Medicaid is managed by individual states. It is paid for by state and federal tax dollars. It gives healthcare to uninsured people who cannot afford it.
Who Is Covered
People must meet certain requirements to qualify for Medicaid. States set eligibility requirements that are within federal guidelines. These may include whether you are pregnant, have a disability, are blind, or are elderly. Most people must also be a US citizen or a legal immigrant. The state and federal government also look at a person's income and resources. People must be low income to qualify for Medicaid. Children can be covered by Medicaid, but they also have to meet requirements.
The Affordable Care Act went into effect in early 2014. It expands coverage for Medicaid and Children's Health Insurance Program (CHIP). People may choose a plan from the Health Insurance Marketplace and find that they need Medicaid or CHIP. The Marketplace will share this information with the correct agencies for follow-up. A person can find out if their state has expanded Medicaid and CHIP coverage by visiting the Marketplace or getting in touch with their local social services department.
What States Cover
The only way to know what your state offers is to contact your local department of social services. States vary widely in their plans and whom they cover. This makes it a good idea to ask about your unique situation. All states must offer certain benefits, such as inpatient and outpatient hospital services and family planning services. Optional benefits may be things like drug coverage, dental services, and chiropractic care.
What Is Covered
These are some of the basic needs that are usually covered:
- Hospital stays
- Outpatient services provided by certain facilities
- Lab and x-ray fees
- Nursing home services
- Family planning
- Doctors' services
- Medical and surgical dental treatment
- Some home healthcare services
- Some home medical supplies and appliances
- Pregnancy, delivery, and postpartum care
- Some physical, speech, hearing, and occupational therapy
- Approved prescriptions
- Eyeglasses
- Screening and preventive services
- Some mental health services
- Hospice care
- Transportation to medical appointments
Some states also supply training and employment services to people with disabilities. And some provide wider services, such as support systems that allow disabled persons to live in the community or in housing that meets their needs. The services a person can get will depend on what the state offers and their eligibility.
How to Apply
Call your state's social services department, Medicaid, or Health Insurance Marketplace to apply. You can also apply online.
Nearly all states will require an interview. You will also be asked for proof of eligibility, such as:
- A birth certificate or other proof of age
- Citizenship papers or other proof of legal alien status (Benefits may be given to all children regardless of their parents' citizenship status, as well as to people who are pregnant, and those needing emergency care.)
- Pay stubs and paperwork from other sources of income, such as retirement, or veteran or Social Security benefits
- A rent receipt or other proof of where you live (People with unstable housing are also covered.)
- Other documents, such as bank statements and insurance policies
RESOURCES
Health Insurance Marketplace http://www.healthcare.gov
Medicaid Services http://www.medicaid.gov
References
Children's Health Insurance Program (CHIP). Medicaid.gov website. Available at: https://www.medicaid.gov/chip/index.html. Accessed October 19, 2021.
Medicaid. Medicaid.gov website. Available at: https://www.medicaid.gov/medicaid/index.html. Accessed October 19, 2021.
Medicaid in New York State. New York State Department of Health website. Available at: http://www.health.ny.gov/health%5Fcare/medicaid. Accessed October 19, 2021.
Revision Information
- Reviewer: EBSCO Medical Review Board
- Review Date: 10/2021
- Update Date: 10/19/2021