MONEY MATTERS
Medicaid – What Is It and
What Does It Pay For?
by Robert Rhinesmith
M
edicaid, created in 1966, is a
joint program between the fed-
eral government and each indi-
vidual state to provide health
insurance to the nation’s most economically
vulnerable people. Nearly one-quarter of
all Americans (almost 75 million people) are
covered by Medicaid, as well are half of all
births.
The program covers low-income adults
and children, pregnant women, seniors in
need of long-term care, and the disabled.
The passage of the Affordable Care Act
increased Medicaid’s role by expanding
coverage to slightly higher earning individ-
uals.
Whether or not you qualify for
Medicaid depends on your income, assets
and the rules of your state. A 2016 Kaiser
survey found that for a child to be covered,
the median income for a family of three
cutoff was a little more than $51,000. Some-
times a small co-payment is required.
While states have leeway establishing
their own Medicaid programs, all must offer
mandatory benefits under federal law. These
include inpatient and outpatient hospital
services, nursing facility services, home
24 HimPower May 2018
health services, rural health clinic services
and birth center services. There’s also a list
of optional features your state may adopt.
(see below)
LONG-TERM CARE
Medicaid provides a vital resource
to seniors in need of long-term care, but
can’t afford it. You need to be over 65, or
disabled, require assistance to get through
so-called daily activities of living (such as
eating and dressing), and be poor enough to
qualify.
And it takes a while.
State officials will pour over years of
your bank accounts to ensure that you don’t
have the funds to pay for yourself, although
you’ll generally be allowed to spend down
your nest egg to around your last $2,000.
LIST OF MEDICAID BENEFITS
The list below outlines mandatory
Medicaid benefits, which states are required
to provide under federal law, and optional
benefits that states may cover if they choose.
MANDATORY BENEFITS
• Inpatient hospital services