The Edg Number is an identification number assigned to each Medicaid recipient. It is used to track an individual’s eligibility and benefits, and to ensure that they receive the appropriate level of care. The Edg Number also helps to prevent fraud and abuse within the Medicaid program. It is typically found on the individual’s Medicaid card, and is often used during healthcare appointments or when applying for Medicaid benefits.
Eligibility Determination Group (EDG) Assignment
The EDG number is a unique identifier assigned to each Medicaid applicant or recipient. It is used to determine the applicant’s or recipient’s eligibility for Medicaid and the level of benefits they are entitled to. The EDG number is also used to track the applicant’s or recipient’s Medicaid history.
The EDG number is assigned by the state Medicaid agency. The agency uses a variety of factors to determine the EDG number, including the applicant’s or recipient’s age, income, family size, and disability status.
The EDG number is a key factor in determining the applicant’s or recipient’s eligibility for Medicaid. The agency uses the EDG number to determine the applicant’s or recipient’s eligibility group. Each eligibility group has its own set of eligibility criteria and benefit levels. There are currently 18 EDG groups in California for non-elderly adults.
The following are the EDGs for non-elderly adults in California:
- EDG 1 – Pregnant women with incomes up to 215% of the Federal Poverty Level (FPL)
- EDG 2 – Children under age 19 with incomes up to 215% of the FPL
- EDG 3 – Parents and caretaker relatives with incomes up to 215% of the FPL
- EDG 4 – Adults with disabilities with incomes up to 215% of the FPL
- EDG 5 – Adults age 65 and older with incomes up to 215% of the FPL
- EDG 6 – Long-term care residents with incomes up to 300% of the FPL
- EDG 7 – Low-income working adults with incomes up to 138% of the FPL
- EDG 8 – Childless adults with incomes up to 138% of the FPL
- EDG 9 – Qualified Medicare beneficiaries with incomes up to 400% of the FPL
- EDG 10 – Breast and cervical cancer patients with incomes up to 250% of the FPL
- EDG 11 – HIV/AIDS patients with incomes up to 250% of the FPL
- EDG 12 – Tuberculosis patients with incomes up to 250% of the FPL
- EDG 13 – Uninsured adults with incomes up to 215% of the FPL
- EDG 14 – Adults with incomes up to 138% of the FPL who are not eligible for other EDGs
- EDG 15 – Children under age 19 with incomes up to 138% of the FPL who are not eligible for other EDGs
- EDG 16 – Parents and caretaker relatives with incomes up to 138% of the FPL who are not eligible for other EDGs
- EDG 17 – Adults with disabilities with incomes up to 138% of the FPL who are not eligible for other EDGs
- EDG 18 – Adults age 65 and older with incomes up to 138% of the FPL who are not eligible for other EDGs
Below is a table showing the EDG assignment process for non-elderly adults in California
| Income | Age 19 or Older? |
Pregnant? | Disabled? | EDG |
|---|---|---|---|---|
| Up to 138% of FPL | Yes | No | Yes | EDG 17 |
| Up to 138% of FPL | Yes | No | No | EDG 14 |
| Up to 215% of FPL | Yes | No | Yes | EDG 4 |
| Up to 215% of FPL | Yes | No | No | EDG 7 |
| Up to 215% of FPL | No | No | No | EDG 8 |
| Up to 215% of FPL | Yes | Yes | No | EDG 1 |
| Up to 215% of FPL | No | Yes | No | EDG 2 |
| Up to 215% of FPL | No | No | Yes | EDG 3 |
| Up to 215% of FPL | Yes/No | No | No | EDG 13 |
EDG Number in Medicaid Applications
The Electronic Data Gathering (EDG) number is a unique identifier that Medicaid uses to track applications for benefits. This number is used to link together all the information that is collected about an applicant, including their application form, income and asset information, and medical records. The EDG number also allows Medicaid staff to track the status of an application and determine if it has been approved or denied.
Medicaid recipients who are eligible for long-term services and supports (LTSS) are assigned an EDG number that is used to track their services and payments. This number is used to identify the recipient in the Medicaid system and to track their eligibility for benefits. The EDG number is also used to authorize payments to providers for LTSS services.
How to Obtain an EDG Number
To obtain an EDG number, you must submit an application for Medicaid benefits. The application process varies from state to state, but typically involves completing an online or paper application and providing supporting documentation, such as proof of income, assets, and medical expenses. Once your application is approved, you will be issued an EDG number.
Benefits of Having an EDG Number
Having an EDG number can provide several benefits to Medicaid recipients, including:
- Easier access to benefits: An EDG number allows you to access Medicaid benefits more easily, as it provides a unique identifier that can be used to verify your eligibility for services.
- Improved care coordination: An EDG number helps providers to coordinate your care more effectively, as it allows them to access your medical records and track your progress.
- Protection against fraud and abuse: An EDG number helps to protect you against fraud and abuse, as it allows Medicaid staff to track your eligibility for benefits and ensure that you are receiving the services that you are entitled to.
EDG Numbers and State Medicaid Programs
EDG numbers are used by Medicaid programs in all 50 states. However, the specific rules and procedures for obtaining and using EDG numbers can vary from state to state. It is important to contact your state Medicaid agency for more information about how to obtain an EDG number and how it will be used in your state.
Contact Information For Medicaid Agencies By State
| State | Agency Name | Website | Phone Number |
|---|---|---|---|
| Alabama | Alabama Medicaid Agency | www.medicaid.alabama.gov | 1-800-362-1501 |
| Alaska | Alaska Medicaid Program | www.medicaid.alaska.gov | 1-800-478-7774 |
| Arizona | Arizona Health Care Cost Containment System | www.azahcccs.gov | 1-800-677-8055 |
Well, folks, this has been a crash course on what an EDG number is when it comes to Medicaid. I hope it’s been as easy to understand as I hoped it would be. If you’re still feeling a little confused, don’t worry, it happens. You can always check back here later or reach out to your local Medicaid office. And if you have any other Medicaid-related questions, be sure to check out our other articles. Thanks for reading, and I hope to see you back here soon!