Medicaid


What is Medicaid?

Medicaid is a joint federal and state program that helps with medical costs for those who have limited income and resources. Medicaid also offers benefits not normally covered by Medicare, like nursing home caer and personal care services. Each State has different qualifications that allow for eligibility and applying for Medicaid. Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States. While all States are not required to participate in this program, most of them do. Medicaid recipients are required to be United States Citizens or legal permanent residents, and may include low-income adults, their children, and people with certain disabilities. Poverty alone is not necessarily qualification for one to have Medicaid. 

How do I know if I am eligible for Medicaid?

Let's say your income exceeds Medicaid income levels in your specific State, it is entirely possible for you to be eligivle under Medicaid spend down rules. Withing the "spend down" process, some States allow you to qualify for Medicaid as "medically need" even if you have too much income to qualify. This process specifically allows you to "spend down", or subtract from, your medical expenses from your income to become eligible for Medicaid. For you to authentically qualify as "medically needy", your measurable resources equally have to be under the same resource amount allowed in your specific State. 

Is it possible to qualify for both Medicare and Medicaid?

Some people who are qualified for Medicaid are also qualified for Medicare. This will fall under the official terminology of "dual eligibles" If you have Medicare and have full Medicaid coverage, most of your health care costs are most likely completely covered. You can get your Medicare coverage through Original  Medicare, or a Medicare Advantage Plan (Part C). If you have Medicare and full Medicaid, you will get your Part D perscription drugs through Medicare, and you will automatically qualify for Extra Help paying for your Medicare prescription drug coverage (Part D). Medicaid may still cover some drugs and other care that Medicare does not cover. It is important to note here, that while Medicaid never pays first for services covered by Medicare it will only pay for services and product after:

  • Medicare
  • employer group health plans
  • Medicare Supplement Insurance have been paid

You would be well advised to seek out what your specific State requires as well as offers, and then follow the necessary steps if you so choose to continue your application for Medicaid. 

 

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