Medicaid is a health insurance program funded by both federal and state governments. As a result, eligibility and coverage rules vary among states. However, as an entitlement program, Medicaid is open to all eligible citizens. As long as you qualify to receive health insurance coverage from Medicaid in your state, you can not be denied services by federal or state governments
Eligibility Groups
Medicaid is available to low-income individuals and families who are part of an eligibility group as defined by federal and state laws. Eligible groups include senior citizens, blind or disabled people, and children. Your child is eligible for health insurance coverage under the Medicaid program if the child is a citizen of the U.S. or legal immigrant. The U.S. Department of Health and Human Services specifies that Medicaid coverage for children is based entirely on the citizenship or immigration status of the child and not on the status of the parents.
Applying
Your application for Medicaid benefits is processed at your local human services office. The application collects information about your citizenship status, age, employment, income and assets. This information helps Medicaid officials determine if you meet the state and federal standards to receive benefits. In addition to providing your information, you need to submit supporting information like recent pay stubs, driver's license and proof of other insurance coverage. You likely qualify for Medicaid benefits if you receive income from the Social Security Administration.
Coverage
Medicaid works similarly to other private health insurance plans in that the program covers the cost of eligible expenses associated with health care. For example, in New York state, Medicaid covers visits to doctors and dentists, hospital services, family planning, prenatal care, ambulance services and mental health services. According to the Centers for Medicare & Medicaid Services, 4.5 million New York residents are covered under Medicaid as of December 2009. Other populous states like California and Texas have 7.1 million and 3.5 million residents respectively enrolled in Medicaid.
How Coverage Works
The Medicaid program covers the cost of your health care directly through the doctor or hospital you visit. As a result, you never receive a cash payment for any of the medical services you receive. For example, if you visit the hospital to care for a broken leg, Medicaid pays the hospital directly for the costs associated with your injury. Depending on your state, you receive health care at no cost or you pay a low co-payment. A co-payment is a small fee you pay your health care provider during your visit while the rest of your bill is covered by Medicaid.
Limits
There are limits to the health insurance coverage of eligible Medicaid recipients. Medicaid is not available for everyone. For example, even if you are poor, Medicaid includes all your assets in determining your eligibility and low-income status. In addition, Medicaid is not available to you if you do not belong to one of the eligible groups noted earlier.
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