People often confuse Medicaid with the more well-known government program Medicare. Truth is, they are similar but different government-run programs aimed at helping American citizens get health insurance.
Both Medicare and Medicaid were created in 1965 under the Lyndon Johnson presidency to help Americans who were unable to acquire private health insurance. The difference is the more common Medicare is a federal program to provide help for elderly Americans, specifically ages 65 and older. Medicaid is a program run both at the state and federal level designed to support individuals with low income.
Who gets Medicaid?
An estimated 72.5 million receive some sort of Medicaid when it is bundled with the Children’s Health Insurance Program. Anyone from children to people with disabilities receive some sort of aid. Seniors and pregnant women also get coverage through Medicaid. Those that are eligible must also be eligible for a Supplemental Security Income (SSI) cash payment for at least a month, be currently disabled, need Medicaid care in order to work, or have a gross income that doesn’t meet normal Medicaid and SSI cash aid.
The difference between states
The question as to who acquires aid through this program gets further complicated because Medicaid is both a federal and state program. States get a bit of leeway when it comes to determining who is eligible. The District of Columbia and 32 states follow closely to the SSI formula for determining eligibility.
However, other states have their set of rules over Medicaid eligibility.Seven states require an additional application to be eligible for Medicaid, though they do tend to follow SSI guidelines. These states are Alaska, Idaho, Kansas, Nebraska, Nevada, Oregon, and Utah.
The other 11 states – Connecticut, Hawaii, Illinois, Indiana, Minnesota, Missouri, New Hampshire, North Dakota, Ohio, Oklahoma, and Virginia – have their own eligibility rules involving Medicaid. For residents of these states, they have to go to their state’s Medicaid web site in order to check whether they are eligible or not.
What coverage does Medicaid have?
Medicaid offers low-income individuals and others a better chance to afford private health care, which is considered a better option that regular care. Many of the top doctoral professionals tend to set up a private practice. Medicaid also aids those disabled, whether permanently or unable to work at the moment. However, a person needs to show that his or her impairment prevents work.
The Medicaid health coverage includes dental services and it is mandatory to give those who can benefit from it and are under age 21. For adults ages 21 and over, it can be optional. Early prevention screening for children are also mandatory coverages under Medicaid. This provides assistance to children of low-income families.
How to Apply for Medicaid
There are two ways to begin the process, but it can depend on the states. For the 32 states that tend to closely follow federal guidelines, then the Medicaid websitesite is a good starting point. For the 18 states that have separate guidelines and rules, check with the state’s Medicaid site in order to determine eligibility.
Affordable Care Act expansion
The Affordable Care Act that was a part of Obamacare expanded Medicaid coverage starting on Jan. 1, 2014. This allowed more people to become eligible. Instead of those at or below the poverty line, those at 133 percent of the poverty line could become eligible, even if adults don’t have any children. The federal government would have paid for all of the care through 2016 and then up to 90-95 percent of such costs beyond 2016. However, states were eventually given the option through a Supreme Court ruling to opt to reject the care expansion. Several states have opted out of the expansion though states can also bundle the extension into their own state programs.