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Eligibility, Coverage and Payments
Eligibility | Coverage | Payment
and the Waiting List | Termination
of Coverage | Impartial
Eligibility Review
Coverage
Who is Covered?
The adult enrolled in the program and named on the Keystone
Health Plan East ID Card is covered by adultBasic. Only
the person named on this card is eligible to receive benefits.
| Note: |
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A baby born to an enrolled adultBasic
female member is eligible for a period of up to
31 days following birth. To ensure continuity of
care for the newborn, the mother of the newborn
should fill out an application for Medicaid or CHIP
as soon as possible. |
How Long Am I Covered?
You are covered as long as you continue to meet adultBasic
eligibility guidelines and pay your premium. At a minimum,
eligibility will be renewed at least once a year on the
anniversary date of your enrollment (see “Renewal of Coverage”).
Renewal of Coverage
Unless otherwise notified, the Caring Foundation will check
your eligibility at least once each year. This is called
renewal. You will receive a form to fill out at least three
months before your insurance is due for renewal. You must
fill out this form completely; attach complete and current
income documentation and mail it back to the Caring Foundation
before the due date. If it is received late or incomplete,
your coverage will be canceled and you will have to go through
the application process from the beginning to renew your
coverage.
The Caring Foundation will notify you if you are no longer
eligible. This will be based on the information you give
on your renewal form.
The Caring Foundation reserves the right to cancel your
coverage at renewal if you:
- give incorrect or misleading information about your
eligibility; or
- try to obtain benefits through misrepresentation or
fraud.
Do I Need an ID Card?
Yes. Each member enrolled in adultBasic will receive an
ID Card from Keystone Health Plan East for medical services.
Here are some important things to do and remember about
your ID Card:
- Check that you receive a Keystone ID Card.
This card will allow you to get all eligible medical
benefits.
Your Medical Card
- Check the information on the ID Card.
Make sure everything is correct.
- Check the name of the primary care physician
on the Keystone ID Card. Make sure the name
of the doctor you chose is shown on the Keystone ID
Card.
- Carry your ID Card with you at all times.
A member must show this card any time medical services
are received.
- Call the Caring Foundation at 1-800-464-5437
if you find an error or if you lose your ID Card.
Look on the back of the Keystone ID Card. There you will
find:
- information about services that will help you in a
medical emergency; and
- a toll-free number that you can tell a hospital to
call if they have questions about your medical coverage.
If I Lose My ID Card
If you lose or misplace your ID Card, call the Caring Foundation
at 1-800-464-5437.
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