Medicaid

Medicaid (the Medical Assistance Program) is a group of health insurance programs that provide health care benefits to low-income individuals who meet eligibility requirements. Medicaid programs are jointly funded by the federal government and state governments. Each state administers its Medicaid program, and eligibility criteria and benefits vary from state to state. A person who is eligible for Medicaid in one state is not necessarily eligible in another. To make it even more confusing, some states use a different name for the program such as Medical Assistance, Medi-Cal or TennCare. 

Since eligibility criteria and benefits are different in each state, if you have questions about Medicaid, the best place to start is your local Department of Family and Children’s Services or Department of Social Services. This can also be confusing because each state has a different name for this department. However, you can look in the Government section of your local phone book, or visit your county or state website for information. You can also ask a social worker or financial counselor at your treatment facility for more information. Finally, you can contact the Centers for Medicare and Medicaid Services directly at www.cms.gov/medicaid/consumer.asp

Even within each state there are many different Medicaid programs. For instance, one Medicaid program may only provide services if an individual is pregnant, while another program may apply if a person has a disability. Most states also have a program for people with significant medical needs, in which Medicaid eligibility is extended to higher-income people who have high medical costs. These programs may be referred to as “Medically Needy Medicaid” or “Spend-down Medicaid.” 


If you are uninsured... or if you are worried that you soon may lose your health insurance, it is advisable to apply for Medicaid, even if you don’t think you will meet the income criteria. Keep records of the application process because many other financial assistance programs require proof that you have applied for Medicaid. Most of these programs will consider you for assistance if you have applied for and been denied Medicaid. However, if you have not applied they may require that you do so before they will consider you for their program.

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