Medicaid is a health insurance program of the federal government that primarily aims to assist adults, children, pregnant women, elderlies, or other individuals that have low income and need medical and health assistance.
This program may be administered differently in each state in the US. This program is also funded by both the federal government and the state governments. Planning for an application?
Medicare and Medicaid: How are they different?
Medicare and Medicaid are both government programs that deal with health and medical assistance. However, they are managed and funded by different sectors of the government and have different targets in the community.
This federal program targets elderly people ages 65 and above, disabled individuals, and individuals undergoing lifetime dialysis, or requiring organ transplants.
Additionally, you can apply to this program no matter how much or how low your income is so long as you meet the eligibility requirements.
Unlike Medicare, this program focuses on individuals who have low incomes and need health and medical assistance. Medicaid offers assistance to any age so long as you meet other criteria.
One of their services is to cover hospitalization and other medical fees. Although, there are instances wherein the individual will pay a portion of the expenses.
How they serve individuals varies from state to state. Ask state government officials managing the Medicaid program to know specific details about the program.
Other than Medicare and Medicaid, the Children’s Health Insurance Program, or known as the CHIP also offers the same services to qualified applicants.
Children’s Health Insurance Program (CHIP)
CHIP is one of the largest and most known existing programs in the US that assist individuals in terms of health and medical services. This mainly provides low-cost health services to qualified individuals.
If you are one of those who tried to apply for Medicaid but did not meet the income requirements, you can apply for CHIP. The CHIP program is a federal program and the services may vary from state to state.
To know more about the CHIP program and application procedures in the state you live in, talk to local government officials who supervise this program.
Some might be thinking that they don’t meet the income qualifications of the Medicaid program, but it is still not a bad choice to give it a try.
There is still a chance that your application will be approved, especially if you have children, you are pregnant, you are elderly, or you have a disability.
The following are some details about the eligibility for Medicaid programs:
- Need to be a resident of the state where you applied for the Medicaid program;
- Must be a citizen of the United States or a legal/qualified non-citizen of the country;
- In some states, they include a specific age group, pregnancy condition, and parenting status in their list of eligibility requirements.
The MAGI or the Modified Adjusted Gross Income is the newest methodology proposed by the Affordable Care Act in determining the financial eligibility of applicants for federal and state programs.
Other than that, some individuals are exempt from undergoing the MAGI methodology in determining their eligibility. Individuals who are aged 65 and above and have blindness or other kinds of disability.
Instead, their eligibility will be determined by the methodologies set by the Supplemental Security Income or SSI.
Moreover, some states use their existing eligibility criteria that might be more restrictive, but they also apply the methodologies set by the SSI
How to Apply for Medicaid
There are two options you can do when applying for the Medicaid program:
Option 1: Applying Through The Health Insurance Marketplace
In this method, you will be asked to fill out an application form. After you submit your application, you just have to wait for the response from the state agency for further application procedures.
You can also determine if you are qualified for an individual Medicaid program by assessing your income.
If you are with the go for this application option, you can start by creating your account by visiting the healthcare's official website.
Option 2: Applying Through The State Agency Of Medicaid
In this method, you just have to get your state’s Medicaid program contact information and be in touch with them for your enrollment procedure.
You can get your State Agency’s contact info by filling up the name of the state you live in on the healthcare official website.
Frequently Asked Questions
Does Medicaid Cover Ambulance Services?
Yes, Medicaid covers ambulance services so long as the service providers are licensed by the state. Thus, patients under the care of Medicaid must be transported by vehicles that the state had thoroughly inspected and given the permit to operate.
Does Medicaid Cover Dental Care?
Yes, dental services are included and required for Medicaid members under the age of 21. Although, this may vary from state to state and other states even elect to provide services to eligible members.
Are There Doctors Who Accept Medicaid Payments?
You can find the right doctor that accepts Medicare and Medicaid payments through the programs’ Physician Compare website.
You can search by simply typing your state, county, zip code, and doctor’s practice field.
What Services That Medicaid Covers?
The services of the Medicaid program vary in each state but rest assured that all essential services apply in each state. The variations involve the duration, the amount, and the coverage of services based on the guidelines set by the federal government.
Further, there are also mandatory services that each state should follow, these include:
- Hospital services like in or out-patient services;
- Physician/Doctor services;
- Home health services; and
- Laboratory services.
What Are The Income Level Qualifications For Medicaid?
Just like the service coverage of Medicaid, the qualifications for applying for the program also vary depending on the state you are in. If the state already expanded its program, you can be qualified based on your income alone.
Whereas if the state has not yet expanded the program, the basic qualifications include the following:
- Number of members in the household;
- Age; and
- Parenting status.