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By Howard Seidman, HealthAtoZ Writer
Medicaid is a health insurance program that is funded by federal and state governments. Eligibility is based on income or need. It is not the same as Medicare.
The federal government sets guidelines for medicaid. Each state has its own rules for eligibility and services.
Who is eligible?
You may qualify for Medicaid if you are eligible for federal assistance and are:
- A low-income senior
- Blind
- Disabled
- A child
Most people who receive Supplemental Security Income (SSI) can qualify for Medicaid. (SSI is not the same as Social Security.)
If you are not sure whether you qualify, you should apply to find out. People who qualify don't always fit classic profiles. You may still get benefits if you have high medical costs.
What does Medicaid cover?
Although it varies by state, some things that may be covered include:
- Doctor visits
- Prescription drugs
- Hearing aids
- Glasses
- Inpatient and outpatient hospital services
- Nursing homes
- Ambulance services
- Emergency dental care
- Transportation to doctors or hospitals
- Medical equipment and supplies
- Home health or hospice care
- Diagnostic, screening and preventive services
- Lab tests and x-rays
- Medicare payments, deductibles and coinsurance
- Mental health care
- Artificial limbs and replacement devices
- Podiatry
- Physical, occupational and speech therapies
- Dialysis
- Stop-smoking programs
Be sure to ask about coverage on any items or services you need. Prior approval may be required.
How do I apply?
Your local department of social or human services handles Medicaid applications. You can find an agency close to you through Social Security or county government offices. Or check online at the Centers for Medicare and Medicaid Services (CMS) Web site.
Most people apply for Medicaid in person. But if you can't travel far, you may be able to apply at schools, hospitals and community centers, on the Web or by mail.
When you apply, answer honestly. Medicaid fraud is taken seriously. If you have concerns, speak with an elder law expert first.
What to bring when applying
Depending on your state, you may need to bring some of the following:
- U.S. passport
- Original or certified copy of birth certificate
- Certificate of naturalization
- Certificate of U.S. citizenship
- Valid state-issued driver's license
- Picture ID card issued by a federal, state or local agency with name, date of birth, sex, height, eye color and address
- Social security number
- Proof of residence - a lease, rent receipt or utility bill
- Recent bank statements
- Recent paycheck stubs, payroll records or W-2 forms
- Letters or forms that show income from Social Security, SSI, Veterans Administration, retirement, pensions, unemployment, worker's compensation, child support or other sources
- Information about property ownership
- Current health and life insurance policies
- Health insurance cards
- Medicare card
- Medical bills you were not able to pay, especially from the past three months
What happens following application?
When you apply, a Medicaid caseworker will speak to you. She or he will review your application and make sure all the facts are right.
A decision on your eligibility is usually made in 30 to 90 days. If you have a disability that needs to be verified, that takes the longest. Notice usually comes in the mail.
After approval, don't assume you should cancel other health insurance policies. Medicaid may be able to help pay for your policy. Your coverage may also be retroactive for up to three months before you apply.
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