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Encyclopedia > Medicaid

Medicaid is the US health insurance program for individuals and families with low incomes and resources. It is jointly funded by the states and federal government, and is managed by the states. Among the groups of people served by Medicaid are eligible low-income parents, children, seniors, and people with disabilities. Medicaid is the largest source of funding for medical and health-related services for people with limited income. Image File history File links No higher resolution available. ... Motto: (Out Of Many, One) (traditional) In God We Trust (1956 to date) Anthem: The Star-Spangled Banner Capital Washington D.C. Largest city New York City None at federal level (English de facto) Government Federal constitutional republic  - President George Walker Bush (R)  - Vice President Dick Cheney (R) Independence from... Health insurance is a type of insurance whereby the insurer pays the medical costs of the insured if the insured becomes sick due to covered causes, or due to accidents. ...

Contents

History and participation

Medicaid was created on July 30, 1965 through Title XIX of the Social Security Act. Each state administers its own Medicaid program while the federal Centers for Medicare and Medicaid Services (CMS) monitors the state-run programs and establishes requirements for service delivery, quality, funding, and eligibility standards. Social Security in the United States is a social insurance program funded through dedicated payroll taxes called FICA (Federal Insurance Contributions Act). ... It has been suggested that Health Care Financing Administration be merged into this article or section. ...


Each state may have their own names for the program. Examples include "Medi-Cal" in California, "MassHealth" in Massachusetts, and "TennCare" in Tennessee. States may bundle together the administration of Medicaid with other separate programs such as the State Children's Health Insurance Program (SCHIP), so the same organization that handles Medicaid in a state may also manage those additional programs. Separate programs may also exist in some localities that are funded by the states or their political subdivisions to provide health coverage for indigents and minors. Medi-Cal is the name of the Medicaid program in the State of California. ... Masshealth is the common name for the Medicaid program in the state of Massachusetts. ... TennCare is Tennessees Medicaid waiver program that provides more than one million Tennesseans with health care. ... The State Children’s Health Insurance Program (SCHIP) is a national program in the United States designed for families who earn too much money to qualify for Medicaid, yet cannot afford to buy private insurance. ...


State participation in Medicaid is voluntary; however, all states have participated since 1982 when Arizona formed its AHCCCS program. In some states Medicaid is subcontracted to private health insurance companies, while other states pay providers (i.e., doctors, clinics and hospitals) directly to ensure that individuals receive proper medical attention. The Arizona Health Care Cost Containment System (AHCCCS) is the name of the Medicaid program in the state of Arizona. ...


Comparisons with Medicare

Although their names are similar, Medicaid and Medicare are very different programs. Medicare is an entitlement program funded entirely at the federal level.[1] It focuses primarily on the older population. As stated in the CMS website,[2] Medicare is a health insurance program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with end stage renal disease. President Johnson signing the Medicare amendment. ... Entitlement is the guarantee for access to benefits because of rights, or by agreement through law. ... Chronic renal failure - Wikipedia /**/ @import /skins/monobook/IE50Fixes. ...


Medicaid is also an entitlement program, but it is not solely funded at the federal level. States provide up to half of the funding for the Medicaid program. In some states, counties also contribute funds. The main criterion for Medicaid eligibility is limited income and financial resources, a criterion which plays no role in determining Medicare coverage. Medicaid covers a wider range of health care services than Medicare. In 2001, about 6.5 million Americans were enrolled in both Medicare and Medicaid, also known as Medicare dual eligible. Year 2001 (MMI) was a common year starting on Monday of the Gregorian calendar. ... This article or section is in need of attention from an expert on the subject. ...


Eligibility

Medicaid is a joint federal-state program that provides health insurance coverage to low-income children, seniors and people with disabilities. While Congress and the Centers for Medicare and Medicaid Services set out the main rules under which Medicaid operates, each state runs its own program. As a result, the eligibility rules are somewhat different in every state, although the framework is the same throughout the country.


Both the federal government and most state governments have made many changes to the eligibility requirements and restrictions over the years. This has most recently occurred with the passage of the Deficit Reduction Act (DRA) of 2005 (Pub.L. No. 109-171) which significantly changed rules governing the treatment of asset transfers and homes of nursing home residents.[3] The implementation of these changes will proceed state-by-state over the next few years. To be certain of your rights under the Act you should consult an expert, as the rules are complex. The DRA now requires that anyone seeking Medicaid must produce documents to prove that they are a United States citizen or resident alien. The Deficit Reduction Act was passed by the US Congress in 1993 under the Clinton administration. ... This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ...


Budget

Unlike Medicare, which is solely a federal program, Medicaid is a joint federal-state program. Each state operates its own Medicaid system, but this system must conform to federal guidelines in order for the state to receive matches and grants. The federal matching formula is different from state to state, depending on each state's poverty level. The wealthiest states only receive a federal match of 50% while poorer states receive a larger match.


