The Medicaid Program is a medical assistance program coordinated by the Federal Government that provides medical benefits to low-income people who have no medical insurance or have inadequate medical insurance. The program is available statewide, but the specific eligibility requirements established for eligible individuals to receive Medicaid benefits are determined by each individual state.
Thus, an individual may be eligible for the program in one state and may not qualify in another state, because each state has the possibility to decide and establish its own rules related to eligibility and coverage within broad Federal guidelines.
The Medicaid Program allows you to qualify if:
- you are a U.S. national, a citizen or a permanent resident;
- you need health care or insurance assistance;
- you have a financial situation characterized as low income or very low income;
- you are a pregnant woman;
- you have (a) child/children with a disability;
- you are responsible for children under 19 years of age;
- you meet federal and state requirements regarding residency;
- you meet federal and state requirements regarding immigration status;
- you meet federal and state requirements regarding documentation of U.S. citizenship.
The Medicaid Program also requires you to meet income limits as established through the MAGI (Modified Adjusted Gross Income) - based Medicaid eligibility levels by state.
The Medicaid Program allows you to cover your medical services retroactively for up to 3 months prior to the month of application; provided that you have been eligible during the retroactive period you had applied then.
The Medicaid Program offers you various covered benefits and services such as:
- Physician services;
- Inpatient hospital services;
- Outpatient hospital services;
- Home health services;
- Rural health clinic services;
- Laboratory and X-ray services;
- Family planning services;
- Tobacco cessation counseling for pregnant women;
- Nurse Midwife services;
- Certified Pediatric and Family Nurse Practitioner services;
- Freestanding Birth Center services (when licensed or otherwise recognized by the state);
- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services;
- Nursing Facility Services;
- Transportation to medical care offices;
- Federally qualified health center services.
The Medicaid Program can be accessed by contacting your state Medicaid office or by phoning directly to the state office you belong to.