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Medicaid
Good health is important to everyone. If you can't afford to pay for
medical care right now, Medicaid can make it possible for you to get
the care that you need so that you can get healthy – and stay
healthy.
Medicaid is available only to certain low-income individuals and families
who fit into an eligibility group that is recognized by federal and
state law. Medicaid does not pay money to you; instead, it sends payments
directly to your health care providers. Depending on your state's rules,
you may also be asked to pay a small part of the cost (co-payment)
for some medical services.
Medicaid is a state administered program and each state sets its own
guidelines regarding eligibility and services. Read more about your
state Medicaid program.
Many groups of people are covered by Medicaid. Even within these groups,
though, certain requirements must be met. These may include your age,
whether you are pregnant, disabled, blind, or aged; your income and
resources (like bank accounts, real property, or other items that can
be sold for cash); and whether you are a U.S. citizen or a lawfully
admitted immigrant. The rules for counting your income and resources
vary from state to state and from group to group. There are special
rules for those who live in nursing homes and for disabled children
living at home.
Your child may be eligible for coverage if he or she is a U.S. citizen
or a lawfully admitted immigrant, even if you are not (however, there
is a 5-year limit that applies to lawful permanent residents). Eligibility
for children is based on the child's status, not the parent's. Also,
if someone else's child lives with you, the child may be eligible even
if you are not because your income and resources will not count for
the child.
In general, you should apply for Medicaid if your income is low and
you match one of the descriptions of the Eligibility Groups. (Even
if you are not sure whether you qualify, if you or someone in your
family needs health care, you should apply for Medicaid and have a
qualified caseworker in your state evaluate your situation.)
Screening Tools
To help you see if you may be eligible for a variety of governmental
programs, you may access the GovBenefits and BenefitsCheckUp websites.
When Eligibility Starts
Coverage may start retroactive to any or all of the 3 months prior
to application, if the individual would have been eligible during the
retroactive period. Coverage generally stops at the end of the month
in which a person's circumstances change. Most States have additional "State-only" programs
to provide medical assistance for specified poor persons who do not
qualify for the Medicaid program. No Federal funds are provided for
State-only programs.
What is Not Covered
Medicaid does not provide medical assistance for all poor persons.
Even under the broadest provisions of the Federal statute (except for
emergency services for certain persons), the Medicaid program does
not provide health care services, even for very poor persons, unless
they are in one of the designated eligibility groups. Low income is
only one test for Medicaid eligibility; assets and resources are also
tested against established thresholds. As noted earlier, categorically
needy persons who are eligible for Medicaid may or may not also receive
cash assistance from the TANF program or from the SSI program. Medically
needy persons who would be categorically eligible except for income
or assets may become eligible for Medicaid solely because of excessive
medical expenses.
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The information contained
in this Web site is provided solely as
a source of general information and resource.
It is subject to change at any time and may vary from state to state.
For a complete description of coverages, always read your insurance policy, including
all endorsements.
Copyright 2008 All Rights Reserved |
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