Medicaid is public health coverage that provides access to health services for individuals and families with low income and assets, as well eligible persons with a disability. Medicaid is financed by the federal government in partnership with each state. Some states use different names for their Medicaid programs, such as Medical in California or TennCare in Tennessee. Because each state administers its own program, there is significant variation regarding eligibility, what services are provided and more.
Income Eligibility and Public Health Coverage
Federal healthcare reform will significantly expand the Medicaid program, especially in year 2014 and beyond. After 2014, the income eligibility requirement for Medicaid will be consistent across all states at 133% of the federal poverty level. States may begin expanding their Medicaid programs prior to 2014, or easing the enrollment process to help people get and stay covered. and Medicaid will be extended to virtually all populations as long as eligibility requirements are met. At this writing, (Fall, 2010) some states make special allowances for people with very high medical expenses regardless of their income, and extend Medicaid eligibility to them through special rules for the “medically needy.”
In addition, every state operates a State Child Health Insurance Program. These also go by different names but are often referred to as S-CHIPs. Enrolling children in S-CHIP can be a very helpful way to assure their continued access to immunizations, checkups and more, even if other members of the family are uninsured. Learn more about S-CHIPs at www.insurekidsnow.gov.
People on Medicare can also get additional help from their states. When someone is eligible for both Medicare and Medicaid, Medicare is the primary payer and Medicaid pays for all other medically necessary costs not covered by Medicare. Even Medicare beneficiaries who do not qualify for Medicaid may be eligible for help through a Medicare Savings Program. These programs help pay for some of the costs that Medicare doesn’t cover, and are administered through state Medicaid offices.
Finally, some states have launched newer programs allowing qualified residents who cannot afford private health insurance to buy into a state public health insurance plan. When asking about your state’s public health insurance programs, make sure you find out about any and all sources of coverage for you or your loved ones. State programs can be run by your state’s Medicaid office, Department of Social Services or Department of Health.
- Researching your health insurance options
- Prescription drug help
- Finding low or no-cost care
- Managing your personal finances, with or without health insurance
Last edited November 2010.