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Medicaid eligibility, applications, and more!
Every day people search the internet looking for help with the costs of their healthcare. With the cost of health insurance rising every year and a recession, people are turning to Medicaid now more than ever to get access to the healthcare they deserve!
What is Medicaid?
Medicaid is a federally funded, state managed, health insurance program to provide free or low-cost health insurance to people based on income and resources.
Why Do Different States Have Different Programs?
Unlike Medicare which is federally funded and administered on a national basis, each state receives Medicaid funds and decides how to best use them. Some states will choose to meet the minimum requirements and others will offer more benefit-rich plans which include coverage for things like vision, dental, and hearing aids.
What Are the Income Guidelines For Medicaid?
There are no standard Medicaid guidelines, but generally they are based on the federal poverty level which usually changes every year. Additional provisions are typically made for individuals with multiple dependents or for individuals that are pregnant.
What Are Resources?
Each state can include a resource test for eligibility with respect to what they will consider a resource and what they will not. For example, in some states it’s ok to have a life insurance policies while in others it’s not. To take that a step further, some states have limits on the cash value of the life insurance policies before they consider it to count against eligibility.
What Counts as Income?
Generally any type of income will count towards your Medicaid eligibility. Whether it’s a w2 job, delivering newspapers, even babysitting for cash all can count against your income eligibility. Although job paying cash or “working under the table” may not be as easy for Medicaid offices to track, it can constitute fraud and will jeopardize Medicaid eligibility.
Is Medicaid Free Insurance?
Generally Medicaid is provided at no monthly cost or at an extremely low cost, but there will typically be cost shares expected such as small copays. The copays will typically be less than a few dollars, but they are an important part of keeping costs low. By charging small copays for services it helps cut back on waste and abuse of the system which helps states make more efficient use of their Medicaid funds.
How Long Does It Take To Apply For Medicaid?
Generally the process of applying for Medicaid is relatively quick, but it can take some time for the applications to be approved or denied. Some states allow for online applications while others may require a face to face interview. Incomplete applications or those suspected of being fraudulent may take longer to approve or be withheld indefinitely.
What is a recertification?
Medicaid is generally intended to be used as a temporary assistance program and as such states generally require that Medicaid recipients recertify as to their financial status once each year. The process can be as simple as calling in to a local office or may require the entire application process be repeated. Typically they will verify that there has been no change in the income or resources or ask for updated information.
What If I Have Medicare?
Medicare and Medicaid generally work together. If you have Medicaid and become eligible for Medicare you will be enrolled and will be automatically enrolled into a Medicare Part D plan which will help with your prescription drug coverage. If you are a full-benefit Medicaid recipient then you will have no cost for the Part D plan and your copays will generally remain the same as before.
For any provider visits to places like doctors, hospitals, and lab work, Medicare will pay first and then Medicaid will pay the balance of what’s left subject to the payment agreements. It’s important that you remain within your Medicaid network, because if you don’t, you may be liable for the cost of anything that Medicare does not cover with any providers that are not participating with Medicaid.