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Share your insurance ideas and expertise. Respond to questions and comments Joslyn [2010-03-09] ... I'm choosing health insurance for the first time. What is the difference between a HMO and a PPO? Reply

Medicaid Insurnace

Given the big debate happenning in the country on health care it is important that everyone look at the requirement for the health care that they have. Here are some requirements for medicaid

There are many factors which are taken into consideration when evaluating a person for Medicaid qualifications. The program is limited to those persons who fall into certain categories. According to federal guidelines there are approximately 25 different categories which are available. These categories range from children to the non-disabled adults who are under the age of 65. In some cases these categories tend to overlap one and other ultimately allowing a person to qualify under more then one category.

As an example you could have a five year old child who may be qualified as a poverty related child, he or she may be a dependent child within a welfare eligibility family or perhaps as a child of welfare to work type of family. In the event that this child also has some sort of disability then they may also qualify as a child who receives SSI benefits. It is this vast number of different categories involved with Medicaid which make it such a complicated program to work with.

In essence there are generally five major categories of coverage eligibility. They are children, adults in families with dependent children, pregnant women, elderly and disabled individuals. This article will briefly focus upon three out of these five categories. Those groups being the children, those women who are pregnant and the adults of families with dependent children.

Let's start with children. There are currently over 41 million people who are enrolled in the Medicaid program and approximately half are children. The usual category of eligibility for these children is a parent who falls under an income below the federal threshold of poverty level.

Pregnant Women on the other hand rely upon the Medicaid program to pay for over 40 percent of births found in America. All pregnant women of any age are eligible for Medicaid in the event that their incomes are below the 133 percent rating established for the federal poverty level. This coverage includes all time being pregnant as well as for a 60 days period afterwards.

Lastly, we have the adults in the families with dependent children. Unlike the other two categories of children or pregnant women the non-disabled adults fail to have the major benefit of a vast Medicaid eligibility which is usually tied closely to the federal poverty level. Those adults that are not disabled, elderly or pregnant can only qualify for Medicaid if they are actually an adult located in a family that has dependent children.

In all reality those Medicaid categories mentioned above tend to exclude millions of poor people from the Medicaid program with no regard what so ever to the actual degree of poverty or medical necessity. Women who may not be pregnant, they may not be disabled or elderly, nor have dependent children are completely excluded. The same situation applies to those men who may be living in poverty.

Even though one must qualify under a specific eligibility category they are not automatically accepted. They would still need to qualify under the income provision as well. This type of requirement takes the form of income tests including ones assets and resource. Naturally the actual financial requirements may vary slightly from one category to the next.

As mention there are many factors which come into pay involving Medicaid eligibility and each factor must be reviewed on its own merits.

Applying for Medicaid

 

AARP Endorses Affordable Health Care for America Act
AARP Endorses Affordable Health Care for America Act. AARP supports heathcare reform

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RECENT COMMENTS

Joslyn
2010-03-09
I'm choosing health insurance for the first time. What is the difference between a HMO and a PPO? insure
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2010-03-08
BCBS PPO coverage for weight loss surgery? I have recently been considering having the lap band done. I am wondering would BCBS PPO cover for it. I am a dependent on this insurance and I am 21. I am covered until I am 25. I have heard it depends on what policy the employer agrees upon but I am not sure what kind of policy my parents have. Does anyone know what kind of policy WLS would be covered under. And if not covered all the way would it be covered any? I am a little apprehensive about doing all this but I need to find out if I am even covered at all and I'm not quite sure how to go about finding out how. insure
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