Medicaid
What is Medicaid?
Medicaid is a program that helps pay for the cost of healthcare for people with low incomes and limited assets. It is paid by federal and state governments. The program is sometimes called Medical Assistance or Title 19.
Who can be covered by Medicaid?
You are automatically eligible for Medicaid if you get:
- Aid to Families with Dependent Children (AFDC)
- Supplemental Security Income (SSI).
Generally, people who qualify for Medicaid are women, and children, and elderly or disabled adults. You may be eligible for Medicaid if your medical costs are higher than your income, even if you are not poor.
Medicaid rules change. Also, Medicaid programs vary somewhat from state to state. For more information, check with your local social services department.
What is covered by Medicaid?
Each state decides what will be covered under Medicaid. Usually Medicaid covers care in a hospital or nursing home, doctor visits, and prescription drugs.
Medicaid pays for most of the nursing facility costs in the US. In some states, Medicaid covers assisted-living care and adult day care programs if these services will keep a person out of a nursing facility.
If you qualify for both Medicare and Medicaid, most of your healthcare costs will be covered. Medicare pays first. Medicaid covers the co-payments (the part of Medicare costs you would otherwise be responsible for). It also pays for things Medicare does not, such as prescription drugs, eye glasses, and hearing aids.
The QMB (Qualified Medicare Beneficiary) or SLMB (Specified Low-Income Medicare Beneficiary) programs can help pay:
- premiums (monthly payments) for Medicare
- co-payments (the part of costs you must pay)
- deductibles (what you must pay first before Medicare begins to pay).
Written by Carolyn Norrgard, RNC, BA, MEd; Carol Matheis-Kraft, PhD, RNC; and Mercedes Bern-Klug, MSW, MA, for RelayHealth.
Published by RelayHealth.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.
