Medicaid is a health insurance program for individuals and families with low incomes and resources. It is managed by the states, but the cost is shared between your state and the federal government. Medicaid provides health care services for low-income parents, children, seniors, and people with disabilities. It is the largest source of funding for medical and health-related services for people with limited income.
Even though the name sounds similar, Medicaid is substantially different from Medicare.Medicaid is a social welfare program with both state and federal funding. It is available to all based on age or disability, and Medicaid’s availability is based on financial need. It is possible to be enrolled in both (Dual Eligible).
Medicaid has been in the news quite a bit lately as it’s the source of the premium subsidies that are offered through the Affordable Care Act (Obamacare). Many states have embraced the program as the federal government pays 90% or more of the cost, but there is a sizable number that limits or refuses to offer Medicaid for political reasons.
Many states have contracted insurance companies to administer Medicaid rather than having to handle bill processing themselves. It’s probably a good idea as it’s a complex process. And most states have their own names for their programs. The majority of recipients are in managed care plans.
Seniors and people with disabilities account for about one-quarter of the beneficiaries, yet their needs consume two-thirds of the cost.
Notably, the majority of funding now goes to home and community-based services that allow independent living in their own or community-based homes. This is a big change from not too long ago when the majority of funding went towards institutional or nursing home care.
Eligibility criteria for Medicaid vary by state, but typically include the following:
- U.S. citizenship or legal residency
- Low income and limited assets
- Children, pregnant women, elderly individuals, and people with disabilities are among those who may be eligible
- Adults without children and without disabilities may be eligible in some states through expanded programs.
To find out if you’re eligible for Medicaid, you can visit their official website or contact your state benefits office.