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What Is Medicaid?

Welcome To: What Is Medicaid? Your Guide To The Medicaid Program

MedicaidThe health of you and your family is very important. If you can't get the health care that you need because you are unable to pay for it, Medicaid can make it possible for you and your family to get the proper health care so you can get healthy and stay healthy.

It is possible to get the medical, dental or nursing home care that you or your family needs because Medicaid was created to help "those in need" pay for some or all of their medical services. The purpose of this Medicaid information website is to provide you with important information and useful links to Medicaid articles and websites that helps make it easier for you to benefit from the Medicaid program.

What is Medicaid?

Medicaid is a combined United States Government and individual State Government health insurance entitlement program that provides eligible low-income individuals and families with medical, dental, and health care benefits.

Like many government programs, the different aspects of the Medicaid program can be difficult to understand. Based on the most popular Medicaid searches, we have provided you with the following list of important Medicaid topics and links.

Important Medicaid Topics:

1. Medicaid Eligibility - You are only eligible for Medicaid if you have limited income and you meet certain eligibility requirements. Are you eligible for Medicaid? click to continue...

2. Medicaid Application - You should apply for Medicaid if your income is limited and you match one of the Medicaid eligiblity groups. The Medicaid application process is easy. click to continue...

3. Medicaid Dentists - Tooth decay is the most chronic common disease among children and it is one of the top concerns of the Medicaid program because it is a wide spread problem among low-income families. click to continue...

4. Medicaid Providers - Medicaid does not pay money directly to you, it pays your health care providers. Not all doctors and dentists accept Medicaid. You need to determine if your medical care givers are Medicaid providers. click to continue...

5. Medicaid Office - For specific information about enrolling in Medicaid, Medicaid eligibility, Medicaid application forms, and Medicaid services in your State, you will need to contact your local Medicaid office. click to continue...

Being able to get the health care you need for you or your family can relieve a lot of your worries because the Medicaid program may be able to help pay for some or all of your medical care: [click to continue...]

Medicaid is for low income people that include these Medicaid eligibility groups:

Children under the age of 19

People age 65 years or older

Pregnant women

People who are blind

People who are disabled

People who need care in a nursing home

If you think that you are eligible for Medicaid coverage, you should go ahead and apply by following the Medicaid application process at your State's Medicaid agency.

Medicaid and Medicare

People often confuse the Medicaid program with the Medicare program. While both programs are managed by the Centers for Medicare and Medicaid (CMS), they are two very different government health programs. If you are over the age of 65 or have certain medical disabilities, you should know more about the different Medicare health care plans and the Medicare program.

So how can Medicaid help you and your family?

If you or members of your family meet both the Federal and State Medicaid eligibility requirements, you may be able to have most of your medical and dental expenses paid. That's right, during 2011, Medicaid helped deliver medical services and health care to more than 60 million people.

The Medicaid program is funded by both Federal and State government agencies at an estimated annual cost of about $405 billion in 2010. In comparison, the Medicare program provided health care benefits to 46 million people at a cost of about $510 billion in 2009.

The Centers for Medicare and Medicaid (CMS), within the U.S. Department of Health and Human Services (HHS), is the agency that is responsible for Federal management of Medicaid.

While the Federal government provides guidelines for the Medicaid program, each State determines your eligibility for Medicaid. The new health reform law made both mandatory and optional changes in the Medicaid program.

For many people, Medicaid can be hard to understand. This is due to the determination of who is eligible, what medical services are paid for, and how those services are reimbursed.

State Medicaid programs can vary greatly. Recently, more and more States have modified the Medicaid program using special waiver authority, changing medical services that are covered, Medicaid income eligibility, and varying reimbursements.

The four states that provide the most Medicaid coverage are California, New York, Texas, and Florida. Each state may have a different name for Medicaid and different agencies that manage the Medicaid programs. To learn more about Medicaid in your state please visit the list of State Medicaid Programs: [click to continue...] 

