Making Medicaid Available to People With Low Income

Adults, 65 years old and older and people with disabilities are eligible for Medicare and Medicaid. Physician services and hospitalizations are covered by medicare. An additional supplemental program may be purchased to cover prescription drugs. Low income families and children may qualify for Medicaid and Children’s Health Insurance Program (CHIP). Medicaid has significantly lower copays and out of pocket expenses compared to private insurance. Unemployed individuals may qualify for Medicaid depending on the state.

Low income families who are unemployed can apply for healthcare coverage through Medicaid. Low income families with children can apply to have

According to the General Medicaid Requirements (2017) section of the Medicaid website, an individual must have at least one of the following qualifying factors to be eligible for Medicaid Services. The individual must be over the age of 65, have a permanent disability as defined by the Social Security Administration, be blind, be a pregnant woman, be a child, or the parent or caretaker of a child. In addition to these requirements, the individual must be a U.S. citizen or meet certain immigration rules, be a resident of the state where they apply, and have a Social Security number.

The Medicare and Medicaid federal programs were put in place as a way to help the less fortunate. Individuals with severe disabilities or over the age of 65 qualify for Medicare. This program helps them with health coverage, so the disabled and elderly who have Medicare do not have to worry about their medical bills and not going to the hospital when they are sick. Medicaid is a similar program, however, it only applies to low income families who cannot provide for their children. Similar to Medicare, this program covers any health related problems and takes away the worry and troubles that come with hospital bills.

Money plays a huge role in access, therefore it is a vital issue to discuss. Within the current system, lack of money results in lack of health care, which leaves thousands of people without any health care coverage. Between 2001 and 2005, the number of people paying for health insurance increased 30%, however income only raised 3% (Health Care Problems). Adequate income is a necessity and unfortunately that is not present. According to the National Conference of State Legislatures, the average annual premium across the country is $16,000. Currently, the average annual income in the United States is $51,107. Mint Money Management suggests that about 4-6% of one’s total income should be spent on insurance, including life, disability, and health insurance. However, the averages in the United States show that the average person spends about 31% of their income on health insurance, which is not financially beneficial. When this rise in health insurance is not parallel to the inflation of income, innocent people are left without a method to achieve health care. There is a program for those who can’t afford health insurance out of pocket nor have access to it, and that is called Medicaid. Issues still exist with the program. There is only so much funding, which leaves many still uninsured. Additionally, people with Medicaid have difficulty

Medicaid is an assistance program. Medical bills are paid from federal, state and local tax funds. It helps low-income people of any age. Generally, patients do not pay any part of the covered medical expenses, sometimes a small copayment. Medicaid is a federal-state program. It varies from state to state. It is administered by state and local governments under federal guidelines.

Each state has their own policies for Medicaid eligibility, services and payments. Medicaid plans have three eligibility groups such as categorically needy, medically needy and special groups. Children's Health Insurance Program (CHIP) is a program that offers health insurance coverage for uninsured children under Medicaid. If Medicaid does not cover a service, the patient may be billed if the following conditions have been met such as the physician informed the patient before the service was performed that the procedure was not covered by Medicaid and if the patient has signed an Advance beneficiary Notice form. However, there are also conditions where the patient cannot be billed if necessary preauthorization was not obtained or service

Consequently, to qualify for Medicaid, which is designed for beneficiaries with low income, one must receive a monthly income below the average poverty level, which is around $2,000 per month and have no cash assets, in order for Medicaid to cover long-term care facilities. When applicants spend down his or her assets, Medicaid will look at any “financial gifts” made within the past 5 years; this could result in the denial of benefits depending on the number of months the gift could have paid for a long-term care facility (Fischer, 2011).

It is not just the poverty-stricken population that can’t afford insurance. The cost of U.S. health care and insurance is out of reach even for those who do not live in what we technically classify as “poverty”. By the 2003 Federal Poverty Guidelines, released by the U.S. Department of Health and Human services, poverty

For close to 50 years, the Mississippi Medicaid program has provided health coverage for its low-income residents. “While Medicaid originally only insured Americans receiving cash welfare assistance, Congress expanded it over the years to help insure those left behind by the private insurance system”.7 Medicaid in the state of Mississippi is a health care program that help pays for medical services for its low income residents. In Fiscal Year (FY) 2009, Medicaid provided $3.9 billion in benefits which attributed to 20.4% of all health care spending in the state7 and insured 754,333 – 1 out 4 (25.6%) state residents.6

For those in states not willing to expand Medicaid, then low-income adults will be denied assistance, in which higher-income adults receive (Healthcare.gov, 2017). When the Affordable Health Care Act (ACA) was established, Medicaid expansion provision was mandatory for those participating in Medicaid, basically included all states participation. For those individuals in households

Those who utilize the Medicaid system range from low income families to the over 65 age group. Within this population is also those who are disabled due to physical or mental problems. This is among the sickliest of our American population. A paper based on a study in Oregon stated that “Medicaid significantly increased the probability of being diagnosed with diabetes, and being on diabetes medication as well as high blood pressure and high cholesterol.”(Baicker et al., 2013, p. 1715). Much of this is due to the struggle that the Medicaid beneficiary has

Although Medicaid may sound generous, the program has many narrowing limitations. Numerous restrictions prevent the program from being offered to everyone who is poor and cannot afford medical care. Eligibility for the program is not based on need alone, but is also affected by age, family status, and medical condition. Beyond the federal programs Medicare and Medicaid, inhabitants of the United States must look to private organizations to provide their healthcare. People may enroll in these independent health insurance plans through their employer or on their own if they can pay for it.

Medicaid is often mistaken as insurance strictly for the poor. This is not the case as many middle income households rely on this insurance. For this reason the program will be

Medicaid is for low income: pregnant women, children under the age of 19, people 65 and over, people who