The state requires newly eligible adults to enroll in their employer-sponsored health plan if one is available. CMS is still reviewing these program components and they may be added to the expansion program if CMS approves them at a later date. CE required some Adult Expansion members to participate in and report completion of specified work-related activities as a condition of continued Medicaid eligibility.
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Based on the withdrawal of this amendment, the community engagement requirement has been removed from policy and rulemaking. Generally, coverage begins on the first of the month that an application is submitted.
For example, if an individual applies during the month of April and is approved, their coverage will begin April 1. The UMIC plans will manage physical and behavioral health benefits through integrated managed care plans. Members who live in Wasatch County will receive behavioral health services through the Medicaid Fee for Service Network.
These members will be enrolled in a PMHP for behavioral health and substance use disorder services. You may also call a Health Program Representative at with questions or concerns about your benefits. Adult Expansion members may be required to enroll in their employer-sponsored insurance ESI. We will tell you if you are required to enroll in your ESI. Once enrolled, Medicaid will reimburse your portion of the monthly premium.
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We will send you a monthly check to cover your insurance premiums. If you receive an ESI reimbursement, you will also receive Medicaid coverage. Medicaid will cover your ESI co-pays, deductibles and other out-of-pocket expenses for Medicaid covered services.
In Augustthe requirement was withdrawn by CMS. Federal courts ruled that a Goshen engagement dating requirement is not consistent with the purpose of the Medicaid program, as stated in the Social Security Act. Because the requirement was adult before it was fully operationalized, there is no impact on Medicaid members.
Adult Expansion Medicaid members do not need to register for single and do not need to complete the assessment, training programs, or job searches.
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If you have questions about eligibility or to apply, call DWS: If you are a provider and have questions about claims or patient eligibilitycall the Medicaid Hotline: You may also questions to: medicaidwaiver utah. Expansion Flyer: English Spanish. Expansion Poster: English Spanish.
Expansion Pass-along Card: English Spanish. Expansion At-A-Glance Chart.
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Employer-Sponsored Insurance Requirement Overview. Material Order Form.
Medicaid Expansion. It is estimated that up toUtah adults are eligible for the expansion program.
Who Is Eligible? Utah Residents Age 19 through 64 U. Family Size. Per Month.
Per Year. What Are the Benefits?
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Doctor, hospital, and emergency services Prescriptions Laboratory and x-rays Behavioral health services including addiction and recovery treatment services Family planning services Maternity care Home health services Preventive and wellness services Chronic disease management services And more! When will coverage start? If approved, where will an individual receive services?
How Do I Apply? To apply, please find more information here. What Are the Program Requirements?
Resources Contact If you have questions about eligibility or to apply, call DWS: If you have questions about Medicaid benefits or providerscall a Medicaid HPR : If you are a provider and have questions about claims or patient eligibilitycall the Medicaid Hotline: If you are a member of the mediacall