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What is Medicaid – What Medical Services Are Available With This Program and When to Apply

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Medicaid provides medical coverage to residents of the state who meet the eligibility requirements of the program for that particular state. This includes, mostly children, pregnant women, disabled adults and seniors.

Medicaid is different in each state. The federal government decides which services are those that every state should offer, as well as services that are not required, but may be offered if the state so chooses. This is good because it offers a variety of services if the state chooses to provide them.

Health Plan Providers: Many Medicaid beneficiaries are enrolled in some form of health plan. Health plans provide a coordinated system of care. These plans include MediPass, maintenance organizations (HMOs), and service provider networks (PSNs). People choose between health plans that are available in the area of ​​the state you reside in and use the health care providers who are part of the plan.

Finding Medicaid Plans: A list of Medicaid plans can be found, in each state, using the comparison tools for the state you are in. The comparison tool provides information on measures of quality for the care of diabetes and asthma, prenatal care, cancer screenings, etc.

Beneficiaries For Medicaid: Beneficiaries are not required to enroll in a health plan can continue to receive the services of any provider that is enrolled in Medicaid. If for you it is not required to enroll in a health plan you can find a Medicaid provider by contacting your Medicaid office.

Which Agency to Talk to: The Agency for the Administration of Health Care (AHCA) operates the Medicaid program while the Department of Children and Families determines who is eligible for Medicaid. This is good to know because it allows you to know who to talk to if you need medicaid. The Agency for the Administration of Health Care has Offices throughout your state to provide services to Medicaid beneficiaries and providers. These offices provide education and assistance to consumers

What the AHCA Can Do For You: They can also provide a list of primary care physicians, dentists and specialists who provide services to Medicaid recipients. (However, the beneficiaries in a Medicaid health plan should contact the health plan for a list of providers.) They can answer questions about Medicaid and help beneficiaries who have MediPass or other Medicaid health plans. They also manage the schedule of examinations for your child as well (Child Health Check-up) and authorize emergency transportation services.

The Medicaid Program: The Medicaid program covers a range of medical services. The type and quantity of services depend on the beneficiary’s age, the type of Medicaid program in which the beneficiary is enrolled in and the type of services determined medically necessary.

Medicaid Services Provided: Medicaid services may include: medical, hospital, family planning (birth, care during pregnancy and childbirth), health care in the home, home and community services, nursing home services, hospice, transportation, dental and vision, behavioral health community services through the medical screening program and child health check-ups as well as other types of services.

Getting Prescription Drugs: The Medicaid program pays the cost of prescription drugs for those who qualify for this coverage. However, if you are covered by both Medicaid and Medicare, your prescription drug coverage will be made for the benefit of the Medicare Part D Medicare Prescription.

The Difference Between Medicaid & Medicare: Medicaid and Medicare are two separate programs. Medicaid is a program for low-income people who meet certain eligibility requirements and programs can vary from state to state. Medicare is a federal health insurance program for people 65 years of age or older, disabled persons, or those suffering from end-stage renal disease. Medicare eligibility is not based on income and basic coverage is the same in every state.

Who Is Eligible For Medicaid? Because this service is only available for some people, there are certain requirements you must meet. The following people may be able to qualify for the Medicaid program in their state if they meet certain financial requirements:

  • Low-income families with children
  • Pregnant women
  • Babies and children under 21 years of age
  • People who receive Supplemental Security Income (SSI)
  • People 65 years of age or older
  • People who are blind or are expected to be disabled for at least one year
  • Individuals with medical emergencies that are not citizens of the United States
  • The medically needy
  • Receiving Help From Medicaid

People who have a large amount of monthly medical bills may be able to get some help with medical expenses through Medicaid even if their income and resources exceed the requirements of the Medicaid eligibility.

How Do I Find a Health Care Provider for Medicaid? If you are in a Medicaid health plan, contact the plan for a list of Medicaid providers. If you are not enrolled in a Medicaid health plan, contact your local Medicaid office for a list of primary care physicians, dentists and specialists.