Alabama Medicaid Agency
501 Dexter Avenue
P.O. Box 5624
Montgomery, Alabama 36103-5624
W. DALE WALLEY
Our Mission - to provide an efficient and effective system of financing health care for our beneficiaries
Recipient Notice 99-11
Name of Medicaid Recipient Here
Recip. Medicaid # + Check Digit Here
Address of Medicaid Recipient Here
Aid Category - XX
City, State, ZIP Here
Date of Birth – xx/xx/xx
The person named above is eligible for Medicaid, subject to the coverage under their designated
Pregnancy-related services restricted to:
Call ______________________ for referral information
Recipient is on restriction (lock-in)
Keep This Notice!
This notice shows that you are on Medicaid!
There is a very small chance computer problems in the Year 2000 may keep your health care provider
from checking to see if you are on Medicaid. If there are problems because of this during January and
February of 2000, this notice will be needed to prove you are on Medicaid.
Once these computer problems are fixed, you will need to show only your Medicaid card. If the
computer problems are not fixed by the end of January, you will use this notice to prove you are
on Medicaid during February 2000. Just in case, keep this notice until March 1, 2000.
When you go to the doctor, drug store or any other place for health care, take this notice with you. (If
you are on Medicaid’s Patient 1st program, you should keep going to your Patient 1st doctor or clinic.)
If your health care provider cannot use the computer to tell if you are on Medicaid, this notice will prove
that you are on Medicaid. Put this notice in a safe place and keep this notice until March 1, 2000. If you
lose this notice, we may not be able to replace it.
If you go for health care services, you must bri