Health InsuranceMedicare

A Beginner’s Guide to Medicaid. Individual and Family Plans

Understanding the Different Types of Medicaid Programs

Medicaid is a state government program that people with low pay and resources can use to pay for a few or the greater part of their health care bills. Obtaining healthcare coverage can be a tricky thing to navigate through. Often times healthcare can be purchased through an individual‘s place of employment, a private company or local and state agencies. There are all sorts of companies designed to help individuals to receive healthcare services. These companies include hospitals, private practice facilities, nursing homes, and the likes. The type of healthcare services that fall under these facilities for individuals who do not have coverage through their employer is considered to be Medicaid. It covers restorative consideration, similar to specialist visits and healing center costs, long-haul care administrations in nursing homes, and long-haul care administrations at home, for example, going to medical caretakers and help with individual consideration. Not at all like Medicare, Medicaid pays for custodial consideration in nursing homes and at home.

State Medicaid Projects

Because there are so many different components to Medicaid it is often times difficult for an individual to determine what type of coverage with the Medicaid they may actually have. Most people do not realize that Medicaid provides more than just health care services. It also covers non-healthcare related issues such as:

  • Dental
  • Chiropractic
  • Therapy
  • Optometrist
  • Pediatric
  • Physical and occupational therapy
  • Case management services
  • Prosthetic’s
  • Podiatry services
  • Prescription drugs

These are just some of the programs available to Medicaid members. General project rules are set for who can be qualified for Medicaid and what administrations are secured depending on government necessities, yet states have extensive slack by the way they work their projects.

Different State Benefits

States are required to cover certain gatherings of people, yet have the choice to cover extra gatherings. Also, states are required to cover certain administrations, however, they have the choice of covering extra administrations in the event that they wish to do as such. Subsequently, benefits fluctuate from state to state.

Medicaid Qualifications

To be qualified for Medicaid you should meet certain prerequisites, including having wages and resources that don’t surpass the levels utilized by your state.  Once your state discovers that you are qualified for Medicaid, the state will make an extra determination of whether you fit the bill for long-haul care administrations.

Nursing Home Care Programs

While figuring out if you meet all requirements for long-haul care administrations, most states utilize a particular number of individual consideration and other administration needs to fit the bill for nursing home care or home and group-based administrations. There might be diverse qualification necessities for various sorts of home and group-based administrations.

The Medical Assistance Office

Your State Medical Assistance office is the best hot spot for data about how to fit the bill for Medicaid in your state and on the off chance that you meet all requirements for long-haul care administrations.

Home Based Care Programs

Medicaid covers nursing home administrations for all qualified individuals age 21 and above. Medicaid likewise covers home and group-based administrations for individuals who should be in a nursing home on the off chance that they didn’t get the home consideration administrations.

What Does Medicaid Cover?

In many states, Medicaid will likewise cover benefits that will help you stay in your home, for example, individual consideration administrations, case administration, and help with clothing and cleaning. Medicaid won’t pay for your rent, home loan, utilities, or sustenance. Verify whether your state Medicaid program offers contrasting options to nursing home consideration administrations.

Ask What Provisions Are Available

Understand that Medicaid projects and qualification for administrations change from state to state. Administrations that might be accessible to you in one state may not be accessible in another. For instance, some states provide living administrations, while others don’t. Contact your state Medicaid office to take in more about your state’s projects and qualification prerequisites. Medicaid has been designed by the government to help with low or no income healthcare needs but when it comes down to each individual state the expanded components of Medicaid may or may not apply. Usually, programs for Medicaid explained can be quite confusing which is why someone who is seeking to receive services through Medicaid must really research Medicaid guidelines, requirements and coverage’s. They should also speak with designated experts that work in the Medicaid division and ask any necessary questions that may be relatable to their health care needs and possible Medicaid coverage.

