In order to access the added benefits, the new program members must sign a personal-responsibility agreement to "do my best to stay healthy" and to "use the hospital room only for emergencies." This package includes benefits covered in the previous program, along with some new benefits.
The package also limits members to four prescriptions a month and no longer grants access to services such as cardiac rehabilitation or smoking cessation classes. According to The Charleston Gazette, only about 7 percent of those who have been eligible since February had signed up for the enhanced plan till mid-July.
The redesigned program that has been launched only in Clay, Lincoln and Upshur counties now plans to cover 243,000 West Virginians in the coming year. It will make it mandatory for members to meet with their health-care provider within 90 days of their annual re-determination date to sign the agreement.
According to Medicaid officials, members of the basic plan were given ample notification before Aug. 1 that they would be placed into the basic benefit plan. Those who failed to respond before this date will now remain in the basic plan until next year, when they will have another opportunity to sign up.
As of Aug. 1, only 14 adults and 38 children were enrolled in the enhanced plan in Clay. Medicaid is a federal health-care program for low-income children, very low-income parents, and some elderly and disabled.
Medicaid members will have the opportunity to enroll in the Enhanced Benefit Package each year upon their date of re-determination and for 90 days after that date.
