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Medicaid Insurance What is Medicaid Insurance? Medicaid health insurance provides health care coverage for some low-income people who cannot afford it. This includes people who are eligible because they are aged, blind, or disabled or certain people in families with dependent children. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. Medicaid is a Federal program that is operated by the States. Each individual state decides who is eligible and the scope of health services offered. Depending on your state's rules, you may also be asked to pay a small part of the cost for some medical services. Who is Eligible for Medicaid? Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home. Your child may be eligible for coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if you are not (however, there is a 5-year limit that applies to lawful permanent residents). Eligibility for children is based on the child's status, not the parent's. Also, if someone else's child lives with you, the child may be eligible even if you are not because your income and resources will not count for the child. When Medicaid Eligibility Starts Medicaid overage may start retroactive to any or all of the 3 months prior to application, if the individual would have been eligible during the retroactive period. Coverage usually stops at the end of the month in which a person's circumstances change. How to Apply for Medicaid To apply for Medicaid, contact your local social services department and show proof of your financial need for this assistance. What Medicaid Does Not Cover Medicaid does not provide medical assistance for all poor persons. Even under the broadest provisions of the Federal statute (except for emergency services for certain persons), the Medicaid program does not provide health care services, even for very poor persons, unless they are in one of the designated eligibility groups. Low income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds.
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