1. Where do I apply for the MSI program?

Applications are taken at MSI contracted hospitals and qualified community clinics. Hospitals and qualified community clinics are listed in the MSI Patient Handbook.

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2. How long is my MSI eligibility effective?

Eligibility is effective for twelve months. MSI recipients may reapply in the twelfth month of their eligibility period if a medical need still exists. It is recommended to call in the tenth month of eligibility to schedule an appointment to reapply.

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3. How will I know if I have been approved or denied for MSI benefits?

Applications are reviewed by the MSI Unit of the Social Services Agency (SSA) for verification of information. This process may take up to six weeks from the date you apply to the Program. Applicants are sent a document called the Notice of Action (NOA) letter once the verification process is done. Eligibility information is also available by calling the SSA Eligibility Information Line at (714) 480-6333.

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4. What types of services does the MSI program cover?

A general overview of covered/non-covered services is outlined in the MSI Patient Handbook.

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5. How do I find a physician who accepts MSI?

MSI eligibles may receive services from any physician in Orange County. Simply ask the physician of your choice if he/she accepts MSI as reimbursement. If you are unable to find a physician on your own, you may receive services through MSI affiliated community clinics; a list of these clinics is outlined in the MSI Patient Handbook.

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6. If I find a physician who accepts MSI, does he/she have to sign a contract to see MSI patients?

Physicians are not required to sign a contract to see MSI patients; however, they are required to register with the MSI program as a condition of reimbursement This is a simple process that is done on-line, and does not obligate them to accept additional MSI eligibles. For further information ask the physician to call Program Support at 714-834-6248.

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7. Where do I get my prescriptions filled?

Prescription medications may be obtained from participating MSI contracted RxAmerica pharmacies. Ask your local pharmacist if the pharmacy is a RxAmerica participant.

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8. Where do I go for diagnostic procedures and other outpatient services?

Physical therapy and diagnostic procedures such as x-ray, MRI and blood/urine analysis must be done at contracted MSI facilities. Refer to the Outpatient Services section of the MSI Patient Handbook for more information.

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9. Where do I go if my doctor’s office is closed and my medical problem is fairly serious but not serious enough to go to an emergency room?

A list of Urgent Care Centers is outlined in the MSI Patient Handbook.

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10. What do I do with the bills I am receiving from the hospitals, physicians, ambulance companies, etc.?

The hospitals, physicians and ambulance companies, also called Providers of Service, often send bills to patients until they are notified of the patient's MSI eligibility. Patients who become eligible for the MSI Program are responsible to notify Providers of Service of their MSI eligibility status. These providers may ask for a copy of the Notice of Action (NOA) letter. It is a good idea to make several photocopies of this document and keep them in a safe place. Your provider must bill the MSI Program within 90 days of the date you received your medical service, or 90 days from the mail date noted on the NOA letter, whichever is later.

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11. If MSI denies payment for a medical service, can I appeal the denial?

MSI eligibles are sent a letter called Notice of Payment Denial by the MSI program’s billing agent whenever payment for a medical service is denied. This letter explains the appeal process and includes the reason for the denial of payment, the name of the provider, the dollar amount denied and the date of service. An overview of the appeal process is outlined in the Patient Handbook.

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12. I have received my Notice of Action (NOA) letter, and the eligibility effective date is wrong. I need coverage for the month of... What can I do?

Eligibility effective dates may be appealed by writing to the address on the reverse side of the NOA letter. This address is SSA Patient Appeals; P.O. Box 22001; Santa Ana, CA 92702-2001. For additional information call the SSA Eligibility Information Line at (714) 480-6333.

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13. I am eligible for MSI benefits but MSI is refusing to pay my bills. What can I do?

Acceptance to the MSI program does not guarantee that all medical services are covered benefits. For information on the MSI program's covered/non covered medical services, refer to the MSI Patient Handbook.

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14. If I am not eligible for the MSI program, where can I obtain free or low-cost medical care?

The County of Orange Health Care Agency clinics provide services such as birth control/family planning, pregnancy testing, immunizations, and well/sick child health care. More information is available by calling the Public Health Referral Line (800) 564-8448. There are also a number of community clinics that provide health care services on a sliding fee scale. A list of these community clinics and their phone numbers is available in the MSI Patient Handbook.

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