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Benefits & Drawbacks of Medicaid

Medicaid is a program spearheaded by the federal government and administered by individual states. The program is designed to help low-income individuals and families with health-related expenses. Not surprisingly, a large social program such as Medicaid has both pros and cons. It is up to individuals and practitioners to determine the best course of action when dealing with Medicaid.

  1. Benefit: Access to Care

    • Medicaid provides access to healthcare for people who are not able to otherwise afford it. Without Medicaid, many low-income individuals and families would go without basic and specialized care. According to the American Student Dental Association, Medicaid covers most necessary dental and medical expenses.

    Benefit: Guaranteed Income for Practitioners

    • Practitioners who accept Medicaid are guaranteed payment by the government. The American Student Dental Association notes that individual states may offer lucrative contacts and other incentives to expand the number of practitioners who participate in the Medicaid program. These payments and bonuses can make up a large part of a practice’s income. There is little risk of nonpayment or expenses related to the collection of overdue bills.

    Benefit: Steady Customer Base

    • Medical and dental practices that participate in the Medicaid program serve a large base of patients. Practitioners can count on this constant stream of customers as a steady and long-term source of income. Participants do not need to spend money on advertising and do not have to seek out patients, since Medicaid recipients are given a list of participating physicians.

    Drawback: Medicaid Coverage

    • Medicaid may not cover all treatments and procedures--especially treatments that the program deems unnecessary or experimental. This can cause problems with a treatment plan and require a physician or patient to go back and forth with Medicaid administrators to verify the necessity of a procedure. If Medicaid refuses to cover the expense, there is little recourse for the patient or the doctor.

    Drawback: Reimbursements

    • Medicaid reimbursements are often lower than what a practitioner usually charges. The All Business website notes that these low reimbursement rates keep costs down for the program but may discourage doctors from accepting Medicaid patients. In addition, Medicaid reimbursement can take between 37 and 155 days, which is a considerable amount of time for practices--especially smaller practices--that need access to cash quickly to pay operating expenses.

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