Medicaid funding has become a major budgetary issue for many states over the last few years, with the program, on average, taking up a quarter of each state's budget. According to CMS, the Medicaid program provided health care services to more than 46.0 million people in 2001.[4] In 2002, Medicaid enrollees numbered 39.9 million Americans, the largest group being children (18.4 million or 46 percent). It is estimated that 42.9 million Americans will be enrolled in 2004 (19.7 million of them children) at a total cost of $295 billion. Medicaid payments assist nearly 60 percent of all nursing home residents and about 37 percent of all childbirths in the United States.


Medicaid is also the program that provides the largest portion of federal money spent for health care on people living with HIV. Typically, poor people who are HIV positive must progress to AIDS before they can qualify under the "disabled" category. More than half of people living with AIDS are estimated to receive Medicaid payments. Two other programs that provide financial assistance to people living with HIV/AIDS are the Social Security Disability Insurance (SSDI) and the Supplemental Security Income. Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... Acquired Immune Deficiency Syndrome or acquired immunodeficiency syndrome (AIDS or Aids) is a collection of symptoms and infections resulting from the specific damage to the immune system caused by the human immunodeficiency virus (HIV). ... Social Security in the United States is a social insurance program funded through dedicated payroll taxes called FICA (Federal Insurance Contributions Act). ... Supplemental Security Income is a monthly stipend provided to some citizens by the United States federal government. ...


Medicaid planners typically advise retirees and other individuals facing high nursing home costs to adopt strategies that will protect their financial assets in the event of nursing home admission. State Medicaid programs do not consider the value of one's home in calculating eligibility, therefore it is often recommended that retirees pursue home ownership. By adopting the recommended strategies, seniors hope they will quickly qualify for Medicaid benefits if the need for long-term care arises. A person should seek advice from a qualified expert who is familiar with Medicaid rules and Medicaid planning. See Elder law. This article needs to be wikified. ...


In some states, there is a program put in place by Medicaid called the Health Insurance Premium Payment Program (HIPP). This program allows a Medicaid Recipient to have private health insurance payed for by Medicaid. Usually this allows the recipient to have better coverages, and have more doctors available to them. Medicaid benefits from this program, because it is less expensive to Medicaid to pay for a private plan than to pay for the coverages out of their own budget.


Important legislation

  • 1965 PL 89-97 Medicaid
  • 1997 PL 105-33 Balanced Budget Act (Children's Health Insurance Program)

1990: OBRA Frderal Legislation: The beggings of the HIPP Program, under the Clinton Ministration 1965 (MCMLXV) was a common year starting on Friday (the link is to a full 1965 calendar). ... 1997 (MCMXCVII) was a common year starting on Wednesday of the Gregorian calendar. ... MCMXC redirects here; for the Enigma album, see MCMXC a. ... The Health Insurance Premium Payment Program (HIPP) is a medicaid program that allows a Medicaid recipient to receive free private health insurance payed for entirely by their states Medicaid program. ... Clinton is an English surname which may refer to a number of persons or places. ...


References

  1. ^ http://www.medicare.gov/LongTermCare/Static/Home.asp
  2. ^ http://www.cms.hhs.gov/MedicareGenInfo/
  3. ^ http://www.cms.hhs.gov/NewFreedomInitiative/downloads/LTC%20Roadmap%20to%20Reform.pdf]
  4. ^ http://www.cms.hhs.gov/publications/overview-medicare-medicaid/default4.asp

External links

  • Trends in Medicare, October 2006. Staff Paper of the Office of the Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services
  • AT Wiki on Assistivetech.net
  • Read Congressional Research Service (CRS) Reports regarding Medicaid
  • Kaiser Family Foundation - Substantial resources on Medicaid including federal eligibility requirements, benefits, financing and administration.
  • State Health Facts Data on health care spending, utilization, and insurance coverage, including details extensive Medicaid information.
  • State of the States 2006 - Information on state health reforms, including Medicaid (PDF).
  • Medicaid information from Families USA
  • Medicaid Reform - The Basics from The Century Foundation
  • National Association of State Medicaid Directors Organization representing the chief executives of state Medicaid programs.

  Results from FactBites:
 
Medicaid (1961 words)
Medicaid is a program for New Yorkers who can't afford to pay for medical care.
Even if you are not eligible for Medicaid benefits, the premiums can still be paid, in some instances, if you lose your job or have your work hours reduced.
If you receive medical services paid for by Medicaid on or after your 55th birthday, or when permanently residing in a medical institution, Medicaid may recover the amount of the cost of these services from the assets in your estate upon your death.
Medicaid: Improving Health, Saving Lives, Rev 8/17/05 (2787 words)
Expansions of Medicaid coverage for low-income pregnant women led to an 8.5 percent reduction in infant mortality and a 7.8 percent reduction in the incidence of low birth weight.
In addition, administrative costs for Medicaid (at 6.9 percent of total costs) are about half as large as administrative costs under private health insurance (which average 13.6 percent of costs), according to estimates by the Centers for Medicare and Medicaid Services.
It is important to remember, however, that Medicaid has proven to be a highly effective mechanism for providing health care coverage to low-income families and individuals and that, contrary to the impression of some policymakers, Medicaid tends to cost less than private insurance.
  More results at FactBites »

 
 

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