The CAPA is a publicly funded program designed to help needy Alaskans with specific illnesses get the medical care they need to manage those illnesses. This is a program primarily for people who are not eligible for Medicaid benefits, who have very little income, and who have no or no health insurance.
Frequently Asked Questions
Who is eligible?
To be eligible for CAMA, you must:
- have a covered medical condition,
- do not have third-party resources to cover the treatment of this medical condition;
- have very limited financial resources; and
- be a U.S. citizen or legal alien.
What medical conditions are covered?
CAMA is only available if you have one of the following medical conditions:
- 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 medical status certification form (MED 11) is used for this purpose. Once 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, which means that you will not qualify for CAMA if you have a resource that covers treatment for your condition. If you have third-party support, you should use this resource. Third-party resources that may be available to meet an individual’s medical needs include the following:
- Coverage by a private medical or hospital insurance policy that will pay 100% of the cost of medical care;
- Veterans Administration, TRICARE, Office of Vocational Rehabilitation, Division of Mental Health and Developmental Disabilities, Medicaid and Medicare and others;
- the Salvation Army, Red Cross, Lion’s International and other charitable organizations that meet the individual’s medical needs;
- Payment of medical expenses or medical insurance coverage available from another responsible person;
- Cash contributions from friends or relatives to cover medical expenses.
Eligibility to receive assistance from the United States Public Health Service through the Indian Health Service (IHS) is not considered an available resource for purposes of determining initial CAMA eligibility.
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 criteria.
Your household income must be:
- $300 per month or less for one person
- $400 per month or less for two people
- add $100 for each additional person
You must have less than $500 in accounting resources that could be used to pay medical bills. Accounting resources include cash, bank/credit union accounts, or personal property. CAMA does not count your home, vehicle, income property, property that is used for your work (boat, fishing gear, etc.) or fishing license.
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;
- medical services; that are directly related to the medical condition that qualifies you for CAMA;
- chemotherapy and radiotherapy services for a recipient with cancer requiring
- chemotherapy, if provided on an outpatient basis; and
ambulatory laboratory and radiology services
How does CAMA work?
If you qualify for CAMA, you will receive a Beneficiary Identification Card (commonly referred to as a “voucher”) to give to your health care provider. A general description of the services covered by the CAMA is printed on the front of the coupon. If you receive medical treatment for something not listed on the coupon, you will have to pay for the service yourself.
Before receiving medical treatment, you must give the coupon to your
doctor, clinic or pharmacist. Your health care provider must be registered with the Department of Health and Human Services, Health Care Services Division. They will send the invoice to the Crown contractor for payment. Payments are made directly to your healthcare provider.
A CAMA recipient is responsible for sharing the cost of services received. There is a $1 copayment on each prescribed drug or medical supply. You pay these fees directly to your health care provider and they will bill the rest to the CAMA program. Your health care provider cannot ask you to pay more.
How to apply for CAMA?
You can apply for CAMA at the nearest Division of Public Assistance office or at a paying agent living in your community. A completed application form, supporting documents and an interview with a social worker or local agent are required. You will be asked to bring the following supporting documents to your interview:
- documents showing your income, such as tax forms, pay stubs, fishing tickets, or a letter from the Internal Revenue Service stating that you do not pay taxes; and
- papers that show any other assets or resources like bank accounts.
At the interview, you will receive a form to present to your health care provider which will be used to document and verify that you have one of the covered medical conditions. Your provider will return this form to your DPA Caseworker. Your application and your interview are confidential. No one will disclose information about your health or financial situation without your permission.
If you have questions about CAMA coverage, please call the Health Care Service Recipient Information Line at 1-800-780-9972