Medicaid Billing

Medicaid is a system that is funded by Federal and State government and helps those who have limited funds to get assistance in paying for medical expenses. There are specific requirements that need to be met in order for an individual or family to receive Medicaid benefits. Age is considered, along with any disabilities, such as blindness. Pregnancies are also taken into consideration along with United States citizenship. Even if you have not been able to get any other type of health insurance, you may find that you are eligible for assistance through the Medicaid program.

It is the responsibility of each state to put aside a certain amount of money that is used for Medicaid purposes. This amount will vary from state to state depending on the economic status and the number of residents who are at the poverty level. There are states that allow as much as 25% of the budget to be applied to Medicaid expenses. To be eligible for Medicaid, you must earn under a certain amount in income. This amount can also vary from one state to the next due to different cost of living expenses across the nation. The Federal government has certain guidelines that all states must adhere to in implementing their Medicaid programs.

Medicaid billing will handle medical expenses for those who qualify for benefits. Listed below are some of the services that Medicaid will cover.

  • Medications.
  • Laboratory tests and X-rays.
  • Doctors’ visits.
  • Hospitalization.
  • Outpatient services, including diagnostic and rehabilitative services.
  • Minor surgeries.
  • Pediatric care.
  • Nursing home care.
  • Vaccinations.

There are states that will also include vision and dental care and assisted living expenses. A certain type of Medicaid will cover prenatal care, but the requirements for this program may differ somewhat, and this form of Medicaid will only cover the prenatal aspect of health care.

If you are approved to receive Medicaid, you will find that there may be a small co-payment that is required for certain medical services. Medicaid billing in the form of co-payments will be the only expense that you will need to be concerned with. These nominal amounts are also much lower than the co-payments that are required by other types of health insurance.

You can apply for Medicaid through your Social Security or Human Services Office. You will need to fill out an application that will inquire as to your income, your medical expenses, your financial assets, who resides with you, and other information that will help to determine your eligibility. There is also documentation that is required that may include what is listed below:

  • Social Security card.
  • Medicare card, if you have Medicare.
  • Expenses on a monthly basis that you are required to pay, such as rent, insurance premiums and utilities. You usually are required to have documentation for the last three months.
  • Your paycheck stubs for the previous three months.
  • Bank account statements, possibly for the last 36 months. You may need to submit documentation for bank accounts that have been closed within the last 36-month period.
  • Documentation on financial assets you may have, such as certificates of deposit, IRAs, Keoghs, stocks and bonds.
  • Birth Certificate.
  • Documentation on other health insurance policies you have, including what each policy covers.
  • The face value and cash value of life insurance policies.
  • Documentation on burial policies and prepaid funeral plans.
  • Titles to vehicles and deeds to property.

If you are approved for Medicaid, your Medicaid billing will handle any medical expenses you may have incurred for three months before the date of your application. This will be the case as long as you were eligible for Medicaid in that three-month period.

If you are also a Medicare recipient, your medical bills will first be paid through Medicare, with Medicaid picking up the tab for remaining expenses. Should there be a change in your financial status that can also change your eligibility for Medicaid, which may stop if your income goes above the limit that has been set.

Fortunately, Medicaid can be of great benefit to those who are hurting financially and need assistance in paying medical bills.