Medicaid is the United States health care program for families and individuals with low income and resources. To avail the services of this national health program, it is imperative for you to be aware of the eligibility criteria. The following article will help you understand who is eligible for medicaid.
The Centers for Medicare and Medicaid Services are the government bodies responsible for running the program known as Medicaid. This program was set up by President Lyndon B. Johnson, with a prospect of providing medical services to the citizens of the United States, who qualify certain criteria, to become eligible to avail the services. This program provides health-related services to people who have low-income and the least of resources. Primarily, the program is controlled at the federal level, but it has its own rules and regulations according to the state it belongs to.
Eligibility Criteria
Each state has its own sets of rules and regulations regarding the services, and you may find that there’s a bit of variation in the rules between any two states. Each state has been given:
- the right to decide the rate of payment levied on patients
- the right to set up its own eligibility standards
- the freedom to type and amount of services
- to administer its own Medicaid program
Although, this health program aims towards helping people with low-incomes, it stresses importance on other factors such as age, pregnancy, status of disability, assets, citizenship, etc., as the parameters to help determine the eligibility of the candidate.
Pregnancy Status
- Expectant mothers can avail the benefits if their family income falls below 133% of the Federal Poverty Level (FPL).
- If the child is born while being covered under this health care program, then both the mother and the child are covered.
Children
- Children whose family income is lower than 133% of the FPL are covered. However, they have to be under the age of 6 years.
- Those children are also covered by this medial insurance whose date of birth falls after September 30, 1983 and are under the age of 19. Also, their family income must be at or below the FPL, in order to avail the benefits.
- The service also covers teenagers who are living on their own.
Age and Disability
- Someone who is over 65 years of age, visually challenged, or has some other kind of disability, and has a limited source of income can avail of this service.
- Some states may choose to provide the services to certain women who have been diagnosed with breast or cervical cancer. However, these women must be uninsured or have low income.
- Some people stricken with tuberculosis are also covered.
Some Basic Facts
It is to be known that Medicaid does not pay its services in the form of any money to the patients. Rather, it sends the payment to centers which provide the service. Also, it is important to understand that the program does not allow everyone to avail its benefits. Being someone with a low income is just one eligibility criteria among the others.
To conclude, no medical examination is required to apply for the benefits. However, if the reason behind availing the services is some disability, then a medical examination could be required. Expectant mothers would be required to produce proof supporting their pregnancy, if they too wish to avail the services.
