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What is Medicaid?

Medicaid helps the poor receive medical care.
Medicaid may cover prenatal care.
Emergency room visits are covered by Medicaid.
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  • Written By: A Kaminsky
  • Edited By: Niki Foster
  • Last Modified Date: 21 October 2014
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Medicaid is a program designed by the US federal government to help ensure that the poor receive quality health care. The program provides medical care to the poor, to children, and to pregnant women living under the federal poverty level. It is funded jointly by the states and the federal government.

This program was established in 1965, at the same time as Medicare, under Title XIX of the Social Security Act. It was designed to assist low-income families in providing health care for themselves and their children, and it also covers certain individuals who fall below the federal poverty level. The program covers hospital and doctor's visits, prenatal care, emergency room visits, prescription medications, and other treatments.

Some of the people who are eligible for Medicaid include low-income children under age 6, low-income pregnant women, Supplemental Security Income recipients, adopted or foster children, specially protected groups, children under age 19 whose family income is below federal poverty level, some Medicare beneficiaries and other groups, as determined by each state. Most families who receive welfare probably have a social worker assigned to them, and this person will usually advise a family on its eligibility. Many healthcare providers will also be able to inform their patients about the program.

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Medicaid is another of those thorny issues that the US Congress perpetually faces. The program is astronomically expensive, but if funding for it were cut, many people — including children — would be without basic medical care. It's a political tightrope.

While perhaps not as Byzantine in construction as Medicare, determining Medicaid eligibility is still tricky. Anyone who thinks that he or she may be eligible for coverage under the program can contact his or her local department of human resources or the Internet for more information. The official website includes a wealth of information, as well as a toll-free number. As is the case when dealing with most federal programs, people are well-advised to seek out professional assistance and get as much information as possible about the program in order to receive the maximum benefit.

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Discuss this Article

eidetic
Post 17

@JessicaLynn - That's really interesting. For some reason I thought Medicaid offered comprehensive health coverage in all states. I guess I shouldn't be surprised that a program like this doesn't cover everything though.

JessicaLynn
Post 16

I think Medicaid is a great program, because a lot of people out there don't have insurance. And from what I've seen, you really do have to be low income to meet the Medicaid qualifications.

That being said, I've been surprised in the past when people tell me what Medicaid does and does not cover. In my state, for example, Medicaid will cover a dental cleaning, but it won't actually cover having the cavities filled. This makes no sense to me, especially because if you're on Medicaid, you probably can't afford to pay out of pocket to get your teeth filled.

Pharoah
Post 15

@Azuza - Yes, it is very hard to qualify for Medicaid unless you have a family or you're a child. On the other hand, I know a few people who were able to get Medicaid for their children, but didn't qualify themselves. This doesn't make sense to me either. How are the parents supposed to take care of their kids if they can't get medical care?

Azuza
Post 14

@anon26766 - That's a very good suggestion. As the article said, trying to determine Medicaid benefits can be tricky, and it varies from person to person. It's a good idea to contact your local office and get someone there to help you file for Medicaid or answer questions about your current coverage.

I have to say though, if you're an average single adult with no children, you probably won't be eligible. I looked into my state program when I was at my last job. I didn't get any benefits at that job, but I wasn't making enough money to afford my bils and pay for my own insurance.

In my state, you pretty much have to have kids to be eligible. I ended up having to quit that job because I wasn't willing to go without insurance.

anon261090
Post 13

My sister is 58, has Social Security as her only income, is diabetic and on insulin twice a day.

Now she has been diagnosed with scleroderma. She needs insulin twice a day, but has arthritis so severe that she cannot give it to herself. She is also partially blind. She has been advised to eat six small meals each day. But it is very difficult as she is not married and has a 91 year old mother who cannot help very much.

Is there any assistance that she can apply for?

ncgirl
Post 10

My son-in law's mother is in a rest home in Michigan and he needs to move her to CT where he lives. Can she switch her medicaid to a Ct rest home if she has always lived in Michigan?

anon61851
Post 7

I just heard of someone taking their one year old child to a dentist for a fluoride treatment on her two teeth. I believed it was advised by a doctor. I think these kinds of goings on should be looked into. If this is true we taxpayers are being taken for a ride.

anon44891
Post 5

We live in Texas and my husband is 54 and had a stroke in Febriary 2008 and is currently paralyzed on his left side and he gets social security disability. His insurance has expired on the cobra plan due to the stroke. One month after, he started a new job with a new company and insurance from his prior company where he worked over 20 years. Now I have to take him to the county clinics to get his meds and have to wait til 2010 for his medicare to start. I do not understand this.

anon43199
Post 4

My 76-year-old father, no assets, income @ $1,800/month (ss and pension), has medicare and needs hearing aids. Would medicaid pay for hearing aids? He does not presently have medicaid. Should he apply?

anon26766
Post 3

If you are looking for specific answers about your own personal Medicaid coverage, you should contact a social worker or your local department of human resources or family and children's services. Many, if not all, specific coverage questions require a case-by-case assessment for the appropriate answeer.

anon23767
Post 2

I live in McKeesport PA by myself and I'm working part time job I make only less than 800$ monthly what kind of assistance I'm eligible to receive I'm 29 years old.

debbiet
Post 1

I live in Arizona. My parents qualify for Medicaid. Can they get dentures through Medicaid? If not, and all their teeth are pulled, isn't it unhealthy not to be able to chew food?

If they can get dentures, what is the process?

Thank you

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