What Is Medicaid?

We help you understand one of America’s largest public programs.

Medicaid finances nearly 20% of all healthcare spending in the U.S.

Medicaid is a joint federal and state public health insurance program that provides assistance with paying medical costs for people with low income or limited resources. The program covers a broad range of health services and helps to lower out-of-pocket healthcare expenses. As of September 2020, over 72.5 million Americans – including low-income adults, pregnant women, elderly adults and people with disabilities – are covered through Medicaid. The program is the main source of long-term comprehensive coverage for millions that face complex and costly healthcare needs; in fact, nearly one-fifth of all personal health care spending in the United States is financed through Medicaid.

Who Can Get Medicaid?

Qualification for Medicaid is based upon your home state’s rules and qualifiers. Although the specific qualifications vary from state to state, qualification usually takes into account household size, age, family status (i.e.: pregnancy), disabilities, etc. While the program is subject to federal standards and regulations, some states also have the flexibility to expand their programs to include eligibility for people that fall below certain income levels. 

In 2010, the Affordable Care Act (ACA), more commonly known as Obamacare, expanded Medicaid as part of a broad health coverage initiative, and helped to modernize and streamline the enrollment process. The act helped expanded Medicaid eligibility to non-elderly adults and adults without dependent children. Prior to this change, most low-income adults and families were excluded and left without coverage. This advancement in American healthcare policies and procedures allows Medicaid to provide care for our most vulnerable citizens. 

What Services Does Medicaid Provide?

In addition to insuring 1 in every 5 Americans, Medicaid covers a wide range of health and long-term care services. The federal law mandates that several services must be covered by Medicaid, which is a provision of ACA known as “essential health benefits“. Services like wellness and preventative services, expanded mental health and substance abuse treatment and nursing home care have to be included in every Medicaid plan, which isn’t necessarily the case with commercial health insurance.

Who Pays For Medicaid?

The current structure of Medicaid entitlement is based upon two guarantees: first, any and all Americans that do qualify and meet their state’s eligibility requirements are guaranteed coverage. Second, the federal government guarantees that it will match dollar-for-dollar spending for all qualifying services that are provided to Medicaid recipients. The basic foundations of this federal-state partnership is what keeps Medicaid supplied with the resources to respond to an ever changing American lifestyle and to keep up with public health emergencies, such as the opioid epidemic. 

How Can I Sign Up For Medicaid?

There is no open enrollment period for Medicaid; you can apply through the Health Insurance Marketplace or through your state Medicaid agency at any time of the year. If you qualify, you are considered “covered” by health care law and do not have to purchase a traditional insurance plan. If your state has elected to expand their program, you can qualify based on income alone. Otherwise, qualification is based off of your individual situation, and you must submit an application to see if you are eligible.

While HealthPlanOptionsToday does not provide Medicaid, we can help you find the health insurance plan that perfectly fits your needs. Click the button below or call 888-375-8879 to get instant information on health coverage options.