Health Care

Understanding the Medicaid assistance program

Low-income earners and senior citizens have to squeeze their meager income to meet medical expenses. After realizing this problem, the government put in place a program to help reduce the cost of medication. Medicaid should not be confused with Medicare. Medicare focuses on senior citizens and disabled while Medicaid emphasis on low-income earners across all age groups. The two programs were set up in 1965 and are run by the federal and state governments.

Over 70 million individuals benefit from Medicaid coverage annually. The program is run by the state government in collaboration with the federal government. Hence, it runs under different names in each state, but the purpose is the same across the country.

Qualification for Medicaid

Although the state to state requirements differ, there are certain factors that are put into consideration. The following people are given a priority in Medicaid.

a)    Low-income earners

One of the primary goals of this program is poverty alleviation through the provision of quality health services. Low-income earners may compromise their health to cater for other expenses such as food, clothing, and shelter. The state governments use Modified Adjusted Gross Income (MAGI) methodology to determine whether you are eligible. This mechanism is used to determine the eligibility of children, pregnant women, adults, and parents.

The blind, disabled, and seniors above 65 of age are not subjected to MAGI assessment. These groups of people are automatically enrolled into Medicaid program. The prescription assistance by the cover may be partial or full. You may be required to cater for a part of the medical bills if your income is relatively stable.

b)    Age

People above the age of 65 years can enroll for the Medicaid program. Children below the age of 19 years who are uninsured are also eligible for Medicaid coverage. Children are under a program called Children’s Health Insurance Program (CHIP) which provide free to low medical services. Young adults below the age of 26 under foster care are also considered for Medicaid coverage.

c)    People living with disability

If you have a disability and cannot afford a private medical cover, you are eligible for Medicaid. In most cases, Medicaid helps individuals who cannot work due to disability full coverage. In case you are eligible for both Medicare and Medicaid, you can receive prescription assistance for your out-of-pocket medical expenses.

What does Medicaid cover?

The coverage of this government program differs from state to another. However, the most common areas covered are screening, diagnostic, in-patient, prescription drugs, and family planning. Long term care for low-income earners is also included in Medicaid program. Children receive a more comprehensive cover if they are uninsured.

When applying for Medicaid program, you are required to submit the following documents:

  1. Proof of citizenship e.g. birth certificate
  2. Copies of medical covers
  3. All previous month’s stubs
  4. A list of assets owned
  5. Recent bank statement
  6. Recent financial statements from other programs like social security fund

Once you submit these documents, your state government will determine your eligibility. If you have a disease like arthritis and you cannot meet Humira costs, you should apply for this prescription assistance.