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What is Medicaid & What Medical Services Are Available With This Program

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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. 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 receives 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.

What Is Medicaid And What Services Does It Offer?Image result for medicaid illustration

The history of Medicaid is one that stretches back to the first days of Medicare. The two programs are very similar, but they serve two different parts of the population. There are people who might have dual enrollment, and there are others who need to learn the difference between Medicaid and Medicare. You simply need to decide which program to sign up for, how to use it, and what it can do for you.

The History Of Medicaid

The history of Medicaid starts with the social programs that came out of the New Deal. Medicaid was meant to be used by people with a low income. This is the welfare system that people often hear about it, and there are many people who do not realize that they must reach a very high-income level just to get out of the system. Medicaid has changed many times over the years because it has been made larger to accommodate more people.

What Does Medicaid Do?

Medicaid makes sure that people are given mostly free services that will help them at the doctor and the dentist. There are a number of people who have taken out Medicaid because they need to take their kids to the dentist, and they get the checkups at the doctor that they need. They can get emergency services, and they will get vision services for people who need glasses. Medicaid can be used for children and adults, but the adult must apply first. The adult will get an explanation of benefits, and they can choose from a large list of doctors who take the program. Medicaid will do all of the following:

  • Cover all basic health services
  • Offer dental coverage
  • Offer vision coverage

How Is Medicaid Serviced?

An insurance company services Medicaid policies. There are many insurance companies that will use Medicaid as a way to grow their business. There are companies like Amerigroup that offer these policies to people through their brand, and the customer will get an insurance card from this firm as opposed to the government. The government can offer service on these policies in most cases, but they also refer to the insurance companies in certain instances.

The Difference Between Medicaid And MedicareImage result for medicare vs medicaid illustration

The difference between Medicaid and Medicare is that Medicare serves the elderly while Medicaid serves the general population. Some people actually stay on Medicaid because they get a deferment from the government. However, most elderly people will switch to Medicare when they turn 65. These people go on Medicare, but they get the same basic service. There are many people who will go to Medicare when they get older so that they do not need to be on private insurance, and there are many others that will want to stay on Medicaid because of services they already receive. However, the difference between Medicaid and Medicare is actually much bigger than that.

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 than 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 is 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 website site 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% 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% 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.

Extra ServicesImage result for medicaid illustration

There are people who will need to get extra services from both Medicaid and Medicare because they need a cell phone, transportation, or a variety of other services that are offered through the program. The purpose of using these programs is that you can get a new cell phone from Medicaid so that you have a way to communicate. You could get transportation to get to the doctor if you do not have a car, and there are even special services for kids who are having trouble in school. There are childcare plans, and there are many other people who will go to Medicare to get a phone for seniors, a way to get to the doctor or to get help with estate planning. This is a holistic service that is meant to help the whole family live well.

How Do You Do Dual Enrollment?

Dual enrollment is offered to people who are elderly or have been inserted into the system because of a deferment they were given. These people are disabled, and they might have been put into both Medicaid and Medicare. There are some people who would like to be dual enrolled because they are unsure of how they are going to get the care that they need that is specific to them. Someone who wants to dual enroll must contact both programs to ask for help with this enrollment plan.

Do Seniors Change Over?

Seniors will change over when they are getting close to 65. They need to put in their application when they are close to their 65th birthday, and someone who wants to get their senior loved ones on the Medicare plan needs to send the application for them so long as they have power of attorney.

Kids On MedicaidImage result for children on medicaid illustration

Kids can be put on Medicaid at any time when their parent has sent in an application. There are many people who would like to see if their kids need to be on Medicaid, and they will want to send these applications in or call to get extra information. The information that they get on these policies should be used to find the income level they need to meet, how to figure out what their options are if they have trouble with their application, or finding out how they can get their kids to the right doctor or dentist. You could contact the office to ask who is covered, or you could ask if your children can stay on the plan if they are over 18. There is often a deferment for children of the covered who are up to 21 years old.

Conclusion 

Someone who would like to get their friends or family onto these plans needs to be sure that they have looked online at all the information for each insurance policy. Medicaid is meant to be used by people who are under 65, and Medicare is for those who are over 65. There is a chance that you could be enrolled in both if you are disabled or need special services.