Long-Term Care

Numerous states have projects to pay for home and group-based long haul care tends to be more established for grown-ups, those 60 and above are those who normally benefits and their families. States frequently draw on assets from an area, state and government sources, for example, the Older Americans Act. The center of these projects is to help more seasoned grown-ups stay in the group as autonomously as could be expected under the circumstances. States regulate these administrations through state and nearby office systems known as the Aging Network and include:

  • Sustenance projects, such as home-conveyed suppers for home bound elderly or dinners served in groups
  • Transportation administrations
  • Well being advancement administrations to avert malady or oversee interminable ailments
  • Individual consideration help and help with family unit errands and shopping
  • Lawful help and administrations that secure the privileges of more established persons, for example, the long haul care ombudsman program
  • Family guardian administrations and backings including time off from their obligation called rest care

Image result for medicaid members pregnant womenPregnant Women

There have been times when Medicaid members have not always taken advantage of all of the benefits that they actually have. This is due partly to the fact that they are not always aware of the additional benefits that are available to them or in certain circumstances certain benefits may not apply. Women who are pregnant also have additional benefits outside of their routine check-ups for the pregnancy. For example, if there is a woman who is pregnant but she also smokes cigarettes she can receive counseling services for the cessation of smoking cigarettes while pregnant. Expecting mothers can also receive freestanding birthing services as well as family planning assistance.


Often time programs for Medicaid explained the basic coverage’s offered but failed to give more in-depth information. There are various components of Medicaid that provides specific services so it is always important for Medicaid recipients to have access to all of the information necessary to them and not just access to some. In certain circumstances, some of the programs available to Medicaid members may have some small type of monetary fee attached. These minor cost can vary depending on the type of services the individual be receiving.

Sliding Fee Scale

However, if an individual is unable to pay the required amount, then the facility can place the member on what is called a sliding fee scale. This allows the Medicaid member to be able to pay for the services in an incremental monthly payment plan that is much more affordable for them. Some programs for Medicaid explained the fee scale payment and other programs do not. Therefore it is always good for a Medicaid recipient to ask additional questions when having procedures performed especially if the Medicaid is going to be utilized as their primary source of health care insurance.

Children Image result for medicaid members

There are specific benefits for Medicaid outside of healthcare treatment that only covers services if the individual is a child. Those benefits include braces and orthodontic care, optometry care, and eyeglasses. Yet they are still some programs available to Medicaid members that are only offered within specific states. For example, Medicaid recipients in Texas can receive coverage for vision and dental. Medicaid recipients who live in California can receive coverage for Cervical and breast cancer treatment. Individuals who live in Florida and have Medicaid are eligible to receive Podiatry and dental coverage’s. Ohio state Medicaid recipients can receive dental, vision, alcohol and drug addiction treatment. New York Medicaid recipients will often times have a co-pay with their services and North Carolina Medicaid recipients can receive early intervention for infants and toddlers that have been diagnosed with autism.

Those Who Are Unemployed 

When discussing Medicaid a majority of the time the assumption that is made is that a Medicaid recipient cannot be employed. However, Medicaid also provides coverage’s and benefits for individuals who may be employed but their income is not at a certain level. Because the government allows the Medicaid to be broken down by individualize states the financial earnings cut off point may vary from state to state. A Medicaid recipient will have to inquire through their local government or agencies to find out how much they can actually make while being employed and still receive Medicaid benefits.


Another benefit offered through Medicaid includes public transportation services which are free of charge to the Medicaid member so long as they have a legitimate medical, dental or other healthcare relatable doctor appointment. The only requirement to receive the free transportation service is that the Medicaid recipient must call in a minimum of three days in advance prior to their scheduled appointment to make arrangements for pick-up and return.

Food Services

Medicaid not only provides health care benefits but it also aides individuals in receiving food services. Medicaid recipients can receive food vouchers or stamps that gives them the ability to grocery shop for everyday household needs. It even provides hot meals on the go to disabled and elderly individuals as well. The programs that these meals are usually set up through are normally handled by local communities, charities or organizations. Even church organizations have been known to utilize Medicaid funded programs that provide food for children during the summer months.

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