appointment and BEFORE you order medical supplies, prescriptions, hearing aids, etc. When you show your card before you get medical care, you can find out if the health care provider accepts Medicaid and whether the service is covered.
Health Plan (ACO) Card: If you are also enrolled in a health plan, your health plan may also send you a separate member card with instructions. Show both your Medicaid Member Card and the health plan card to each medical provider. Then you can find out if the services you will receive are covered by Medicaid.
Picture I.D. Card: When you see a health care provider for the first time, you may be asked to show a picture identification card as well. This is to prevent someone else from using your Medicaid or health plan cards to get health care services. Neither Medicaid nor your health plan will pay a provider for services given to a patient who was not covered.
What do I do with medical bills?
Pay attention to the mail you get for medical care. If the bill says that you owe money, you should:
- Make sure your provider’s office has a copy of your Medicaid card for the month of the service.
- Call the provider’s office. Ask if they have billed your health plan or Medicaid.
- If they have billed for the services but have not heard back from the health plan or Medicaid, ask if they will check on the claim. You can also call and check on the claim.
- If you have called your provider’s office and checked on the claim but you still have problems, call an HPR.
You may have to pay your own medical bills for Medicaid covered services if:
- You see a provider who is not part of your health plan
- You receive services without showing your Medicaid Member Card to the provider
You will have to pay the bill for services you get:
- When you were not eligible for Medicaid
- During an appeal, grievance or hearing if the action is denied
- If the services you receive are not covered by Medicaid
If you get services that Medicaid does not cover, you have to pay for the services yourself. You should sign a form that says:
- What non-covered service you will have.
- You know it is not a Medicaid covered service.
- How much you will have to pay.
If you receive about a bill from a medical provider, you talk to the provider about the bill, and you still have a question, call Medicaid Information at 801-538-6155 or toll-free at 1-800-662-9651.