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Question:


What is Medicaid? Do I need it? Does everyone qualify for it?
-Approaching65


Answer:


Medicaid is a program created by the federal government and administered by the states to provide health care for people who have low incomes and also fall into one or more categories, including children; those children’s parents; pregnant women; blind people, as well as older people who are not otherwise eligible for Medicare. The exact eligibility criteria, including income levels and ages, are determined by each state. The program, by the way, goes by a different name in some states. In California, it’s called Medi-Cal, for instance, and in Wisconsin it’s known by the scary-sounding BadgerCare. Government agencies don’t employ doctors or run hospitals through Medicaid. Rather the federal government and the states jointly reimburse insurance companies for the cost of providing coverage to eligible individuals. This is usually done through managed-care programs, another name for health maintenance organizations, or HMOs, in which the insured obtain care only through a network of approved doctors and facilities, except in emergencies.

The Affordable Care Act called for Medicaid to be expanded to all individuals and families whose income is less than 133 percent of the levels below which individuals or families are considered to be living in poverty. That would mean that a family of four in the 48 contiguous states would be eligible for Medicaid if their income in 2013 was less than $31,321.50. But the Supreme Court ruled that states may choose not to expand their Medicaid rolls, and many states have not or else have yet to decide whether they will go along with the new guidelines. As for whether you qualify, it depends on your income and family situation, of course. If you do qualify, you indeed may need Medicaid if you’re not covered by a health plan at work. To find out if you qualify and then to apply for benefits if you do, go to https://www.healthcare.gov/do-i-qualify-for-medicaid/ and follow the link to the Medicaid website in your state or else click on the link to apply for health coverage. It should tell you whether you qualify after you fill out the appropriate form.

-Conrad de Aenlle



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