What is Medicaid?
Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, like nursing home care and personal care services.
What is the Children’s Health Insurance Program (CHIP)?
The Children’s Health Insurance Program (CHIP), provides health coverage to eligible children through both Medicaid and separate CHIP programs. CHIP is administered by states according to federal requirements. CHIP was created in 1997 and is funded jointly by states and the federal government.
Who May Apply for Medicaid?
Elderly (65 years old and older), Blind, Families with Dependent Children up to 20 years old, Permanently and Totally Disabled Individuals, and Adults (21 – 64 years old.
The income and resources will be reviewed and assessed based on the following criteria
Where are applications for Medicaid accepted?
Please visit or call the Bureau of Economic Security (BES) offices located at any of the following Department of Public Health & Social Service facilities below Monday to Friday, 8:00am to 5:00pm. Closed on the weekends and GovGuam Holidays.
CENTRAL OFFICE (Mangilao, CASTLE MALL, Unit #15)
Telephone Number: 735-7519, 735-7340, 735-7256 or 735-7375
Districts Covered: Mangilao, Barrigada, Maina, Yona, Agat, Asan,
Mongmong-Toto-Maite, Ordot, Agana, Sinajana,
Chalan Pago, Agana Heights, Santa Rita, and Piti
NORTHERN OFFICE (Dededo)
Telephone Number: 635-7429 or 635-7488
Districts Covered: Dededo, Harmon, Tumon, Tamuning, & Yigo
SOUTHERN OFFICE (Inarajan)
Telephone Number: 828-7542 or 828-8524
Districts Covered: Talofofo, Inarajan, Merizo, & Umatac
When does eligibility begin for Medicaid?
When all qualifying requirements are met, eligibility begins on the first day of the three (3) months preceding the month of application submission. The income and resources will be reviewed and assessed for eligibility and for the preceding months.
When shall I use Guam Memorial Hospital Authority (GMHA) Emergency Room?
After clinic hours, in an emergency situation (accident, severe pain, bleeding, difficulty breathing, or any other condition which if not treated immediately will endanger your life, or health), go to the emergency room of GMHA for medical services. However, Medicaid will not be responsible for payment if you use emergency room for non-emergency care.
Will Medicaid pay for medical bills I already have?
If you have accumulated those bills within the three (3) months before you filed you application and the bills are for types of services listed on this brochure and do not require prior authorizations, Medicad can pay for them. This is not an automatic benefit. Your income and resources for that period are subject to review.
How are medical bills paid?
All payments covered by the Medicaid Program are made directly to the hospital, clinics, dentists and other providers. Should you have paid for the bills, Medicaid WILL NOT reimburse you
What Benefits does Medicaid provide?
What services are not covered by Medicaid?
What Dental Benefits are covered by Medicaid?
What covered services require Prior Authorization (PA)?
Can a person with other insurance apply for Medicaid?Yes. It is also the only allowable deduction, health insurance premium, to the gross income for eligibility. The income and resources will be reviewed and assessed for eligibility and adjustment.
The primary insurance must be billed first. Medicaid is the payer of last resort.