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Saturday, August 15, 2009

Understanding the Eligibility Requirements of Medicaid

Medicaid is an insurance program that is offered by every state to people with lower incomes. The program is, in part, federally funded, but each state is given freedom in how they implement their Medicaid Program.

Medicaid, while federally funded and regulated, varies from state to state, because each state is given freedom to choose how to meet the federal regulations. The same federal agency that administers Medicare, the Center for Medicare and Medicaid Services (CMS,) is responsible for ensuring that the states are meeting the federal regulations.

Medicaid is intended to help those with lower incomes afford medical care, but over 50% of those in poverty do not qualify for Medicaid.

Eligibility for Medicaid is divided into several categories, with each category having several requirements that must be met. The basic categories are children, pregnant women, the parents of eligible children, single parents, and single individuals. The actual requirements can change a great deal between states, specifically because each state administers their own Medicaid Program, but the states are required by the Federal Government to cover individuals who fall into the above categories.

While poverty is an overall requirement to be eligible for Medicaid, being poor by itself does not qualify someone for Medicaid. Instead, an individual or family must both have a low income and fall into one of the specific categories.

Typically, Medicaid is only available to American Citizens or those who are otherwise legal residents. However, in the case of children, as long as the child is a resident, the status of their parent or caretaker does not matter. As long as the child is a legal resident, they may receive Medicaid benefits.

Medicaid is available for a number of disabilities, including HIV. In fact, Medicaid is the single largest source of funding for HIV care from the federal government. However, in order for HIV to be classified as a Disability, the disease must have progressed to Aids, which is defined as having a T Cell count of less than 200.

In order to become enrolled in Medicaid, it is necessary to submit an application to your state. In order to adhere to federal regulations, the state must review and act on the application within 45 days of receipt, although they are given 90 days in the case of disabilities.

Beginning in 2005, as part of the Deficit Reduction Act, there were several changes to Medicaid, which serve to provide tighter control over who can receive these benefits. It is now necessary to provide proof of residency or citizenship before being approved for Medicaid Benefits.

The government has also put in place much stricter financial requirements on an individuals assets. Most states cap an individuals assets at $2000, although this figure does vary. The government now analyzes all money transfers and gifts over the past five years. The total of these assets is then used to penalize the individuals receipt of nursing home benefits. In the case of many seniors that have made gifts of their assets, this penalty prohibits them from qualifying for Medicaid, even though they do not have the money to pay for it.



Article Source: http://EzineArticles.com/?expert=Samuel_Tarwell

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