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Article #2: What is Medicaid

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Medicaid is the US health insurance eligibility rules are somewhat different
program for individuals and families with in every state, although the framework is
low incomes and resources. It is jointly the same throughout the country.
funded by the states and federal Both the federal government and most
government, and is managed by the states. state governments have made many changes
Among the groups of people served by to the eligibility requirements and
Medicaid are eligible low-income parents, restrictions over the years. This has
children, seniors, and people with most recently occurred with the passage
disabilities. Medicaid is the largest of the Deficit Reduction Act (DRA) of
source of funding for medical and 2005 (Pub.L. No. 109-171) which
health-related services for people with significantly changed rules governing the
limited income. treatment of asset transfers and homes of
History and participation nursing home residents. The
Medicaid was created on July 30, 1965 implementation of these changes will
through Title XIX of the Social Security proceed state-by-state over the next few
Act. Each state administers its own years. To be certain of your rights under
Medicaid program while the federal the Act you should consult an expert, as
Centers for Medicare and Medicaid the rules are complex. The DRA now
Services (CMS) monitors the state-run requires that anyone seeking Medicaid
programs and establishes requirements for must produce documents to prove that they
service delivery, quality, funding, and are a United States citizen or resident
eligibility standards. alien.
Each state may have their own names for Budget
the program. Examples include "Medi-Cal" Unlike Medicare, which is totally
in California, "MassHealth" in federal, Medicaid is a joint
Massachusetts, and "TennCare" in federal-state program. Each state
Tennessee. States may bundle together the operates its own Medicaid system, but
administration of Medicaid with other this system must conform to federal
separate programs such as the State guidelines in order for the state to
Children's Health Insurance Program receive matches and grants. The federal
(SCHIP), so the same organization that matching formula is different from state
handles Medicaid in a state may also to state, depending on each state's
manage those additional programs. poverty level. The wealthiest states only
Separate programs may also exist in some receive a federal match of 50% while
localities that are funded by the states poorer states receive a larger match.
or their political subdivisions to Medicaid funding has become a major
provide health coverage for indigents and budgetary issue for many states over the
minors. last few years, with the program, on
State participation in Medicaid is average, taking up a quarter of each
voluntary; however, all states have state's budget. According to CMS, the
participated since 1982 when Arizona Medicaid program provided health care
formed its AHCCCS program. In some states services to more than 46.0 million people
Medicaid is subcontracted to private in 2001. In 2002, Medicaid enrollees
health insurance companies, while other numbered 39.9 million Americans, the
states pay providers (i.e., doctors, largest group being children (18.4
clinics and hospitals) directly to ensure million or 46 percent). It is estimated
that individuals receive proper medical that 42.9 million Americans will be
attention. enrolled in 2004 with (19.7 million of
Comparisons with Medicare them children). Medicaid payments assist
Although their names are similar, nearly 60 percent of all nursing home
Medicaid and Medicare are very different residents and about 37 percent of all
programs. Medicare is an entitlement childbirths in the United States.
program funded entirely at the federal Medicaid is also the program that
level. It focuses primarily on the older provides the largest portion of federal
population. As stated in the CMS money spent for health care on people
website,[2] Medicare is a health living with HIV. Typically, poor people
insurance program for people age 65 or who are HIV positive must progress to
older, people under age 65 with certain AIDS before they can qualify under the
disabilities, and people of all ages with "disabled" category. More than half of
end stage renal disease. people living with AIDS are estimated to
Medicaid is also an entitlement program, receive Medicaid payments. Two other
but it is not solely funded at the programs that provide financial
federal level. States provide up to half assistance to people living with HIV/AIDS
of the funding for the Medicaid program. are the Social Security Disability
In some states, counties also contribute Insurance (SSDI) and the Supplemental
funds. The main criterion for Medicaid Security Income.
eligibility is limited income and Financial advisors typically advise
financial resources, a criterion which retirees and other individuals facing
plays no role in determining Medicare high health costs to adopt strategies
coverage. Medicaid covers a wider range that will protect their financial assets
of health care services than Medicare. In in the event of large medical bills. Many
2001, about 6.5 million Americans were programs do not consider the value of
enrolled in both Medicare and Medicaid, one's home in calculating eligibility,
also known as Medicare dual eligible. therefore it is often recommended that
Eligibility retirees pursue home ownership. By
Medicaid is a joint federal-state program adopting the recommended strategies,
that provides health insurance coverage seniors hope they will quickly qualify
to low-income children, seniors and for Medicaid benefits if the need for
people with disabilities. While Congress long-term care arises. A person should
and the Centers for Medicare and Medicaid seek advice from a qualified expert who
Services set out the main rules under is familiar with Medicaid rules and
which Medicaid operates, each state runs financial planning.
its own program. As a result, the






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