Medicaid..

By: Taylor


Medicaid is a health insurance coverage program for people of all ages who’s assets, income and resources are insufficient to afford private health insurance. Medicaid is the largest source of funding for medical and health-related services in the United States and is jointly funded by the individual state and the federal government, however the program within each state is managed by the state itself. Each of the fifty United States have a Medicaid program, though they are not required to have a Medicaid program. Recipients of Medicaid must be a United States citizen or legal permanent resident and may include low-income adults and their children along with people suffering from certain types of disabilities, however poverty alone does not qualify a person for Medicaid.

Each state is free to design their own reimbursement and delivery system under the Medicaid Program. The Social Security Act allows flexibility in Medicaid operation by states by authorizing multiple waivers. This program offers coverage for Long Term Care Services including Institutional Care and Home and Community Based Services. Some states run Medicaid and the Children’s Health Insurance Program (CHIP) as a single combined program.

The goal of Medicaid is to provide safe, effective, efficient and quality care, which is equitable and patient-oriented.

Eligibility for Medicaid

Medicaid and CHIP together cover around 60 million Americans including children, pregnant women, parents, seniors and disabled people. Each state has its own eligibility criteria. Federal law requires States to cover certain mandatory eligibility groups, they are also free to cover optional eligibility groups. Most people under age 65 having individual incomes up to about $15,000 per year will qualify for Medicaid in every state by beginning of 2014.

Some common eligibility criteria for Medicaid are:

Disabled people are eligible for Medicaid in every state. Some states include them automatically if they get Supplemental Security Income (SSI) benefits. In other state they are included on basis of income and resources.
The Affordable Care Act expands help to low-income adults with disabilities failing to meet disability requirements of the SSI program. It will also include people under age 65, including people with disabilities, with income of about $15,000 yearly.
Some states allow people with disabilities above regular income limit to enroll in Medicaid through “buy-in” programs.
The child born of Medicaid covered parent(s) will automatically have Medicaid coverage until they are one year old.
Coverage for children is offered through Medicaid and CHIP in all 50 states. In a family of four. Children are eligible for Medicaid if the family’s yearly income does not exceed $45,000.
Pregnant women are eligible for Medicaid coverage including their unborn and infant if they fall under limited income group i.e. about $20,000 as an individual. This may vary from state to state.
Women with breast or cervical cancer are also eligible for Medicaid through Breast and Cervical Cancer Prevention and Treatment (BCCPT) Medicaid programs.

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