 In California, Medicaid is known as Medi-Cal and is managed by the California Department of Health Care Services (DHCS). There are more than 10 million people enrolled in the California Medi-Cal program.

The Department of Health oversees the New York Medicaid program in New York. About 4.6 million New York residents were eligible for Medicaid coverage during 2010. Spending around $48 billion a year, New York spends the more on Medicaid than any other State.

The Texas Medicaid program helps provide medical coverage for about 3 million low income Texans. Texas Medicaid is provide to help improve the health of Texas residents that may not be able to afford needed medical care for themselves or their families. The Texas Medicaid program is administered by the Texas Health and Human Services Commission (HHSC).

The State of Florida leads the country in Medicaid reform. In Florida, Medicaid is administered by the Agency for Health Care Administration, but your Medicaid eligibility is determined by either the Department of Children and Families (DCF) or the Social Security Administration (SSA) for people that receive Supplemental Security Income (SSI). Visit the Florida Medicaid page for an overview of the Florida Medicaid program click to continue...

One of the most popular and important benefits of Medicaid are the Medicaid dental services which provides payments to dentists that accept Medicaid dental patients. Listed under Title XIX of the Social Security Act, the Medicaid dentist coverage is an optional service for adult, individuals age 21 and older.

However, Medicaid dental services are a required service for most Medicaid-eligible individuals under the age of 21, as a required component of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. Learn more about Medicaid dental coverage.

Remember that not all dentists accept payments from Medicaid. Before making your dentist appointment make sure that the dentist does accept Medicaid patients and payments.

While Medicaid is a program that assists low-income individuals, not all poor people are eligible, and not all the people that are covered are poor. Primary and acute care for children and families are usually delivered through managed care, while people with disabilities and the elderly typically get medical care on a fee-for-service plan.

Throughout the U.S., Medicaid finances the majority of long-term care services such as nursing home care and community-based services that provide in-home assistance to the elderly and the disabled. In recent years, some States have started combining Medicare and Medicaid financing for acute and long-term services.

Because of all the different State Medicaid programs and variations, trying to generalize Medicaid can be difficult. Federal Medicaid rules do outline Medicaid eligibility, the services that are provided and how they are provided, how the Medicaid program is administered and financed, reimbursements to Medicaid providers, and the role of waivers in expanding Medicaid eligibility and coverage.

Are You Eligible For Medicaid?

The federal Medicaid program provides definitions for more than 50 distinct groups of people that may be eligible for Medicaid. Traditionally, Medicaid eligibility involved categorical restrictions that basically limited Medicaid coverage to the elderly, families with dependent children, certain pregnant women and children, certain women with cervical or breast cancer, uninsured individuals with tuberculosis, and persons with disabilities (as defined under the Supplemental Security Income (SSI)) program. Changes in the law now provide Medicaid eligibility for nonelderly, childless adults that do not fall within the traditional categories.

To be eligible for Medicaid coverage, an applicants' income, and sometimes other financial resources and assets have to meet Medicaid financial requirements. Originally, Medicaid eligibility was based on cash assistance from other programs like Aid to Families with Dependent Children (AFDC) or the SSI program.

Recently, eligibility for Medicaid has been based on income because most enrollees do not get cash assistance. The States' are still required to apply rules used by the federal SSI program or the former AFDC programs. The SSI rules apply to those persons with disabilities and the elderly. The AFDC programs applied to the families and children.

Some Medicaid eligibility groups are mandatory, which means every State that is in the Medicaid program must cover certain groups of people. Other group coverages are optional, meaning each State decides if they want to provide coverage to a certain group of people.

For additional Medicaid information: [click to continue...]

For additional Medicare information: [click to continue...]

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WhatIsMedicaid.net is an information website owned by What Is It LLC.

Learn more about What Is It at MyWhatIsIt.com... "We Simplify The Complex".

The official U.S. Government Medicaid Web site is CMS.gov and Medicaid.gov 


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