What is Medicaid?
Through Medicaid, the federal government works with state governments to provide healthcare coverage for millions of children, pregnant women, seniors, and people with disabilities. It pays for medical care such as doctor visits, hospital stays, home health services, and lab fees. Medicaid may also cover prescription medications, physical therapy, and occupational therapy.
Unlike Medicare, you don’t have to be a senior citizen to qualify for Medicaid — you only need to meet your state’s requirements. Rules differ among states, but typically states consider family size and income when you apply for Medicaid.
How does Medicaid work?
Medicaid is administered on a state-by-state basis, and state eligibility requirements can vary widely.
To receive Medicaid, you typically need to submit an application through your state’s Medicaid agency or fill out an application through the federal Health Insurance Marketplace.
Depending on the state, you may also have to pay a small fee to apply.
Who does Medicaid cover?
Typically, you must be a low-income resident of the state that you’re applying for coverage in and meet other eligibility criteria. Some states also consider your age, household size, and whether you’re pregnant or have a disability to determine eligibility.
What does Medicaid cover?
The exact benefits available through Medicaid can vary greatly depending on your state. However, federal rules require all state Medicaid programs to cover hospital and doctor visits, laboratory and X-ray services, home health services, and nursing facility services. They’re also required to provide certain screenings, diagnostics, and treatments for children younger than 21.
States may also cover additional services, such as:
How much does Medicaid cost?
Most states don’t charge premiums for Medicaid coverage. However, some states may require recipients to share in the costs of some services, such as nonpreventive doctor visits, nonemergency visits to an emergency room, inpatient hospital visits, and prescription medications.
Learn More: How to Switch Back to Medicare from Advantage Plans