What is Medicaid?

Section IX.c. Medicaid and Medicare
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Medicaid is a federal and state program that covers medical care for certain people with low incomes.

Each state runs several different Medicaid funded programs for different groups of people. All state programs have some things in common. For example,

  • Each state must cover certain groups of people, including:
    • older people, people with disabilities and people who are blind; and
    • children and pregnant women.
  • However, the financial eligibility levels for these different groups do not have to be the same.

  • All states have programs to cover the cost of nursing home care for people with limited incomes and assets who need this level of care.
  • All states have programs to provide home and community- based care to people with limited incomes and assets who need long-term care services.
  • All states must cover home health care for those with limited incomes and assets who need it.

Each state uses financial eligibility rules to determine whether you are eligible for Medicaid coverage. Generally, your income and assets must be below a certain amount to qualify, but this amount varies from state to state.

You can have both Medicare and Medicaid. Medicaid can cover services that Medicare does not, like extended long-term care. It can also pick up Medicare's out-of-pocket costs (deductibles, coinsurances, copayments). There are certain programs that people with Medicare who have low income will be more likely to qualify for.

Even if your income is above the limits, your state may have a program called the "spend-down" or "medically needy" program. This program allows you to deduct your medical expenses from your income so that you can meet the Medicaid spend-down income limit in your state. Some states allow people with disabilities to place their "spend-down" amount into a trust to make them Medicaid eligible. Some states may also have higher Medicaid financial eligibility levels for working people with disabilities.



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