Maintaining good health is crucial for every individual. However, medical expenses can be overwhelming, especially when paid out-of-pocket. Thankfully, the US government offers policies and programs designed to assist eligible citizens in covering health care costs.
In this blog post, we will discuss one of these programs: Medicaid. Keep reading to learn about Medicaid’s eligibility requirements and how it works.
What Is Medicaid?
Medicaid is a government health program that provides comprehensive health coverage to low-income individuals and families in the United States. Federal and state governments fund the program via a federal matching program. However, the administration is carried out on a state level. As a result, eligibility requirements and program benefits may vary slightly. Nevertheless, all Medicaid programs follow a broad range of federal guidelines.
Medicaid is an essential program in the United States that has helped several low-income or disabled individuals access proper healthcare at little or no cost.
Currently, Medicaid provides health coverage to over 90 million low-income Americans. In 2019, Medicaid covered half of all American births.
Who Is Eligible for Medicaid?
Eligibility for Medicaid differs per state. However, there are general rules that apply across all jurisdictions.
Medicaid is available to all adults above 65 years old. It’s also available to pregnant women, children in foster homes, low-income families, and persons with disabilities.
Usually, disabled people whose income falls below 100% and 200% of the FPL are considered eligible. The same applies to children, senior citizens, and pregnant women. Also, individuals whose income falls below 138% of the FPL may be eligible for the program. You can find out if you are eligible for the program by contacting your state’s Medicaid agency or filling out a form on healthcare.gov.
Benefits of Medicaid
Medicaid benefits low-income individuals or families who aren’t eligible for Medicare, do not have health insurance via their jobs, or cannot afford private insurance.
The program is administered on a state level, so the benefits offered vary per state. However, there are certain benefits that are mandatory and must be offered by all states. These benefits include inpatient and outpatient hospital services, physician services, family planning services, early and periodic screening, diagnostic and treatment services, home health services, X-ray and laboratory services, pediatric and family nurse practitioners’ services, and many more.
In addition to mandatory benefits, there are also optional benefits which vary from state to state. They include prescription drugs, dental services, hospice, optometry, private-duty nursing services, and others.
Sometimes, Medicaid programs will cover different home and community-based services so that affected persons living at home can stay active in their community instead of getting institutionalized. These programs cover transportation services, meal planning, and personal and skilled nursing care.
You should note that not all service providers accept Medicaid. To find service providers that accept Medicaid, visit the Beneficiary Resources page on Medicaid’s official website. You will also find a comprehensive list of the benefits your state offers.
How Do You Apply For Medicaid?
There are two ways to apply for Medicaid. You can apply via your state’s Medicaid Agency or create an account with the Health Insurance Marketplace. Once you’ve created your account, your application will be reviewed, after which you will be informed of your eligibility status.
Wrapping Up
Medicaid is one of the four government-sponsored medical insurance programs. Individuals covered by Medicaid are usually not required to pay anything for medical expenses. In the worst-case scenario, they’re only required to pay a small percentage for certain items or services. Conversely, Medicare requires its members to fund parts of the coverage via deductibles, coinsurance, and monthly premiums.