Friday, July 6, 2012

Alternative Assistance for Patients with Medicaid

Medically Dependent Children Program (MDCP) and Rider 28 Program
MDCP is a program that helps to decrease the amount of children and young adults cared for in nursing facilities by assisting to transfer the services in to the home. MDCP can provide assistance with many aspects of care including private duty nursing or provider services for respite, adaptive aids or equipment and minor home modifications such as wheelchair ramps and bathroom modifications.
If your child has Medicaid benefits and you are interested in enrolling in this program, you can call and enroll by phone. However due to the high demand for the program, there is a waiting list for services. To bypass this waiting list you can have your child enrolled under the Rider 28 program. If your child meets medical necessity, this program requires a short stay in a nursing facility to get benefits.
To apply for services, call 1-877-438-5658. Once you have complete the MDCP enrollment by phone, call the same number back and ask to be put on the Rider 28 waiting list.

Texas Health Steps
There are several tools out there for parents and children with Medicaid. Some you may not know about or you may not know how to access them. Below are some helpful programs offered through Texas Health Steps through the Texas Department of State and Health Services.
All services can be accessed by Monday through Friday 8 a.m. to 8 p.m. Central time by dialing:

1-877-847-8377 (1-877-THSTEPS)

Dental Checkups
Texas Health Steps dental checkups are recommended every 3-6 months, starting at 6 months of age. Below are the different types of dental health services offered for children and young adults who have Medicaid.
Preventive Services include:
·         Dental examinations (initial or periodic)
·         Cleaning (prophylaxis)
·         Oral health education
·         Application of topical fluoride
·         Application of sealants to certain teeth
·         Maintenance of space
Treatment Services include:
·         Restorations (fillings, crowns)
·         Endodontic treatment (pulp therapy, root canals)
·         Periodontic treatment (gum disease)
·         Prosthodontics (full or partial dentures)
·         Oral surgery (extractions)
·         Implant services and Maxillofacial prosthetics
Emergency Dental Services include:
·         Procedures necessary to control bleeding, relieve pain, and eliminate acute infection
·         Procedures that are required to prevent imminent loss of teeth
·         Treatment of injuries to the teeth or supporting structures
Orthodontic Services include: (Prior authorization is needed)
·         Correction of cleft palate
·         Crossbite therapy
·         Treatment for severe, handicapping malocclusion
·         Treatment for facial accidents involving severe traumatic deviation
Case Management
Need help finding and getting services?
A case manager might be able to help you.                  
Who can get a case manager?
Children (birth to age 20) and pregnant women who get Medicaid and: 
- Have health problems.
- Are at a high risk for getting health problems.
What do case managers do?
A case manager will visit with you and then:
- Find out what services you need.
- Find services near where you live.
- Teach you how to find and get other services.
- Make sure you are getting the services you need.
What kind of help can I get?
Case managers can help you:
- Get medical and dental services.
- Get medical supplies or equipment.
- Work on school or education issues.
- Get other services.
Medicaid Transportation
If you need a ride to the doctor or dentist’s office, hospital, drug store or any place you get Medicaid services, call us toll-free at: 
1-877-633-8747 (TTY: 1-800-735-2989)

Monday to Friday, 8 a.m. to 5 p.m.

To get a free ride, you or your child must be on Medicaid or be in the Children with Special Health Care Needs program. You also must not have any other way to get to the doctor or drug store.
Before you call for a free ride you must have already set up a time to see a doctor. To get a ride:
·         Call at least 2 work days or more before you need a ride. If you will need to travel a long way out of town to see your doctor, call us at least 5 work days before you need a ride. If you need a ride the same day you call us, we will do everything we can to help, but we can’t promise we will be able to get you a ride.
·         Tell us your Medicaid ID, Children with Special Health Care Needs program number or your Social Security number.
·         Tell us the address where we will pick you up. If there is a phone number at the place we are picking you up, we need that too.
·         Tell us the name, address and phone number of the doctor or drug store where you need to go.
·         Tell us the date and time of your doctor’s visit.
·         Tell us if you or your children have any special needs so we can send the right type of vehicle. For example, for people who use a wheelchair, we can send a van with a wheelchair ramp.
For more information on all Texas Health Steps Programs, go to: