Medicaid
What Is Medicaid?
Medicaid is an insurance option that is available and provides health coverage to millions of Americans. This particular insurance typically provides coverage to eligible low-income adults, children, pregnant women, the elderly, and people with disabilities.
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If you are eligible for Medicaid, it is important to note that this plan typically covers: hospital stays, doctor visits, pregnancy care, shots for children, and tests and x-rays.
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Medicaid is managed solely by each state. With that being said, it is important to note that the eligibility for this plan can widely vary from state to state and the state you are located in may have it's own name for their Medicaid program.
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If you have any questions in regards to this plan, do not hesitate to reach out to me via phone, email, or fill out the form on this site. I would be happy to assist you with getting you into the right plan!
Important Information About Medicaid:
Medicaid is a program that allows anyone who meets the eligibility rules the right to enroll in coverage. It also means that each state has a guaranteed federal financial support for a portion of the cost of their Medicaid programs.
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It is important to note, that in order to receive the federal funding for this program, each state must cover certain areas of the population. These areas are considered mandatory, so if you call within these guide lines there is a good chance you will be approved for this program.
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Mandatory Areas Required To Be Covered
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Children through the age of 18 that is apart of a family with an income that is below 138% of the federal poverty level.
In 2023, this was an income average of 24,860 or below for a family of 3.
Anyone who is pregnant and also falls below the 138% of the poverty line.
Select parents/care takers with a low income.
Most Elderly and most persons who have a disability and receive cash assistance through the SSI (Supplemental Security Income) program or the SSDI (Supplemental Security Disability Income) program.
States are also required to provide additional services that are a bit more comprehensive for children under the age of 21. These services are known as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefits.​
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There are states within the US that may also receive Federal Medicaid funds to cover additional optional populations as well. These additional populations include (but are not limited to):
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Individuals in the above groups who's income exceeds the limits for mandatory coverage.
Most Elderly and most persons who have a disability and do not receive SSI and have an income below the poverty line.
People considered "Medically needy." This would be individuals who's income exceeds the regular Medicaid eligibility limit, but they have high medical expenses. High medical expenses could be from things such as: nursing home care​​ that will cause their disposable income to be below the poverty line.
Select individuals who have a higher income, but are in need of long-term services or support.
Non-Disable adults that have an income below 138% of the poverty line which does include those without children.
(This is thanks to the Affordable Care Act)
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Who Would Not Be Included:
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Most individuals who are not U.S. Citizens are not eligible for Medicaid, despite having a lawful immigration status.
Persons with temporary protected status. This means that the federal government has allowed them to stay within the US for humanitarian reasons.
Persons granted permissions to come to the US Temporarily for: education purposes, work, travel, and more​​.
Any residents that are here lawfully (also known as green card holders) that have been in the US less then 5 years, even if the eligibility requirements are met. (Some states do have the ability to extend eligibility to all lawfully present children and woman who are pregnant without waiting the 5 year time frame)
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What Services Does Medicaid Cover?
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​Hospital and Doctor Care
Lab and X-ray Services
Home Health Services
Nursing Facility Services For Adults
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States also have the ability to cover additional services if they choose (and currently all do)
The additional service provided by all states include:
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Prescription drugs
Dental care
Vision services
Hearing aids
Personal care services for frail seniors / People with disabilities
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It is very important to note that Medicaid does not provide the direct health care, only the insurance to cover the care received. It is also important to note that not all doctors offices accept Medicaid.
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Please remember, that I am always here to help. If you choose me to be your insurance advisor, you will have exclusive contact to me via phone or email which is answered within 1 to 2 business days.
If you have any questions in regards to this plan, don't hesitate to reach out to me via phone, email, or fill out the form on this site. I would be happy to assist you with getting you into the right plan!