Becoming a Medicaid Beneficiary

Medicaid insurance offers low-income Citizens the opportunity to receive health care coverage for preventative and emergency medical services when they otherwise could not afford it. Medicaid eligibility is primarily based on household income.

Medicaid benefits are aimed at helping the most vulnerable members of society, which keeps everyone healthier and also decreases overall healthcare expenses for everyone. The Medicaid expansion in recent years has demonstrated that fact, which is why more and more states are choosing to implement that expansion. The application covers all of the necessary factors to prove that an applicant is qualified for and in need of assistance. Understanding Medicaid, how it works and whom it helps, is important for all taxpayers and for all voters in the U.S. Whether you need services or not, learn all about the Medicaid program.

What is Medicaid?

Medicaid insurance is a joint federal-state program that provides health care coverage to low-income Citizens in need of assistance. While operated on a national level by the Centers for Medicare and Medicaid Services (CMS), each state has control over its own Medicaid program. This means that each state can determine the eligibility criteria and the application processes required of Medicaid applicants. Some states operate their own health care marketplace, while others utilize the national Healthcare.gov Marketplace. Medicaid services can usually be applied for within those marketplaces online.

Medicaid benefits include a variety of medical services that are both preventative and for emergencies. These benefits include everything from family planning to X-rays to inpatient hospital care and more. The list of mandatory benefits set by the federal government is required of each state Medicaid agency. However, there is a long list of optional benefits that a state can offer. Medicaid beneficiaries can utilize these services to maintain their health and that of their families. Without the assistance of these Medicaid services, these medical costs would be prohibitive for most beneficiaries.

Related Article: Medicaid Benefits Explained 

The Medicaid program has been in existence for decades and currently offers assistance to millions of citizens. By providing health care coverage to more citizens, individuals and families can stay healthier and the overall insurance pool costs go down. That helps all private insurance purchasers to receive better quotes for the same services required.

Medicaid Expansion

The ACA Medicaid expansion refers to the Affordable Care Act, which is commonly referred to as Obamacare. When the ACA was written, it proposed an expansion of the Medicaid program to cover even more low-income citizens in need.

This expanded Medicaid proposal must be accepted at the state level, so not all states have accepted and implemented the changes yet. That means you must understand if Medicaid expansion was accepted in the state where you live to determine your eligibility for assistance. In some states, you could qualify based on your low level of income, but in others, you might not. Unfortunately, where you live can determine whether you get the help, you need for your health care costs.

Knowing the Medicaid expansion states that have accepted and the states that have denied the new rules can help you to understand your own eligibility criteria. More states are continuing to implement the Medicaid expansion changes due to the positive effect of the expansion on those states that have already accepted it. If your state has not yet implemented the new rules, you can always contact your representatives to voice your opinion on the program expansion.

Eligibility Requirements for Medicaid

Understanding who qualifies for Medicaid means understanding the different eligibility factors involved. Due to the Medicaid expansion being accepted only in certain states so far, not all states are equal when it comes to Medicaid programs. Those states that have accepted the expansion offer assistance to a wider range of recipients in need.

The Medicaid qualifications primarily focus on the total household income of the applicant or applicants. This income is actually a Modified Adjusted Gross Income (MAGI) that is calculated as total earnings minus various deductions to find the estimated MAGI. In states that expanded Medicaid, that income amount alone could determine the qualifications of the applicant.

Other eligibility factors for Medicaid include your citizenship, state residency, family status, household size, age and disability status. While not all of these will impact every applicant, it is important to understand that Medicaid applications include a variety of detailed categories of information to ensure the integrity of the program and to make sure that those in need receive the assistance they require. While providing proof can seem like a burden to an applicant, it does ensure that those who need it receive assistance while simultaneously minimizing fraudulent activity.

How to Apply for Medicaid

The Medicaid application asks questions related to each of the eligibility factors that determine an applicant’s qualification to receive assistance. Applying for Medicaid requires an applicant to submit the initial application form completed with personal details and income information, and then to provide any necessary supporting documentation for proof of eligibility. A thorough review of each application is made to determine eligibility for assistance before an application is approved.

If an applicant is deemed eligible to receive Medicaid benefits, then those benefits can be retroactively used back to the date of application, depending on the state Medicaid agency’s rules. This is why understanding how to submit an application as soon as you require assistance is so important. If you can apply for Medicaid online, it helps to file your details as quickly as possible to get the services you need.

Learning how to apply for Medicaid assistance can help you to more efficiently complete the process and to begin receiving your benefits. Make sure you do your research and fully understand this program to get the best benefit when you need the assistance.

Related Article: How to Apply to Medicaid 

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