North Dakota Sample Letter for List of Medical Expenses

State:
Multi-State
Control #:
US-0817LTR
Format:
Word; 
Rich Text
Instant download

Description

This form is a sample letter in Word format covering the subject matter of the title of the form.

How to fill out Sample Letter For List Of Medical Expenses?

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FAQ

Hospital. Inpatient: Covers room and board, regular nursing services, supplies and equipment, operating and delivery room, X-rays, lab and therapy. Outpatient: Covers emergency room services and supplies, lab, X-ray, therapies, drugs and biologicals, and outpatient surgery.

Medicaid is a program that helps pay for medical services for qualifying low-income adults, children, pregnant women, older adults and people with disabilities. Medicaid Members: Learn more about Medicaid renewals and what you need to do to prepare on our Stay Covered ND webpage.

Medicaid Expansion is available to individuals between 19-64 with household incomes up to 138% of the federal poverty level (FPL). Individuals eligible for Medicare or Supplemental Security Income (SSI) are not eligible for coverage under Medicaid expansion.

Who is eligible for North Dakota Medicaid Program? Household Size*Maximum Income Level (Per Year)5$46,7376$53,5737$60,4098$67,2454 more rows

Medically necessary covered services may be provided outside of North Dakota if the services are not available within North Dakota and have been prior approved by the department or if the services are provided in an emergency situation.

Medicaid covered services received more than 50 miles outside of the state of South Dakota, except Bismarck, ND, will require prior authorization. This applies to all Medicaid recipients, including those not in the PCP or HHP program.

Adults enrolled in Medicaid in North Dakota are eligible for extensive dental services, although North Dakota does not offer dental benefits to those enrolled through the ACA's Medicaid expansion.

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North Dakota Sample Letter for List of Medical Expenses