image 1Human Resources
Payroll Medicare Creditable Coverage

Important Notice from Adelphi University
About Your Prescription Drug Coverage and Medicare

If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of February 16, 2010. You should contact your State for further information on eligibility.

ALABAMA – Medicaid CALIFORNIA – Medicaid
Website: www.medicaid.alabama.gov
Phone: 1-800-362-1504		 Website: www.dhcs.ca.gov
Phone: 1-866-298-8443
ALASKA – Medicaid COLORADO – Medicaid and CHIP
Website: health.hss.state.ak.us
Phone (Outside of Anchorage): 1-888-318-8890
Phone (Anchorage): 907-269-6529		 Medicaid Website: www.colorado.gov/
Medicaid Phone: 1-800-866-3513
CHIP Website: www.CHPplus.org
CHIP Phone: 303-866-3243
ARIZONA – CHIP
Website: www.azahcccs.gov
Phone: 602-417-5422
ARKANSAS – CHIP FLORIDA – Medicaid
Website: www.arkidsfirst.com/
Phone: 1-888-474-8275		 Website: www.fdhc.state.fl.us
Phone: 1-866-762-2237
GEORGIA – Medicaid MONTANA – Medicaid
Website: dch.georgia.gov/
   Click on Programs, then Medicaid
Phone: 1-800-869-1150 		Website: medicaidprovider.hhs.mt.gov
Telephone: 1-800-694-3084
IDAHO – Medicaid and CHIP NEBRASKA – Medicaid
Medicaid Website: www.accesstohealthinsurance.idaho.gov
Medicaid Phone: 208-334-5747
CHIP Website: www.medicaid.idaho.gov
CHIP Phone: 1-800-926-2588 		Website: www.dhhs.ne.gov
Phone: 1-877-255-3092
INDIANA – Medicaid NEVADA – Medicaid and CHIP
Website: www.in.gov
Phone: 1-877-438-4479 		Medicaid Website: dwss.nv.gov/
Medicaid Phone: 1-800-992-0900
CHIP Website: www.nevadacheckup.nv.org/
CHIP Phone: 1-877-543-7669
IOWA – Medicaid
Website: www.dhs.state.ia.us
Phone: 1-888-346-9562
KANSAS – Medicaid NEW HAMPSHIRE – Medicaid
Website: www.khpa.ks.gov
Phone: 785-296-3981 		Website: www.dhhs.state.nh.us
Phone: 1-800-852-3345 x 5254
KENTUCKY – Medicaid NEW JERSEY – Medicaid and CHIP
Website: chfs.ky.gov
Phone: 1-800-635-2570 		Medicaid Website: www.state.nj.us
Medicaid Phone: 1-800-356-1561
CHIP Website: www.njfamilycare.org
CHIP Phone: 1-800-701-0710
LOUISIANA – Medicaid
Website: www.dhh.louisiana.gov
Phone: 1-888-342-0555
MAINE – Medicaid NEW MEXICO – Medicaid and CHIP
Website: www.maine.gov
Phone: 1-800-321-5557 		Medicaid Website: www.hsd.state.nm.us
Medicaid Phone: 1-888-997-2583
CHIP Website: www.hsd.state.nm.us
   Click on Insure New Mexico
CHIP Phone: 1-888-997-2583
MASSACHUSETTS – Medicaid and CHIP
Medicaid & CHIP Website: www.mass.gov
Medicaid & CHIP Phone: 1-800-462-1120
MINNESOTA – Medicaid NEW YORK – Medicaid
Website: www.dhs.state.mn.us
   Click on Health Care, then Medical Assistance
Phone: 800-657-3739 		Website: www.nyhealth.gov
Phone: 1-800-541-2831
MISSOURI – Medicaid NORTH CAROLINA – Medicaid
Website: www.dss.mo.gov
Phone: 573-751-6944 		Website: www.nc.gov
Phone: 919-855-4100
NORTH DAKOTA – Medicaid UTAH – Medicaid
Website: www.nd.gov
Phone: 1-800-755-2604 		Website: health.utah.gov
Phone: 1-866-435-7414
OKLAHOMA – Medicaid VERMONT– Medicaid
Website: www.insureoklahoma.org
Phone: 1-888-365-3742 		Website: ovha.vermont.gov/
Telephone: 1-800-250-8427
OREGON – Medicaid and CHIP VIRGINIA – Medicaid and CHIP
Medicaid Website: www.oregon.gov
Medicaid Phone: 1-800-359-9517
CHIP Website: www.oregon.gov
CHIP Phone: 1-800-359-9517 		Medicaid Website: www.famis.org/
Medicaid Phone: 1-800-432-5924
CHIP Website: www.famis.org/
CHIP Phone: 1-866-873-2647
PENNSYLVANIA – Medicaid WASHINGTON – Medicaid
Website: www.dpw.state.pa.us
Phone: 1-800-644-7730 		Phone: 1-800-562-6136
RHODE ISLAND – Medicaid WEST VIRGINIA – Medicaid
Website: www.dhs.ri.gov
Phone: 401-462-5300 		Website: www.wvrecovery.com
Phone: 304-342-1604
SOUTH CAROLINA – Medicaid WISCONSIN – Medicaid
Website: www.scdhhs.gov
Phone: 1-888-549-0820 		Website: dhs.wisconsin.gov
Phone: 1-800-362-3002
TEXAS – Medicaid WYOMING – Medicaid
Website: www.gethipptexas.com/
Phone: 1-800-440-0493 		Website: www.health.wyo.gov
Telephone: 307-777-7531

To see if any more States have added a premium assistance program since February 16, 2010, or for more information on special enrollment rights, you can contact either:

U.S. Department of Labor
Employee Benefits Security Administration
www.dol.gov/ebsa
1-866-444-EBSA (3272) 		U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
www.cms.hhs.gov
1-877-267-2323, Ext. 61565
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Contact Us
For more information, please contact:

Office of Human Resources
p - 516.877.3220
f - 516.877.4970
e - humanres@adelphi.edu
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