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Effective August 1, 2021, Medicaid will no longer require a Primary Care Physician (PCP) referral for services rendered for Medicaid recipients.
Income & Asset Limits for Eligibility 2023 Alabama Medicaid Long-Term Care Eligibility for SeniorsType of MedicaidSingleMarried (both spouses applying)Medicaid Waivers / Home and Community Based Services$2,742 / month?$4,000 ($2,000 per spouse)Regular Medicaid / Medicaid for Elderly and Disabled$934 / month$3,0002 more rows ?
Prior authorizations must be received by the fiscal agent within 30 days of dispensing equipment, providing vision services, or for laboratory procedures within 30 days of the date of service. A Letter of Medical Necessity (LMN) with sufficient information to meet criteria may be submitted.
A: The number of outpatient pharmacy prescriptions is limited to five total drugs (including up to four brands) per month per adult recipient.
For questions related to prior authorization or overrides, contact KEPRO at 1-800-748-0130.
Medicaid patients get medical care from a variety of sources. Covered medical services include dental, eye and hearing care, lab and x-ray services as well as renal dialysis and transplant coverage.
More than a million Alabamians each year qualify for full or partial Medicaid coverage. To qualify for Medicaid, applicants must meet income, age or other requirements; provide proof of income and other information, fill out forms correctly and turn in a completed application to the correct office or worker.