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Apr 7 2019

DSS Medical Assistance Services: Medicaid – Delaware Health and Social Services – State of Delaware

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Medicaid

Medicaid furnishes medical assistance to eligible low-income families and to eligible aged, blind and/or disabled people whose income is insufficient to meet the cost of necessary medical services. Medicaid pays for: doctor visits, hospital care, labs, prescription drugs, transportation, routine shots for children, mental health and substance abuse services.

  • Delaware Medicaid providers may access the Delaware Medical Assistance Provider manual at: http://www.dmap.state.de.us/index.html

Eligibility

  • You can have a car, bank account, and a home and still qualify for Medicaid. DSS does not look at any of your resources when determining your eligibility for Medicaid.
  • You can work and still qualify for Medicaid.
  • Some persons can have other insurance and still receive Medical Assistance.
  • Low-income uninsured adults between the ages of 19 and 65 may qualify for Medicaid.
  • Certain children living with stepparents, grandparents, or siblings with income may receive Medicaid.
  • Needy families with children may be eligible for Medicaid if they are part of Temporary Assistance for Needy Families.
  • When a family getting a welfare check starts working and leaves welfare they still may receive Medicaid.
  • Low-income pregnant women and children under age 19 may qualify for Medicaid.
  • Most women of child bearing age may be eligible for birth control and family planning services for up to 24 months after their regular Medicaid stops.

Most people receiving Medicaid are enrolled with one of the managed care plans under the Diamond State Health Plan.

To apply for Delaware Healthy Children’s Program click here

Diamond State Health Plan – Delaware s Medicaid Managed Care Program

The majority of people receiving Medicaid must choose a family doctor who, along with a managed care organization (MCO), will provide or arrange for all your preventive care and medical needs. The following individuals are not enrolled with a MCO:

  • Individuals entitled to or eligible to enroll in Medicare
  • Individuals residing in a nursing facility or intermediate care facility for the mentally retarded (ICF/MR).
  • Individuals covered under the Medicaid home and community based waiver programs.
  • Non lawful and non qualified non citizens (aliens).
  • Individuals who have military health insurance for active duty, retired military, and their dependents.
  • Individuals eligible for the Medicaid Breast and Cervical Cancer program.
  • Presumptively eligible pregnant women.

Government and Services


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