Facts about Medicaid Enrollment

for New Parents

Now that your new infant will be coming home from the hospital, you need to be aware of your healthcare choices under the Medicaid program.  The hospital should have started an application for your child shortly after the time of birth.  If you are receiving a medical card for yourself, your new child should be added to that same medical card.  Because you have a new family member who will become part of the Medicaid system, this is a good time to give you a few facts about your program options.  In addition, you need to know that if your child is receiving SSI, he or she may not be enrolled in an HMO but must be covered by a straight Medicaid plan.  Therefore, if your child is on SSI and on an HMO, contact the HMO immediately to have them removed.    

The following is a list of information you should consider when finalizing your child’s medical plan.

  •  The Medicaid program provides coverage for your child’s healthcare costs and there are different medical plans available within the Medicaid system.

  • One medical plan is straight Medicaid.  Enrollment in straight Medicaid allows you to see any doctor that you choose, so long as that doctor accepts Medicaid.

  • The other medical plan is a Medicaid HMO.  Enrollment in a Medicaid HMO will allow you to see only those doctors that are part of the particular HMO network.  They will not pay for medical costs from doctors you see who are outside of their network, without a referral from one of their own network doctors. 

  • There are many different types of Medicaid HMOs, with a variety of different names.  You may sign up for these different HMOs in a variety of places such as grocery stores, malls and parking lots.  They may approach you by offering a free pamper program.  While their medical program may provide you with free pampers or other incentives, it is also important to know that it may change the doctors that you and your family are able to see.  If your current doctors are not in the HMO network that you sign up for, you will no longer be able to see them.  

  • If you are already enrolled in a Medicaid HMO and want to return to a straight Medicaid plan, you will need to disenroll from the HMO by contacting them directly.  This often takes as much as 60 days to  complete.

Questions, Contact:

Minerva Esparza, NICU Social Worker, at 773.257.5708 or
 Laura Barnickol, Heath & Disability Advocates, 312.223.9600