Medicaid and Health Insurance

Medicaid is government provided health insurance for those of low to moderate income. Medicaid is a federal program but it is administered and regulated on the state level, and requirements and benefits vary from state to state.

Medicaid currently provides affordable health insurance, premium assistance, and long term care services for more than 55 million U.S. citizens.

Eligibility

Medicaid is available only to people with limited income. You must meet certain requirements in order to be eligible for Medicaid. When you qualify for Medicaid, you do not receive any payments; rather payment is made directly to your health care providers. Depending on your particular state’s rules, or the particular Medicaid plan you are enrolled in, you may also have to pay a small part co-payment for some covered medical services. While requirements for adults may vary, all children born after September 30, 1983, under the age of 19, whose family’s income is below 133 percent of the Federal poverty level must be covered by Medicaid.

Benefits offered

Medicaid is very comprehensive medical insurance. Covered benefits include:

  • Ambulance transportation
  • Clinic services
  • Delivery expenses
  • Dental care
  • Hospital inpatient services
  • Laboratories
  • Medical equipment
  • Medical treatments
  • Nursing home care
  • Outpatient services
  • Postpartum care
  • Prenatal care
  • Prescription drugs
  • Preventive health care
  • Psychiatric treatments, as long as individuals are under the age of 21 or over the age of 65.
  • X-rays

Not all of the above services are available to all Medicaid recipients. Keep in mind that some services might not be available to you because of your financial circumstances, family situation, and state regulations.

Most states provide “State-only” health programs for the “working poor” or others of low-income status who do not qualify for Medicaid, but do not earn enough to afford private health insurance. These programs are almost always available for children and unwed mothers.

Since benefits and eligibility requirements vary from state to state its recommended that you check with your local Department of Children and Families, or other Social Service organization for the full details about Medicaid and other low income health insurance programs available in your area.

Information needed to apply for Medicaid

In most states you can apply online for Medicaid benefits. In some cases you may need to apply in person. In either case you will need:

  • Bank records and proof of your current income
  • Any documentation that proves your physical address
  • Birth certificate, in order to prove your age
  • Social Security numbers or Documents that prove the citizenship of any members of your family applying for benefits

Am I eligible for low-income insurance if I have a disability?

Under the Social Security Act you may be eligible for Medicaid if you are disabled and cannot work. In this case you should contact your local department of social services. They will guide you through the process of applying for disability low-income health insurance coverage.

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