Information Concerning Your Medicaid Provider

Medicaid will provide health coverage for individuals and families who are in a low-income bracket and fit certain eligibility requirements. These requirements differ from state to state. If you have Medicaid, your health care providers will receive payments for their services through the Medicaid program. Depending on the state where you reside, there may be co-pay that you will be responsible for pertaining to certain services.

Both the Federal and State Government fund the Medicaid program, and it is administered through the state. It can cover children, the elderly, and those with disabilities who meet the eligibility requirements. There are certain factors that are taken into consideration to ascertain if you are eligible for Medicaid.

Some Common Factors for Medicaid Eligibility:

  • Age.
  • Disability.
  • Income.
  • Assets.
  • Pregnancy.
  • U.S. citizen or lawful resident.

If you have a disabled child who lives with you, he or she may be eligible for Medicaid even if you are not. As long as your child is a U.S. citizen or a permanent resident of the U.S., he or she may be covered, as the individual status of the child is used to ascertain eligibility. There are also special rules for those residing in nursing homes.

Funding for Medicaid programs has been an issue for many states in recent years. In 2008, it was estimated that 49 million individuals were receiving benefits through a Medicaid provider, and this figure included children, the elderly, nursing home residents and disabled individuals. This was at a cost of approximately $204 billion. In November of 2008, a new rule was passed by the Federal Government that gave states the power to charge higher co-pays and premiums to those who were receiving Medicaid. In this way, these states would not have the financial losses that were previously occurring.

If you are receiving SSI, which is Supplemental Security Income, you will most likely be eligible to also receive Medicaid. In some states, it is automatic that having SSI provides you with Medicaid. But if you do not have Medicaid and are in need, there is a certain simple process that will allow you to apply for it. This process is outlined below.

Process for Applying for Medicaid

You should contact your local Department of Human Services or Social Security Office to get information on the proper procedure to apply for Medicaid. You may want to make an appointment to go to the office. If you cannot leave your house, you can have an application mailed out to you that you can easily mail back. Personnel from the office can help you over the phone if you have any difficulty in filling out the application. Sometimes the entire application process can be handled by a phone call.

If you are able to get into the office, you will fill out the appropriate application on the premises. Be certain to put all pertinent information on this application, as it will be used to ascertain whether you will or will not get benefits through a Medicaid provider.

There are certain documents that you may have to bring with you, including your social security card, driver’s license, documents pertaining to income and bank accounts, birth certificate, copies of utility bills showing monthly expenses and ID cards for any other insurance you may have. You may not need all of these documents, but it is best to be prepared.

When you have filled out the appropriate application and produced whatever pertinent documents are required, it may take up to 45 days to get word regarding whether you are eligible for Medicaid benefits. If you are declined Medicaid benefits due to being above the allowable income, be certain to reapply should your income decrease for any reason. A lower income will change your status and may make you eligible for benefits through a Medicaid provider where you were not eligible previously.

Medicaid is a way for those who do not have enough of an income for health insurance to get coverage if they are eligible. No one should be denied medical coverage. With the Medicaid program, you may get the coverage you need for yourself and your family.