The CAMA program is a state funded program designed to help needy Alaskans who have specific illnesses get the medical care they need to manage those illnesses. It is a program primarily for people age 21 through 64 who do not qualify for Medicaid benefits, have very little income, and have inadequate or no health insurance.

Who is Eligible?
To be eligible for CAMA, you must:
   (1) have a covered medical condition,
   (2) have no third party resources to cover treatment of that medical condition;
   (3) have very limited financial resources; and
   (4) be a U.S. Citizen or legal alien.



What are the Covered Medical Conditions?
CAMA is available only if you have one of the following medical conditions:
   • a terminal illness;
   • cancer requiring chemotherapy;
   • chronic diabetes or diabetes insipidus
   • chronic seizure disorders;
   • chronic mental illness;
   • chronic hypertension.

Note: Prior to November 1, 2002, CAMA provided inpatient hospital coverage to an eligible individual with an emergent need for acute care, regardless whether that individual had one of the medical conditions listed above. This coverage was eliminated on November 1, 2002, due to significant reductions in program funding. CAMA is now a maintenance program only for individuals with one of the covered medical conditions listed above.

Verification of a Covered Medical Condition?
A physician, physician assistant, or advanced nurse practitioner must verify that you have one of the covered medical conditions. A Certification of Medical Status form is used for this purpose. When completed, your health care provider submits the form directly to your public assistance caseworker.

What Do You Mean By “Third Party Resources”?
CAMA is considered a last resort, meaning that you will not qualify for CAMA if you have a resource that covers treatment of your medical condition. If you have assistance available from a third party, you must use that resource. Third party resources that may be available to meet an individual’s medical need include the following:

   (1) Coverage by a private medical or hospital insurance policy that will pay 100 percent of the cost of medical care;

   (2) Veteran’s Administration, TRICARE, Office of Vocational Rehabilitation, Division of Mental Health and Developmental Disabilities, Medicaid, and Medicare and others;

   (3) Salvation Army, Red Cross, Lion’s International, and other charitable organizations that meet the individual’s medical need;

   (4) Payment for medical bills or medical insurance coverage available from another person who is liable;

   (5) Cash contributions from friends or relative intended to defray medical costs, including medically related transportation.

Eligibility to receive assistance from the U.S. Public Health Service through the Indian Health Service (IHS) is not considered an available resource for the purposes of determining initial eligibility for CAMA.

Who Is Financially Eligible?
In addition to having a covered medical condition and no other resources to meet that health care need, you must meet the following financial eligibility requirements.

Your household income must be:
   • $300 a month or less for one person
   • $400 a month or less for two people
   • add $100 for each additional person

You must have less than $500 in countable resources that could be used to pay medical bills. Countable resources include cash, bank/credit union accounts, or personal property. CAMA does not count your home, one vehicle, income producing property, property that is used for your job (boat, fishing gear, etc.), or a fishing permit.

What Coverage is Available with the CAMA program?
For those who are eligible, CAMA pays for the following services:
   (1) prescription drugs and medical supplies;
   (2) physician services, including services related to major medical or nursing home care;
   (3) major medical care provided to an inpatient in a hospital IF it is directly related to a covered medical condition and approved in advance;
   (4) medical transportation related to major medical care or nursing home care;
   (5) chemotherapy and radiation services for a recipient with cancer requiring chemotherapy, if provided in an outpatient setting;
   (6) skilled nursing home care; outpatient laboratory and X-ray services for nursing home patients; and
   (7) intermediate nursing home care.

How does CAMA work?
If you qualify for CAMA, you will be given a Recipient Identification Card (commonly called a “coupon”) to give to your health care provider. A general description of CAMA covered services is printed on the face of the coupon. If you receive medical care for something that is not listed on the coupon, you will have to pay for the service yourself.

Before you receive medical treatment, you must give the coupon to your doctor, hospital, or clinic. Your health care provider must be enrolled with the Department of Health and Social Services, Division of Health Care Services. They will send the a bill to the state’s contractor for payment. Payments are made directly to your health care provider.

A CAMA recipient does have a responsibility to share in the cost of the services received. You must pay $50 for each day you are in the hospital up to a maximum of $200. There is also a $1 co-payment on each prescribed drug or medical supply. You pay these charges directly to your health care provider and they will bill the CAMA program for the rest. Your health care provider may not ask you to pay more.

How do I apply for CAMA?
You can submit an application for CAMA at the nearest Division of Public Assistance office or with a fee agent living in your community. A completed application form, supporting documents, and an interview with a caseworker or local fee agent are required. You will be asked to bring the following supporting documents with you to your interview:

   • papers that show your income such as tax forms, pay stubs, fish tickets, or a letter from the Internal Revenue Service saying that you do not pay taxes; and
   • papers that show any other assets or resources like savings accounts

At the interview, you will be given a form to take to your health care provider that is used to document and verify that you have one of the covered medical conditions. Your provider will return that form to your DPA caseworker. Your application and interview are confidential. No one will give out information about your health or financial status without your permission.

Your application will be reviewed and a notice will be sent to you within 30 days. If your application is approved, your benefits will start the month after you submitted your application. If your application is denied, you may have a right to appeal that decision at a fair hearing.

If you have any questions regarding the CAMA program, please contact the Division of Public Assistance office nearest you or the fee agent in your community.

More Information
Detailed information about CAMA eligibility policy is available by contacting either Kathy Ensor: kathy_ensor@health.state.ak.us / 907-465-1163, or Kevin Henderson: mailto:kevin_henderson@health.state.ak.us / 907-465-5821.