Medicaid was created to help low-income individuals and families with health care they could not otherwise afford. Although a federal program, it is administered by state human services departments.
Medicaid is administered by the Centers for Medicare and Medicaid Services (CMS), (formerly known as the Health Care Financing Administration (HCFA).
State Income requirements can be as low as $600 per individual and $800 per family, so this program is definitely aimed at those living below poverty level, one of the primary criticisms about qualifying for Medicaid.
Medicaid providers (doctors, hospitals, and pharmacies) are prohibited from requiring their patients to pay any additional charges. If a provider tries to charge you, report them immediately to your caseworker.
To apply for Medicaid, contact your state human services department. You will need:
At your initial appointment, your caseworker will give you a list of required documents. The more you have available, the faster your claim can be processed..
The process of approval can take two weeks to over a month depending on how soon you provide the paperwork, how busy the caseworker is, and how urgent your need is.
If you qualify for Medicaid, you will be given a Medicaid medical insurance card to present to providers. NOTE: Obtaining a replacement takes time so hang onto this card like it's gold.
Not all medical providers accept Medicaid., so check with physicians first before showing up for an appointment. All state- and federal-funded facilities are required to accept Medicaid. All pharmacies accept Medicaid. Some do not do so happily, but they have no choice. They may refuse to order in drugs they do not carry because the reimbursement from Medicaid is much less than that from private insurance companies.
If your income is too high to qualify for pure Medicaid, you can enter into their "Spend-Down Program." In this program, you spend a set amount of your income for medical expenses each month and then Medicaid takes over the remainder. Typically the amount you pay is quite high, but if your medical expenses are eating up your entire income, it is a viable option.
Working to put patients at the center of our health care system by making sure they have the resources they need to make the best decisions for themselves and their families.
In addition to administering the Medicaid program, CMHS also administers related quality assurance programs, and other programs. It ensures its beneficiaries are aware of the services for which they are eligible, services are accessible, and that they are provided in an effective manner.
CMS ensures that its policies and actions promote efficiency and quality within the total health care delivery system. Questions concerning Medicare or Medicaid can be made to the above number or sent by mail or electronic mail to the agency.
Medicaid will also provide transportation to and from medical appointments by taxi or wheelchair-accessible van if you are unable to drive or do not have a car, and bus passes are also available.
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