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Medicaid Program

The Medicaid Program

Imagine being in a situation where you need medical care for you or your family but not being able to see a doctor because you can't afford to pay the medical bill. It can be a helpless feeling... That is when Medicaid can help you.

The purpose of this Medicaid Program website is to provide you with easy to understand information regarding Medicaid in the United States and how Medicaid may be able to benefit you or your family.

We provide you with information regarding the Federal and State Medicaid programs. We help you determine if you are eligible to receive Medicaid benefits for the State in which you live, and the type of Medicaid coverage and Medicaid benefits you may be able to receive.

One of the biggest questions you might have about Medicaid is how the new Affordable Care Act (also called Obamacare) is going to affect or compliment the Medicaid program. As of October 1, 2013, you can enroll in the Affordable Care Act program but the affordable health care coverage doesn't start until January 1, 2014. For more information read the Medicaid and the Affordable Care Act article. We will continue to update you on the Affordable Care Act and Medicaid.

Medicaid provides comprehensive and long-term medical care for more than 60 million low-income Americans. Medicaid spending for 2011 was $275 billion and in 2012 was estimated at $258 billion.

Medicaid is an increasingly important source of coverage if you need medical care and can't afford to pay for it. In 2011, it was estimated that 1 in 5 Americans were enrolled in the Medicaid program. Medicaid covers 36% of all births, 50% of all HIV patients, and 68% of all nursing home patients in America.

Data from Medicaid claims allows health care information to be tracked for doctor's office visits, prescription claims, use of an emergency room, hospital and long-term care facilities stays. This information can then be used to provide you with better health care services.

What is Medicaid?

Medicaid is the United States health benefit program that helps provide for you and your family if you have low incomes and limited financial resources. Medicaid is essentially an entitlement program where the costs are shared by the states and the federal government, and the local Medicaid programs are managed by the states.

People that benefit from Medicaid are eligible low-income parents, children, elderly seniors, and people with chronic disabilities. You need to remember that having a low income does not necessarily qualify you for Medicaid.

The Medicaid program is run by the individual states and each state has their own requirements for eligibility and Medicaid application process.

Feel free to explore the Medicaid information that we have provided to help you determine if you are eligible for Medicaid and which aspects of the Medicaid program will benefit you the most.

Where do you start?

First, you need to know if you are eligible for Medicaid. Next you will need to know how to apply for Medicaid. Finally, you will need to know what health care coverage Medicaid can provide.

Additional common questions that you may have include Medicaid annuities, Medicaid benefits, Medicaid dental coverage, Medicaid prescription drugs, Medicaid eligibility, State Medicaid programs, and how Medicaid differs from Medicare.

Remember that Medicaid is a different program than Medicare. If you want to learn more about the Medicare program please visit the Medicare Programs site.

Do You Qualify For Medicaid?

Basically, there are about 25 different categories of Medicaid eligibility. These can be grouped into 5 general Medicaid coverages that include people over the age of 65, children, pregnant women that have children, adults with dependent children, and people that are disabled.

While Medicaid eligiblity does vary by state, there are mandatory groups of people that do qualify no matter where they live. These mandatory groups include low income families with dependent children, and women that are pregnant and have children and are below the federal poverty level. Also, beneficiaries of Medicare that have low income may also qualify.

How To  Apply For Medicaid

The Medicaid application process is easy and varies by each state. In most cases, you will need to contact your local state Department of Social Services or Human Services office. Each state may have a different name for the state agency that handles Medicaid. Essentially, it will be the agency that helps provide financial assistance and food stamps. Check the list of State Medicaid Programs for more information about Medicaid in your State.

The four states that have the largest number of people enrolled in Medicaid are California, New York, Texas, and Florida. Like we outlined, each state may have a different name for Medicaid and different agencies that manage the Medicaid programs.

For example, Medicaid in California is called Medi-Cal and is managed by the California Department of Health Care Services (DHCS). There are more than 10 million people enrolled in the California Medi-Cal program.

In New York, the Department of Health oversees the New York Medicaid program and if you live in New York City, you contact the Human Resources Administration. Outside of New York City you contact your local Department of Social Services (DSS) office to apply for Medicaid.

In Texas, the Health and Human Services Commission (HHSC) is responsible for the Texas Medicaid program.

In Florida, Medicaid is administered by the Agency for Health Care Administration, but your Medicaid eligibility is determined by either the Department of Children and Families (DCF) or the Social Security Administration (SSA) for people that receive Supplemental Security Income (SSI). Visit our Florida Medicaid page for an overview of the Florida Medicaid program and eligiblity.

No matter where you live, once you locate your local Medicaid office, you will need to ask for a Medicaid application and fill it out either online or at the Medicaid office. Make sure that you have your birth certificate, Social Security card, driver's license, proof of your address, pay stubs, proof of other insurance if you have it, and your bank account information.

You need to be ready to answer questions about your finances and financial situation. Your Medicaid eligibility is based on your level of income.

If your income is low and you need medical care, you should apply for Medicaid and have a qualified Medicaid caseworker in your state take a look at your situation. In addition to mandatory Medicaid coverage the states offer optional Medicaid coverage also known as Medicaid waivers.

Medicaid Annuity - A Medicaid annuity can allow you to protect your assets against the expected expenses of nursing home care and healthcare. The use of an immediate annuity is considered a Medicaid friendly annuity.

Medicaid Dental Coverage - Dental services are an optional service for adults (age 21 and older). However, dental services are a required service for most Medicaid-eligible individuals under the age of 21. For more information about  dental coverage please visit our Medicaid dental coverage page.

Medicaid Eligibility - Medicaid is only available to individuals and families with low income. Many different groups of people might be eligible for Medicaid assistance but different requirements must be met even within the groups. If you need medical assistance and you have low income and limited financial resources, you should apply for Medicaid. For more eligibility information feel free to visit our Medicaid eligibility page.

Waste of Medicaid Funds

One of the main concerns that people have about some of the state's Medicaid programs is the waste of Medicaid funds. Recent audits of New York's Medicaid system by the State Comptroller revealed that New York wasted at least $92 million dollars in Medicaid funds to billing errors, improper payments and poor recordkeeping during the last five years. There needs to be an increased effort to reduce Medicaid fraud and waste.

MedicaidProgram.net is an information website owned by What Is It LLC.

Learn more about What Is It at MyWhatIsIt.com... "We Simplify The Complex".


The official U.S. Government Medicare Web site is cms.gov.

 


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