Author: Geoffrey Ejiga
Medicaid is a joint health insurance program supported by the federal government and the states to provide health coverage for over 75 million low-income American residents.
In this post, we’ll analyze five important points you need to know about the Medicaid health scheme.
Let’s get started!
What Is Medicaid?
Medicaid is the country’s public health insurance program for low-income citizens. It operates as the central provider of long-term health coverage for most citizens and funds nearly one-fifth of all health care costs nationwide.
The HHS (Department of Human Health Services) and CMS (Centers for Medicare and Medicaid Services) regulate the control of the Medicaid program. Regardless, the policy of each state’s program may differ.
What Does Medicaid Cover?
Each state creates and distributes its Medicaid program, deciding the type, duration, amount, and range of services it offers within federal guidelines.
However, Federal law requires states to supply certain compulsory services. While also allowing the choice for states to choose additional benefits. These mandatory benefits cover a variety of health needs and generally focus on those regarded as the most “basic” and “comprehensive.”
Under the ACA (Affordable Care Act), each state’s Medicaid policy must insure at least the following services:
- Hospital services – both outpatient and inpatient.
- ESPDT (Early and Periodic Screening, Diagnostic and Treatment Services).
- Physician care.
- Freestanding birth center care.
- Certified pediatric and nurse practitioner care.
- In-home health care services.
- Nursing facility services.
- Nursing midwife services.
- Medical care transportation.
- Federally qualified health care center services.
- Family planning services.
- X-ray and Laboratory services.
- Rural clinic services.
How to Qualify for Medicaid
Although eligibility specifications depend on the state in discussion, however, federal law dictates some eligibility requirements which apply to all Medicaid programs.
It states that vulnerable categories, such as dependent children, qualified pregnant women, and low-income households must be eligible for Medicaid regardless of the state.
Each state can implement Medicaid for more groups, such as foster care residents and patients receiving home or community-based services.
Applicants must also be a native of the state in which they apply and be capable of providing proof of lawful residence in the country.
Make sure to check with your community Medicaid office for further information regarding your eligibility because eligibility requirements can vary widely from one state to another.
How to Apply for Medicaid
The Medicaid application process is simple – you can apply by mail, in person, or online. To apply by mail – call 877-267-2323 to request a paper application be sent to your address.
To apply online – visit the health.gov website. The site will direct you to fill out a form to give you an idea of your chance of approval for the Medicaid program benefits.
Depending on your results, the site will direct you to the next steps to follow for applying for the program.
Application requirements dictate that you provide copies of any of the following documents:
- Your Tax bill.
- Your bank statements.
- Birth certificates for each household member.
- Social Security cards for each household member.
- Other documents required by your state program.
There is no open enrollment period for Medicaid benefits applications, so you are free to sign up and apply for program benefits at any time. After submitting your application, you should wait between 45-90 days to receive a reply concerning your application status.
Medicaid Coverage Stats in 2022
Medicaid ensures that the nation’s most vulnerable residents have access to good healthcare services. Protecting one in every five citizens, the Medicaid health program plays a significant role in the American healthcare system.
As of 2022, Medicaid covers:
- 80% of medical care costs for low-income children
- Over 40% of all births in America.
- 47% of medical care costs for children with special health care needs.
- Over 40% of health care expenses are for adults with disabilities – beneficiaries include people suffering from physical disabilities, complicated mental issues, traumatic brain injury, Alzheimer’s disease, and developmental problems like autism.
Summary
Owing to the Medicaid program, healthcare institutions across America such as hospitals, nursing homes, and community health centers get the funding necessary to continue successful and optimal operations.
