Oftentimes we get asked, What is Medicaid? This isn’t surprising, because people often confuse Medicaid and Medicare, and who can blame them? Having major healthcare programs with such similar names can definitely lead to a lot of questions. The programs even function similarly in certain ways, but in others, they are very different. Let’s look at what Medicaid actually is.
Medicaid is a state and federally funded health insurance program that is available to children as well as those who are aged, blind, or disabled. If people receive federally assisted income maintenance programs, such as social security payments, or certain types of disability or retirement programs that are federally controlled, then Medicaid may be applicable to them.
In some states, applying for Supplemental Security Income (SSI) is considered a joint application for Medicaid. In other states, the rules for eligibility are the same, but a different application is required. In still other states, the state government uses different rules to determine if someone is eligible for Medicaid. For example, the state might determine that some people who receive certain state determined benefits will also automatically qualify for Medicaid. Some states also offer Medicaid insurance to single people with very low income.
For some people who are disabled but are also able to work to a certain degree, Medicaid may be available at a higher income limit than would otherwise be allowed. The rules are complicated, and the SSDI payment may still be reduced, but the individual may be able to continue to receive Medicaid. This is particularly important for those who are only able to work because of their Medicaid coverage allowing their health care costs to be covered.
Since each state has different Medicaid rules, it’s very difficult to say who will and will not be qualified for Medicaid. Individuals need to look at their specific state to find out what will allow them to qualify; this resource at Healthcare.gov is a great place to start. If a state accepted the Medicaid expansion, there are often a much broader range of people who are eligible for Medicaid; if the state did not accept that expansion, then the pool of Medicaid recipients may remain very small.
In general, Medicaid covers doctor, hospital, and prescription costs for qualified members. Exactly what benefits are covered, and which doctors accept Medicaid, again varies from state to state. Being eligible for Medicaid will generally not affect someone being eligible for Medicare; in some states, Medicaid works as a supplemental insurance for Medicare. It helps to pay what Medicare does not.
We hope we’ve helped clear up what is Medicaid for those that have been wondering. For more information on whether or not you or your children would qualify for Medicaid, follow the above link or find the organization in your state that manages Medicaid eligibility.