HFI Program

Optima Health partners with HFI to help our Medicaid members apply for federal and state benefits, including Supplemental Security Income (SSI). Social Security benefits provide members with tax-free monthly income and resources to improve their basic needs and health. You may receive a letter or phone call from HFI, our trusted partner, about how you might qualify for these benefits.

Frequently Asked Questions

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  • Why did I receive a letter from HFI?

    HFI is reaching out to help you apply for Medically Complex and/or Social Security disabilities benefits. They will only send you a letter if they feel you may qualify for this benefit. This service is offered at no cost to you.

    HFI will help you with the application process. Their experience with this process will help you fill out the application correctly and completely the first time. Their help does not mean the benefits will be approved.

    Call 1-833-342-8766 (TTY: 711) to speak to an HFI member advocate. They can be reached Monday through Friday, 9 a.m. to 5 p.m.

    Members can call the number listed on their letters to disenroll from the HFI program.

  • What happens if I participate in the program?

    Social Security disability benefits:

    • HFI staff will call you to get the following information:
      • current health status
      • medical history
      • work history
      • ability to perform Activities of Daily Living for possible SSI benefits (for example – bathing, dressing, feeding, and mobility)
      • Social Security number
      • date of birth
      • address
      • income
      • immigration status

    If you qualify for Social Security benefits, HFI will send you a set of forms by mail or email. These forms allow HFI to legally represent you with the Social Security Administration (SSA).

    • Once HFI gets the signed and completed forms from you, they will submit the application, and advocate for you with SSA throughout the entire process.
    • Working with HFI does not mean benefits will be approved.

    Medically Complex benefits:

    • To evaluate if you are a candidate for Medically Complex benefits, HFI will call you to complete an MCO Medical Health Screening (MMHS).
    • If you qualify, HFI will send your answers from the MMHS to Optima Health.
    • An Optima Health care manager will use the answers to help you get the care that you need.

  • Besides Medically Complex and Social Security disability benefits, does HFI help Optima Health members get other benefits?

    No, HFI is only helping members through the process to see if they qualify for Medically Complex or SSI benefits. They do not assist with enrolling members into any other state or federal program.

  • English is not my primary language. Does HFI offer translation services?

    Yes, HFI staff is fluent in Spanish, Haitian Creole, Cape Verdean Creole, Portuguese, French, and Vietnamese. If you need assistance in another language, HFI will use a translator at no cost to you.

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