Medicaid & CHIP
Using your new Medicaid or CHIP coverage
If you're enrolled in Medicaid or the Childrenâs Health Insurance Program (CHIP), here are some things to know about coverage and care.
Using your coverage
For most questions, contact your state Medicaid or CHIP agency.
- If youâre enrolled in a health plan through Medicaid or CHIP, contact the member services phone number on your eligibility letter or the back of your enrollment card. This information should also be on the websites of your health plan or Medicaid or CHIP agency.
- Talk to your doctor or pharmacist. They may be able to answer questions about what services are covered.
When to contact your state Medicaid or CHIP agency
Issues to take to your state Medicaid or CHIP agency include:
- You didnât get an enrollment card and arenât sure youâre covered
- You canât find a doctor who accepts Medicaid or CHIP, or you canât get an appointment
- You want to know if a service or product is covered
- You have a life change that may affect if youâre eligible for Medicaid or CHIP â like getting a job that increases your income, your dependent reaching an age where they no longer qualify, or getting married or divorced.
If they donât have enough information, most pharmacies can give you enough medicine for 3 days. Call your Medicaid or CHIP agency or health plan for help getting the rest of your medicine.
If your pharmacy doesnât accept Medicaid, CHIP, or your health plan, call the number in your eligibility letter to find a pharmacy you can use. You can usually find this information on the state Medicaid or CHIP agency website too.
More answers
If you got a letter stating youâve been enrolled in Medicaid or CHIP, you should still be able to get health care services. Show your provider a copy of your eligibility letter. Your provider can verify your enrollment.How do I find a doctor or pharmacist in my area that accepts Medicaid or CHIP?
- Ask your current doctor or pharmacist if they accept Medicaid, CHIP, or the health plan you selected. If you've been getting care from a provider who doesnât accept Medicaid, CHIP, or any of its health plans, you may be able to keep seeing that provider for a short time until you can find another provider. But you need to ask your stateâs Medicaid or CHIP program, or the health plan you selected.
- Most Medicaid and CHIP programs and health plans have websites that tell you what providers are available.
- Call your state Medicaid or CHIP agency or your health plan. The phone number should be on your eligibility letter, the back of your enrollment card, or your agency or health planâs website.
When you make an appointment, be sure to tell your provider that youâre enrolled in Medicaid or CHIP, or give them the name of your health plan. If youâre having trouble getting an appointment, call your state Medicaid or CHIP agency or your health plan.
You can ask your stateâs Medicaid or CHIP program to review the providerâs bill. This is called an appeal.
Your state Medicaid or CHIP agencyâs website will have information on how to file an appeal. Or you can call your state agency or your health plan. Theyâll help you with your appeal.