Medicaid, also called Medical Assistance, is a joint Federal and state program that helps pay medical costs for certain people and families who have limited income and resources. Medicaid will pay participating doctors, pharmacists, hospitals, or other providers for your care. Each state decides what counts as income and resources, who is eligible, what services are covered, and the cost for services. States also decide how to run their program as long as they follow the Federal guidelines. As a result, there are 56 different Medicaid programs - one for each state, territory, and the District of Columbia.
A few states have their own names for Medicaid. Examples are "Medi-Cal" in California or "MassHealth" in Massachusetts. States may bundle together the administration of Medicaid with other programs such as the Children's Health Insurance Program (CHIP), so the same organization that handles Medicaid in a state may also manage the additional programs. Separate programs may also exist in some localities that are funded by the states or their political subdivisions to provide health coverage for indigents and minors.
State participation in Medicaid is voluntary; however, all states have participated since 1982 when Arizona formed its Arizona Health Care Cost Containment System (AHCCCS) program. In some states Medicaid is subcontracted to private health insurance companies, while other states pay providers (i.e., doctors, clinics and hospitals) directly.
Some states have incorporated the use of private companies to administer portions of their Medicaid benefits. These programs, typically referred to as Medicaid managed care, allow private insurance companies or health maintenance organizations to contract directly with a state Medicaid department at a fixed price per enrollee. The health plans then enroll eligible people into their programs and become responsible for assuring Medicaid benefits are delivered to beneficiaries. A Federal law requires Medicaid to cover and arrange for all medically necessary health care services to Medicaid-eligible children, even if the state's Medicaid program wouldn't normally cover the services. Also included in the Social Security program under Medicaid are dental services.
Medicare and Medicaid work together to provide medical insurance for seniors who might otherwise be unable to afford certain medical treatments. If they qualify for both programs, Medicaid and Medicare, elderly, disabled, or otherwise disadvantaged citizens may receive the required health care without having to worry about medical bills.
You may be eligible for Medicaid if you meet the requirements for your state. In addition to having limited income and resources, you may be asked the following questions:
What is your age? Are you pregnant? Are you a child under the age of 19? Or, are you the parent or
caretaker of a child with Medicaid? Are you disabled? Are you blind? Are you a U.S. citizen or an immigrant who meets certain requirements?
Even if your income seems to exceed Medicaid income levels in your state, you may be eligible under Medicaid under certain circumstances. Check with your State Medical Assistance (Medicaid) office to find out whether you or someone in your family qualifies.
Author Resource:
Go to Medicare and Medicaid to learn more about the differences and eligibility.
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