To
Enroll into or find out more about the Medical Access Program:
Please call the MCAC Marquette city office and ask to speak
with an enrollment scheduler. The scheduler will explain the
Medical Access Program to you and schedule a time for you to
meet with an enrollment volunteer. After the time, and date
of the enrollment have been scheduled, you will be instructed
to bring to the enrollment: A) a list of your prescribed medications
including the dosages, B) A copy of your picture identification
and, C) a current stub or bank statement for every current source
of income that your household would record on its taxes. You
can reach the MCAC office at 906.226.4400.
What to Expect
at Your Enrollment
1. The volunteer enrollment counselor will check
your proof of residency, income, age and make 3 copies of each.
2. The Medical Access Program Application will
be completed.
3. Often, eligibility can be determined after
the MAP Application is finished.
4. A hospital financial assistance form is completed
for both Marquette General Hospital and Bell Memorial Hospital,
depending on your geographic location within the county.
5. A Medicaid application is completed. If you
have a letter from the Family Independence Agency which states
that you are not eligible (called a Medicaid or SMP Denial Letter),
and the letter is 90 days or less old, copy the letter and give
it to your volunteer enrollment counselor. You will not need
to fill out the Department of Human Services form.
6. A list of your responsibilities under the program
will be read to you. You will need to sign the form and take
a copy.
7. Three Releases of Information will need to
be signed. These will give MCAC the right to pass your hospital
and DHS forms along to the appropriate agency. Releases will
also allow MCAC to schedule appointments with your doctor(s),
and secure needed medical information.
8. Each new MCAC client will soon be assigned
to a physician or to MCAC’s medical clinic. Please remember
that you must stay with your assigned Primary Care Doctor, and
that you must first call MCAC to make appointments to all specialist
physicians before going to your first appointment. This is the
only way MCAC can insure that you will be referred to the correct
participating specialist physician. You may call your assigned
primary care physician anytime for appointments.
9. You will be asked what prescription medications
you take. Medications are secured in three different ways under
the Medical Access Program: 1) The first way is through your
doctor's supply of sample medications. Always ask your doctor
if samples can be provided. If so, continue to get that medication
from your doctor as long as it is available. 2) If the doctor
has no samples available, please call MCAC to see if samples
can be delivered to your doctor for you. MCAC often has access
to branded medications through the sampling programs and donation
programs offered by pharmaceutical companies. 3) If MCAC tells
you that no samples are available for delivery, MCAC may ask
you to get the medication from a local pharmacy (you pay a $4.00
co-payment, MCAC pays up to $1,500 per year and all local pharmacies
cooperate but Walmart). Many generic medications are offered
through the co-pay program at local pharmacies. 4) If the medications
are not available through the above three options, you will
need to pay out of pocket for the prescription.
10. At the end of the enrollment, the volunteer enrollment counselor
will review the coverage of the program and answer whatever
questions that you may have. You will leave with information
about the MAP covered benefits and with the carbon copies of
your MAP Patient Responsibilities form and the Authorization
for Medical Treatment form.
Qualifications
for Enrollment:
There are several basic criteria to qualify for
the Medical Access Program. Please read below for the criteria,
and click for further details regarding qualifications.
1. Income:
To qualify for the Medical Access Program, a person's total income
must be below 200% of the Federal Poverty Level.
2. Age: A patient
must be over 18 and under 65 years of age.
3. No Medical
Benefits/Insurance: A patient may not have any kind of health
insurance to qualify for MCAC.
4. Residency:
A patient must be a Marquette County resident and provide proof
of residency.
5. Legal:
A patient with available compensation for work related injuries
sustained on the work site is not eligible for MCAC treatment
of those injuries.
Disenrollment
Medical Care Access Coalition encourages all members to provide
needed information in a timely fashion, to understand the benefits
guidelines for the Medical Access Program, and to cooperate with
the volunteer medical staff. As part of your entry into the MAP,
you will need to understand and sign a Patient Responsibilities
Form and Authorization for Medical Treatment which you will be
expected to adhere to. If you have been disenrolled from the Medical
Access Program, you may be able to re-enroll. Please call MCAC
at 906.226.4400 for reenrollment information.
Failure to Complete the DHS Application: A patient
who does not file a Medicaid application at enrollment or within
3 business days of applying for MCAC will be disenrolled from
the program until the completion of the Medicaid Application at
the Family Independence Agency. Persons may call the Marquette
County Family Independence Agency at 906.228.9691 for more information
on the Medicaid/ Health Assistance Program application process.
Failure to Complete the DHS Process and/ or Provide Requested
Verifications to DHS: Persons who have begun but failed
to complete the enrollment process with the Family Independence
Agency’s heath benefits will be disenrolled from the Medical
Access Program. This disenrollment will be effective immediately
upon notice from DHS of a client’s failure to comply, and
the client will be notified by mail and/or phone. Re-enrollment
into the Medical Access Program may take place only after the
client has completed the DHS process, and MCAC has been notified
by DHS of the client’s cooperation with DHS enrollment,
and pending status in Medicaid or HAP. Persons may call the Marquette
County Family Independence Agency at 906.228.9691 for more information
on the Medicaid/ Health Assistance Program application process.
Failure to Inform a Physician’s Office of a Pending
Missed Appointment: A patient who has missed two medical
appointments within a calendar year without calling to cancel
24 hours in advance of the appointment will be disenrolled. Patients
are not eligible to reapply for services for a six-month period
following the second missed appointment.
Discharge from a Physician’s Care due to Inappropriate
Behavior: Due to the limited capacity for specialist
and primary care in the Medical Access Program, clients who have
been discharged from the care of a volunteer physician for inappropriate
behavior may not be reassigned to another volunteer doctor. If
a client is discharged from the care of a doctor, MCAC will disenroll
the client from the Medical Access Program immediately upon notice
from the physician’s office, and notified by mail and/ or
phone. Clients may not re-enroll into the program until the following
cycle of volunteer physician commitments (1 year from disenrollment).
Clients may, at that time, contact MCAC and request to be re-enrolled.
Disenrollment due to Inappropriate Behavior:
Clients who have behaved inappropriately with MCAC staff, volunteers,
providers, members, or partners may be disenrolled by MCAC. Disenrollment
will follow a review of the case by the Executive Director, Enrollment
Coordinator, and Administrative Coordinator. Clients will be disenrolled
immediately upon review of the case, and notified by mail and/
or phone. Reenrollment will typically be allowed after 6 months,
but will be specified otherwise by the Executive Director at the
case review.
Failure to Complete the 1Year Re-enrollment Process: Patients
that fail to schedule their 1 year re-enrollment after notification
from MCAC within the time stipulated on the notification letter
will be disenrolled from the Medical Access Program and barred
from re-enrollment for a period of 90 days from the date of scheduled
disenrollment. Patients who cancel for 2 reenrollment dates will
be treated as having not complied with re-enrollment process.
Disenrollment will be notified of disenrollment by mail and/or
phone.
Failure to Complete the 6 Month Enrollment Questionnaire:
Patients that fail to return their 6 Month Enrollment form within
the stipulated time will be disenrolled from the Medical Access
Program and barred from re-enrollment for a period of 90 days
from the date of scheduled disenrollment. Disenrollment will be
notified of disenrollment by mail and/or phone.
Other Disenrollments: MCAC reserves the right
to disenroll a patient for any reason. A review of disenrollment
may be performed by the Executive Director and the Executive Committee.
Marquette County Enrollment
Sites
All enrollments are scheduled by calling 906.226.4400
Marquette
Upper Peninsula Medical Center
1414 W. Fair Ave Ste 26
Marquette MI 49855
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