How to Understand Medicaid

Medicaid is federally funded health insurance for low-income or disabled individuals. Even though Medicaid is sponsored by the government, each state has its own Medicaid program. The benefits and eligibility guidelines vary, depending on your state. Typically, Medicaid covers inpatient care, outpatient care and services, lab work, prescriptions, dental services, pregnancy-related services and nursing home care. Understanding how to qualify for Medicaid and the services covered can seem complicated at first. Once you learn the basics, though, it will be easier to understand how Medicaid works.

Instructions

• 1

  Know your eligibility group. Medicaid is available to financially needy children, parents or guardians of children, pregnant women, the elderly and the disabled. The age and health conditions vary from state to state. In Florida, children under 19 who are living with their parents are eligible to receive Medicaid. In Texas, children under 18 living with their parents are eligible. You must also be a U.S. citizen to receive benefits.

• 2

  Check financial requirements. The income guidelines vary from state to state. In most states, the person's income must be 133 percent below the poverty level. There are also limitations on your countable assets. An individual cannot have more than $2,000 in countable assets. Exempt assets include your home, primary vehicle and personal possessions.

• 3

  Determine if you have a co-payment. Individuals who meet the income and asset requirements to receive Medicaid coverage do not usually have a co-payment associated with treatment. Some states allow recipients to enroll in an HMO for more tailored coverage. Certain HMO plans may charge a small co-payment.

  Those who are classified as medically needy can receive Medicaid coverage. If you have high monthly medical bills but exceed the income or asset limit, you may be awarded Medicaid with a "share of cost." This means you will be required to pay a portion of your medical bills each month before Medicaid provides coverage.

• 4

  Contact your state's Medicaid office. Since each state has its own Medicaid program, it is best to get information on qualifying and the services covered. For help locating a local Medicaid office, contact the department of health and human services in your state (see Resource).