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Recipients can obtain the above listed services by visiting a managed care plan provider. However, some types of mental health services can be obtained by seeing any provider who is certified as meeting the applicable Medicaid program provider requirements and is willing to accept Medicaid payment.

Individuals eligible for emergency Medicaid services are only eligible for medical services for a medical condition (including labor and delivery) manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in:

 placing the patient's health in serious jeopardy,  serious impairment to bodily functions, or  serious dysfunction of any bodily organ or part.

Retroactive Eligibility 2.2.5

When a person applies for Medicaid, s/he can also apply for three months of retroactive eligibility. If s/he meets the financial and non-financial eligibility criteria during the three months prior to application, Medicaid will pay his/her outstanding bills from that three-month period.

Salazar Court Order 2.2.6

The Salazar court order governs how Medicaid applications filed on behalf of groups who are not categorically eligible (i.e., groups composed of TANF recipients, GC recipients, SSI recipients, children in foster care, department wards, or children receiving IV-E foster care payments or IV-E adoption assistance benefits, see Chapter 12: Categorical Eligibility in Part IV) and groups who are not applying based on disability are to be processed. It requires the following:

 covered Medicaid applications are to be processed within 45 days;  if an application is not processed within 45 days, the Department will automatically deem it eligible for not less than three months; and  all recertifications must be registered in ACEDS as soon as they are received, if they are signed.

Policy Categories 2.2.7

The bulk of the Manual relating to MA pertains to the following ACEDS MA program types: AR, AX, SR, and QM. Information specific to Refugee-Related Medicaid (RR program type) is located in Chapter 7: Citizenship/Alienage in Part IV and Section 1.4: Refugee Medical Assistance in Part VII). Issues related specifically to emergency Medicaid are also found in Chapter 7: Citizenship Alienage in Part IV. Policies relating to LTC Recipients (LT program type) are found in Chapter 2: Long-Term Care/Impoverished Spouse in Part VII.

Most policies relating to non-financial and financial eligibility requirements are consistent within the ACEDS program types (AR, AX, SR, and QM). Therefore, when describing MA policies that are not consistent between these program types (that is, the policy for the AR program differs from the policy in the SR program), the policies for each program type will be described.

Sometimes, MA policy is not divided between the AR and AX program types. This is because application processing rules for children, parents, and caretaker relatives do not depend on whether the family will ultimately be found eligible under the AR or AX program type but rather depend on the type of application submitted (see Part III: Application Processing). Families applying only for Medicaid can fill out the D.C. Healthy Families Application. Families applying for Medicaid in addition to TANF and/or FS must