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October 1, 2013 - September 30, 2014
What is an ACCESS card?
The Pennsylvania ACCESS card is a permanent plastic card that is issued to each individual who is eligible for Medical Assistance (also referred to as Medicaid). The ACCESS card has a place for a signature on the back; recipients should sign the card upon receipt. The signature panel is tamper-proof and does not allow signatures to be rewritten. Medical Assistance recipients enrolled in managed care plans are also given a managed care identification card.
Is the ACCESS card also an EBT card?
If the individual cardholder is also the payment name for a cash assistance or Food Stamps case, the ACCESS EBT (Electronic Benefit Transfer) card is used to obtain cash or Food Stamps benefits, in addition to medical benefits. The ACCESS card for Medical Assistance only is yellow; the ACCESS EBT card is green. If cash assistance and Food Stamps benefits stop, the green card will continue to be the ACCESS card to be used for medical services.
How is the ACCESS card used to verify eligibility for medical services?
The ACCESS card is presented to the medical provider at the time of service. (Note: individuals receiving services through a managed care plan must use both the ACCESS card and the managed care identification card for those services.) The magnetic coding stripe on the card contains unique information to identify eligibility for benefits. The medical provider uses the ACCESS card in conjunction with the Eligibility Verification System (EVS) to obtain real-time information on Medical Assistance eligibility. EVS can provide verification of present and past, but not future, eligibility for benefits. Medical providers contact the EVS system by point-of-sale devices, computers or telephone. EVS identifies the scope of services covered for the individual, third-party resource information, managed care plan enrollment and any individual restrictions to services.
Do other agencies use the ACCESS card?
Non-medical providers such as the Women, Infants and Children (WIC) Program, Medical Assistance Transportation Program and schools use the ACCESS card and EVS to verify eligibility for their services.
What happens when a card is lost or stolen?
When a Medical Assistance recipient reports a lost or stolen card, the issue number is voided to prevent misuse and a new card is issued. The recipient must then use the new card with the new issue number to obtain services. NOTE: EVS will not provide Medical Assistance information for voided ACCESS cards because data is changed on the EVS system. If the old card is found or returned after a new card is obtained, the old card should be destroyed, as it is no longer usable.
Should a recipient destroy his or her ACCESS card when their Medical Assistance case is closed?
No. The card will not cover Medical Assistance services if the Medical Assistance case is closed; however, it can be reactivated if the client again becomes eligible at a later date. If the recipient has an ACCESS card when the case is reopened it is more convenient for the client and saves the cost of reissuing the card.
Does an individual still need an ACCESS card if they are covered by a managed care plan?
Yes. Every Medical Assistance recipient must have an ACCESS card.
Does the ACCESS card cover services provided out-of-state?
Services provided out-of-state are not always covered. Providers must enroll with Pennsylvania Medical Assistance in order to receive payment for Medical Assistance services. Out-of-state medical providers may call 717-772-6456 to request an enrollment application.
Where can one report fraud or abuse of the ACCESS card?
Call the Office of Inspector General Welfare Fraud Tipline at 1-800-932-0582.