Know the requirements for Medicaid benefits
Medicaid is a federal health care assistance program implemented by the states.The requirements for Medicaid benefits is a complex topic because although the federal government sets certain guidelines to which each state must adhere, within these guidelines each state is allowed to set its own rules. A brief survey of federal laws can help familiarize you with subject of Medicaid benefits, but check the specific requirements of the state you live in. You can do this at the GovBenefits.gov website.
Eligible Groups
The federal government requires that states admit certain eligible groups into their Medicaid programs to receive federal funds. According to the Department of Health and Human Services, those eligible groups include Social Security Income (SSI) recipients; infants whose mothers are eligible for Medicaid; children under age 6 in families whose income is at or below 133 percent of the federal poverty level and pregnant women whose income is at or below the same level. Also, children born after Sept. 30,1983, are Medicaid eligible until age 19 if their family income is at or below the federal poverty level.
Categorically Needy
Certain groups the federal government defines as "categorically needy " are eligible for Medicaid at each state's discretion. If a state includes these groups in its Medicaid program, it will receive matching funds from the federal government. Some of the groups the Department of Health and Human Services defines as categorically needy are institutionalized individuals with limited income; pregnant women and infants under age 1 not covered under the mandatory requirements but whose income is at or below 185 percent of the poverty level; and elderly, blind or disabled adults who do not meet the mandatory requirements but whose income is below the federal poverty level. Low income women without health insurance who have been diagnosed with breast or cervical cancer by the Center for Disease Control's Breast and Cervical Cancer Early Detection Program and need treatment for either disease are also in this category.
Medically Needy
The federal government gives states the option of enrolling other categories of people, who would not qualify otherwise into their Medicaid plans, under the "medically needy " program. This program, according to the Kaiser Commission on Medicaid and the the Uninsured, targets two specific groups: low income parents and adults aged 19 to 20 who do not otherwise qualify for Medicaid, and individuals with significant medical expenses and whose income is above the required levels but below the state-established threshold for Medicaid eligibility after those expenses are subtracted. The latter option is extremely important for disabled people in nursing facilities who typically incur high health care expenses.
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