Davis Behavioral Health 2024-2025 Benefit Guide | Page 46

Important Notices and Disclosures

GEORGIA – Medicaid

GA HIPP Website : https :// medicaid . georgia . gov / health-insurancepremium-payment-program-hipp Phone : [phone] , Press 1 GA CHIPRA Website : https :// medicaid . georgia . gov / programs / third-party-liability / childrenshealth-insurance-program-reauthorization-act-2009-chipra Phone : [phone] , Press 2

IOWA – Medicaid and CHIP ( Hawki )

Medicaid Website : https :// dhs . iowa . gov / ime / members Medicaid Phone : [phone] Hawki Website : http :// dhs . iowa . gov / Hawki Hawki Phone : [phone] HIPP Website : https :// dhs . iowa . gov / ime / members / medicaid-a-to-z / hipp HIPP Phone : [phone]

KENTUCKY – Medicaid

Kentucky Integrated Health Insurance Premium Payment Program ( KI-HIPP ) Website : https :// chfs . ky . gov / agencies / dms / member / Pages / kihipp . aspx Phone : [phone] Email : KIHIPP . PROGRAM @ ky . gov KCHIP Website : https :// kynect . ky . gov Phone : [phone] Kentucky Medicaid Website : https :// chfs . ky . gov / agencies / dms

INDIANA – Medicaid

Healthy Indiana Plan for low-income adults 19-64 Website : http :// www . in . gov / fssa / hip / Phone : [phone] All other Medicaid Website : https :// www . in . gov / medicaid / Phone : [phone]

KANSAS – Medicaid

Website : https :// www . kancare . ks . gov / Phone : [phone] HIPP Phone : [phone]

LOUISIANA – Medicaid

Website : www . medicaid . la . gov or www . ldh . la . gov / lahipp Phone : [phone] ( Medicaid hotline ) or 1-855-618-5488 ( LaHIPP )

MAINE – Medicaid

Enrollment Website : https :// www . mymaineconnection . gov / benefits / s /? language = en _ US Phone : [phone] TTY : Maine relay 711 Private Health Insurance Premium Webpage : https :// www . maine . gov / dhhs / ofi / applications-forms Phone : [phone] TTY : Maine relay 711

MINNESOTA – Medicaid

Website : https :// mn . gov / dhs / people-we-serve / children-and-families / healthcare / health-care-programs / programs-and-services / otherinsurance . jsp Phone : [phone]

MONTANA – Medicaid

Website : http :// dphhs . mt . gov / MontanaHealthcarePrograms / HIPP Phone : [phone] Email : HHSHIPPProgram @ mt . gov

MASSACHUSETTS – Medicaid and CHIP

Website : https :// www . mass . gov / masshealth / pa Phone : [phone] TTY : 711 Email : masspremassistance @ accenture . com

MISSOURI – Medicaid

Website : http :// www . dss . mo . gov / mhd / participants / pages / hipp . htm Phone : [phone]

NEBRASKA – Medicaid

Website : http :// www . ACCESSNebraska . ne . gov Phone : [phone] Lincoln : 402-473-7000 Omaha : 402-595-1178

Davis Behavioral Health

46