Overview of Medicaid
Good health is important to everyone. If you can't afford to pay
for medical care right now, Medicaid can make it possible for
you to get the care that you need so that you can get healthy –
and stay healthy.
Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. Depending on your state's rules, you may also be asked to pay a small part of the cost (co-payment) for some medical services. Medicaid is a state administered program and each state sets its own guidelines regarding eligibility and services. Read more about your state Medicaid program. Click here to view Medicaid At-A-Glance 2005.
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
In general, you should apply for Medicaid if your income is low and you match one of the descriptions of the Eligibility Groups. (Even if you are not sure whether you qualify, if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state evaluate your situation.)
Screening Tools
To help you see if you may be eligible for a
variety of governmental programs click on the following links to
see if you are eligible:
GovBenefits.gov
and
BenefitsCheckUp.org.
When Eligibility Starts
Coverage 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 generally
stops at the end of the month in which a person's circumstances
change. Most States have additional "State-only" programs to
provide medical assistance for specified poor persons who do not
qualify for the Medicaid program. No Federal funds are provided
for State-only programs.
Who is Not Covered
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. As noted earlier, categorically
needy persons who are eligible for Medicaid may or may not also
receive cash assistance from the TANF program or from the SSI
program. Medically needy persons who would be categorically
eligible except for income or assets may become eligible for
Medicaid solely because of excessive medical expenses.
Medicaid in Wisconsin
To view facts on Medicaid use in Wisconsin compared the rest of
the United States, please
click here (Kaiser Family, 2006).