The ACAM 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 insufficient 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 the treatment of this medical condition;
- have very limited financial resources; and
- be a US citizen or a 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 doctor or advanced nurse practitioner should 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 case worker.
What do you mean by âthird party resourcesâ?
CAMA is considered a last resort, which means that you will not be eligible for CAMA if you have a resource that covers treatment for your condition. If you have third-party help, you should use this resource. Third-party resources that may be available to meet an individual’s medical needs are as follows:
- Coverage by a private medical or hospital insurance policy that will pay 100 percent of the cost of medical care;
- Veterans Administration, TRICARE, Office of Vocational Rehabilitation, Division of Mental Health and Developmental Disorders, Medicaid and Medicare and others;
- Salvation Army, Red Cross, Lion’s International and other charities that meet the medical needs of the individual;
- Payment of medical bills or medical insurance coverage available from another responsible person;
- Cash contributions from friends or relatives to cover medical costs.
Eligibility for United States Public Health Service assistance through the Indian Health Service (IHS) is not considered an available resource for the purposes of determining initial CAMA eligibility.
Who is financially eligible?
In addition to having a covered medical condition and no other resources to meet this 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. Countable resources include cash, bank accounts / credit unions, or personal property. CAMA does not count your home, vehicle, income producing property, property used for your work (boat, fishing gear, etc.) or a fishing license.
What coverage is available with the CAMA program?
For eligible persons, CAMA pays for the following services:
- prescription drugs and medical supplies, limited to 3 prescriptions per month and no more than 30 days 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 ACAM work?
If you are eligible for CAMA, you will receive a beneficiary identification card (commonly known as a âcouponâ) to give to your health care provider. A general description of the services covered by CAMA is printed on the front of the coupon. If you are receiving medical attention for something not listed on the coupon, you will need to pay for the service yourself.
Before receiving medical treatment, you must return the voucher to your
doctor, clinic or pharmacist. Your health care provider must be registered with the Department of Health and Human Services, Division of Health Care Services. They will send the invoice to the state contractor for payment. Payments are made directly to your health care provider.
A CAPA beneficiary is responsible for sharing the cost of the services received. There is a $ 1 co-payment on each prescribed drug or medical supply. You pay these fees directly to your health care provider and they will bill the CAMA program for the remainder. Your health care provider may not ask you to pay more.
How to register
How can I apply to CAMA?
You can submit a CAMA request to the nearest Public Assistance Division office or to a fee agent living in your community. A completed application form, supporting documents, and an interview with a local social worker or fee officer are required. You will be asked to bring the following supporting documents with you during 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 other assets or resources such as bank accounts.
During the interview, you will be given a form to take to your health care provider which is used to document and verify that you have any of the covered medical conditions. Your provider will return this form to your DPA social worker. Your application and your interview are confidential. No one will give out information about your health or financial situation without your permission.
If you have any questions about CAPA coverage, please call the Health Care Recipient Information Line at 1-800-780-9972