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EMERGENCY
MEDICAID
Emergency Medicaid coverage is
limited to treatment required after the sudden
onset of a medical emergency. The acute symptoms
of the condition must be sufficiently severe
that the absence of immediate medical attention
could reasonably be expected to result in
placing the patient's health in serious
jeopardy, serious impairment to bodily
functions, or serious dysfunction of any bodily
organ or part.
Emergency Medicaid does NOT pay
for treatment of chronic conditions, even if the
condition has the potential to be life
threatening. For example, a person with a heart
condition that may lead to a heart attack unless
it is treated cannot get Emergency Medicaid
UNTIL there is a heart attack or sudden onset of
a medical emergency.
This type of Medicaid can never be
pre-approved. Instead the medical bill for the
treatment of the emergency is submitted for
review by a Medical Review team at the
Connecticut Department of Social Services.
PREGNANT WOMEN
Emergency Medicaid covers labor
and delivery for pregnant women who do not have
health insurance and who meet Medicaid income
and asset limits. It does not cover prenatal
care.* However, if the pregnant woman has
complications to her pregnancy or if the unborn
baby is at risk, then Emergency Medicaid will
cover the cost of care. Likewise, Emergency
Medicaid will cover the cost of an abortion if
the mother's life is in danger, but not if the
abortion is an elected procedure.
(* NOTE: Prenatal care for
pregnant women who are not citizens or who do
not have permanent residency can get prenatal
care at community health centers.)
IMMIGRANTS AND NONCITIZENS
Immigration status is NOT a factor
for Emergency Medicaid eligibility. Any person,
regardless of legal immigrant status can be
eligible for Emergency Medicaid if he/she meets
income and asset limits.
NOTE: Hospitals cannot
deny anyone emergency medical treatment,
regardless of financial status or
immigrant/citizenship status. So patients with
medical emergencies would be able to get care,
and financial payment sources would have to be
determined later. The State of Connecticut
reimburses hospitals for "uncompensated care."
In addition, most hospitals have discretionary
funding that may be able to help when people
unable to afford medical care cannot access
Medicaid or HUSKY because of citizenship issues.
FOR MORE
INFORMATION ABOUT EMERGENCY MEDICAID:
Connecticut
Department of Social Services
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SOURCE: Connecticut Department
of Social Services
PREPARED BY: 211/tb
CONTENT LAST REVIEWED: May2013
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