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Last): ______________________________________________ Medicaid ID# or MS License #: ___________________ Telephone #: (____) ______-________ Ext. _________ CLINICAL INFORMATION (THIS SECTION MUST BE COMPLETED BY THE PHYSICIAN/NP/PA.) ICD-9-CM DIAGNOSES Est. Length of Need (# of Months): ___1 – 99 (99 = Lifetime) ANSWERS CIRCLE Y FOR YES N FOR NO or D FOR DOES NOT APPLY Y N D Is the child’s caregiver deaf? Y N D Does the child have a medical condition that would require specific...
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If approved for Social Security disability benefits or SSI the successful applicant also gets medical insurance you either get Medicare or Medicaid or both each of these programs has its pluses and minuses in comparison to the other program whether you get Medicare or Medicaid strictly depends on whether you approve for SSI or disability or in some cases of both, but this option is only available for certain people who are very low-income so in some cases you would only get Medicare but fortunately that usually means that your check is substantially higher

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