Chronic & Acute Medical Assistance (CAMA)
The Chronic & Acute Medical Assistance (CAMA) program is a state funded program designed to help needy
Alaskans who have specific illnesses get the medical care they need
to manage those illnesses. It is a program primarily for people age
21 through 64 who do not qualify for Medicaid benefits, have very
little income, and have inadequate or no health insurance.
Frequently Asked Questions
Who is Eligible?
To be eligible for CAMA, you must:
- have a covered medical condition,
- have no third party resources to cover treatment of that medical condition;
- have very limited financial resources; and
- be a U.S. Citizen or legal alien.
What are the Covered Medical Conditions?
CAMA is available only if you have one of the following
medical conditions:
- a terminal illness;
- cancer requiring chemotherapy;
- chronic diabetes or diabetes insipidus
- chronic seizure disorders;
- chronic mental illness;
- chronic hypertension.
Verification of a Covered Medical
Condition?
A
physician or advanced nurse practitioner must verify that you have
one of the covered medical conditions. A Certification of
Medical Status (MED 11) form is used for this purpose. When
completed, your health care provider submits the form directly to
your public assistance caseworker.
What Do You Mean By “Third
Party Resources”?
CAMA
is considered a last resort, meaning that you will not qualify for
CAMA if you have a resource that covers treatment of your medical
condition. If you have assistance available from a third party, you
must use that resource. Third party resources that may be available
to meet an individual’s medical need include the following:
- Coverage by a private medical or hospital insurance policy that will
pay 100 percent of the cost of medical care;
- Veteran’s Administration, TRICARE, Office of Vocational Rehabilitation,
Division of Mental Health and Developmental Disabilities, Medicaid,
and Medicare and others;
- Salvation Army, Red Cross, Lion’s International, and other charitable
organizations that meet the individual’s medical need;
- Payment for medical bills or medical insurance coverage available
from another person who is liable;
- Cash contributions from friends or relative intended to defray medical costs.
Eligibility to receive assistance from the U.S. Public Health Service through the Indian Health Service (IHS) is not considered an available resource for the purposes of determining initial eligibility for CAMA.
Who Is Financially Eligible?
In addition to having a covered medical condition and no other resources
to meet that health care need, you must meet the following financial
eligibility requirements.
Your household income must be:
- $300 a month or less for one person
- $400 a month or less for two people
- add $100 for each additional person
You must have less than $500 in countable resources that could be used to pay medical bills. Countable resources include cash, bank/credit union accounts, or personal property. CAMA does not count your home, one vehicle, income producing property, property that is used for your job (boat, fishing gear, etc.), or a fishing permit.
What Coverage is Available with the CAMA program?
For
those who are eligible, CAMA pays for the following services:
- prescription drugs and medical supplies, limited to 3 prescriptions per month and no more than a 30-day supply of any drug;
- physician services; which are directly related to the medical condition that qualifies you for CAMA;
- chemotherapy and radiation services for a recipient with cancer requiring
- chemotherapy, if provided in an outpatient setting;
and
outpatient laboratory and X-ray services
How does CAMA work?
If
you qualify for CAMA, you will be given a Recipient Identification
Card (commonly called a “coupon”) to give to your health
care provider. A general description of CAMA covered services is printed
on the face of the coupon. If you receive medical care for something
that is not listed on the coupon, you will have to pay for the service
yourself.
Before
you receive medical treatment, you must give the coupon to your
doctor, clinic, or pharmacist. Your health care provider must be enrolled
with the Department of Health and Social Services, Division of Health
Care Services. They will send the bill to the state’s contractor
for payment. Payments are made directly to your health care provider.
A CAMA
recipient does have a responsibility to share in the cost of the services
received. There is a $1 co-payment on each prescribed drug or medical
supply. You pay these charges directly to your health care provider
and they will bill the CAMA program for the rest. Your health care
provider may not ask you to pay more.
How to Apply
How do I apply for CAMA?
You
can submit an application for CAMA at the nearest Division of Public
Assistance office or with a fee agent living in your community. A
completed application form, supporting documents, and an interview
with a caseworker or local fee agent are required. You will be asked
to bring the following supporting documents with you to your interview:
- papers that show your income such as tax forms, pay stubs, fish tickets, or a letter from the Internal Revenue Service saying that you do not pay taxes; and
- papers that show any other assets or resources like bank accounts.
At the interview, you will be given a form to take to your health care provider that is used to document and verify that you have one of the covered medical conditions. Your provider will return that form to your DPA caseworker. Your application and interview are confidential. No one will give out information about your health or financial status without your permission.
Your
application will be reviewed and a notice will be sent to you within
30 days. If your application is approved, your benefits will start
the month after you submitted your application. If your application
is denied, you may have a right to appeal that decision at a fair
hearing.
Contact Us
If you have any questions regarding the CAMA program, please contact
the Division of Public Assistance
office nearest you or the fee agent in your community.
More Information
If you have questions about CAMA eligibility, please
contact dpapolicy@health.state.ak.us.
If you have questions about CAMA coverage, please call the Health
Care Services Recipient Information Line at
1-800-780-9972