Medicaid is yet another affordable health insurance cover, especially for individuals and families earning a low income. It can either be free or cheap when it comes to pricing, depending on that particular family or individual. Its administrators are the various states of the United States of America. These states ensure that they cover 20% of the Americans, which translates to one out of five people. The beneficiaries include qualified pregnant women and qualified children. People who receive Supplemental Security Income abbreviated as SSI also qualify. However, it is important to note that the beneficiaries differ from one state to another. For instance, an adult must be below the set income threshold to qualify in some states. So, if you are a low-income person, this article is a must-read. So, keep reading as we unveil what you need to know about Medicaid.
What is Medicaid?
Medicaid is a national initiative that gears toward offering low-income families and individuals health insurance coverage. The qualifying individuals often comprise people living with disability, pregnant women, elderly adults, low-income earning parents, and children. It is the responsibility of an individual state to run its Medicare program. The responsibility of determining who should get the medicare medical cover, the services to be covered and how to deliver this health care coverage lies in the hands of that particular state. That said and done, these decisions must conform to the federal government laws governing this program.
What is the Working Mechanism of Medicaid?
It is a program that has been in existence since 1965. That’s something worth appreciating, and it also begs a million-dollar question. How does Medicaid work given its success and having passed the test of time? First of all, Medicaid’s manager is the individual state. However, it works under the supervision of the federal government. There is also the collaboration with the Children’s Health Insurance Program (CHIP). This teamwork has seen the program facilitate the health insurance coverage for approximately 74.2 million residents of the United States.
The administration of Medicaid by the states involves several responsibilities, the running and overseeing of the program includes determining several important aspects of this health insurance coverage program. They include:
- The health services that the health insurance plan will cover
- Its amount
- The duration
- The type of health services
It is worth mentioning that these decisions are made according to the federal guidelines that govern this program. For instance, some mandatory health services are part of the Medicaid benefits. At the same time, the program also has optional benefits. When it comes to the optional medicare benefits, it is up to the individual state to choose what to cover and what not to. However, that can’t be said about the mandatory medical benefits. This remarkable balance has made the Medicare program relevant and useful for decades.
What Health Services Does Medicaid Cover?
We have highlighted that we have mandatory and optional Medicaid benefits. Let’s discuss them in detail.
These are the health services you will receive coverage for if you qualify for the Medicaid program, regardless of the state. The services include;
- Transport to medical care facilities
- Family planning services
- X-ray and laboratory services
- Rural health clinic services
- Physician services
- Nursing facility services
- Home health services
- Inpatient hospital services
- Outpatient hospital services
As for these health services, whether the program covers them or not depends on the state you reside in. They include;
- Chiropractic services
- Dentures and other dental services
- Vision services
- Respiratory care services
- Physical therapy
- Prescription drugs
- Clinic services
It is important to note that the above are just some of the mandatory and optional Medicare benefits. As a matter of fact, the list is quite long and readily available on the program’s official website.
Home and Community-Based Services
In some states, the home and community-based services are also covered by a Medicaid health insurance cover. The coverage ensures that qualified patients in need of these services live independently and actively in their communities and home. Bear in mind that what you get depends on your needs. The direr the needs are, the higher the level of support this program will accord you. Some of the services to get under the Medicaid program as far as HCBS programs are concerned;
- Meals delivered at home
- Physical and speech therapy
- Diet and nutrition management
- Showering and other personal care services
- Nursing care from skilled professionals
That said and done, the health care that the Medicaid program provides its qualified patients is usually indirect. It has most of its care plans under the management of private institutions. The program pays care providers such as nursing homes, hospitals, and doctors in other cases. Once these stakeholders receive the necessary payment, the eligible patients are at liberty to receive their services.
Final Words: Medicaid
It turns out that settling hospital bills don’t have to be tough for the people of the United States of America, including those who earn low incomes. The program also considers the disadvantaged groups, including people living with disabilities and pregnant women. Under such circumstances, it becomes impossible for people to miss out on health services regardless of their backgrounds. Medicare makes these services affordable to everyone by making them either free or low-cost. The fact that they are only eligible to people who deserve them makes the program useful.
It is important to take note of the mandatory and optional Medicaid benefits. When it comes to the latter, ensure that you also understand what to expect depending on your state of residence. Consequently, you will know what your Medicaid health plan covers and what it doesn’t.
There is no secret that there is more to know about the Medicaid program, especially if you can’t afford the regular plans. Fortunately, FindMyQuotes always gets out of its way to ensure that you are always informed. After all, information is power. That’s why we will discuss Medicaid eligibility in our next article. It is important to learn more about qualified individuals and families.