What Is a Medicaid Assistance Program?


Quick Answer

Medicaid, also known as the Medical Assistance program, provides medical coverage for people with disabilities, women who are pregnant, minors, elderly and families with children, as of 2015. Typically, recipients must fall below a specific income level. The program receives federal and state funding, and qualifications depend on each state.

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Full Answer

The federal government sets minimums for Medicaid coverage, although states can increase coverage from federal standards. Federal guidelines require coverage for hospital stays, outpatient procedures, most preventative services, doctor fees, some diagnostic testing, reproductive and pregnancy health services, private home and nursing home care and transportation for medical services. States have the option to include eye wear, long-term rehabilitation, dental coverage, psychiatric services, prescription coverage and other limited services. Recipients of Supplemental Security Income and Temporary Cash Assistance automatically receive Medicaid.

Some states charge premiums and deductibles for services for recipients who make over 150 percent of the federal poverty line, those receiving Medicaid under certain disability programs and those who do not qualify for private insurance. States can also institute cost-sharing provisions for individuals who use the emergency room for non-emergency services, such as a minor illness. For patients responsible for partial payment, billing from hospital services or doctor visits first go to the supervising government agency before sending a bill to patients.

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