Medicaid is a federally run program that provides healthcare to low-income individuals and families, special needs individuals, and other people who need assistance.
Each year, the U.S. government spends over $600 billion on Medicaid expenses and costs. These costs include payments to doctors, hospitals, pharmacies, insurance companies, and pretty much anywhere that a person might have healthcare costs.
In this post, we are going to give you an overview of how Medicaid benefits work.
Medicaid Benefits Are Controlled By The State Where You Live
The U.S. Department of Health and Human Services sets the budget and policies for the Medicaid program on a federal level. However, if you want to actually get benefits, and if you are wondering if you are eligible, you have to apply through your local state agency.
That’s because, in the U.S., each state has its own system for determining eligibility and administering benefits. Find your local Medicaid agency here.
For example, if you live in Florida, you will have to apply through the Agency For Health Care Administration (AHCA). If you live in Ohio, you’d apply through the Ohio Department of Medicaid.
Now, let’s say you qualify and are getting Medicaid benefits in Florida (or any other state), it might be tricky for you to get medical coverage out of state. If you took a trip up to New York, for example, and have to visit an emergency room, it might be a hassle to get Florida’s AHCA to cover those. (But it may be possible).
With that in mind, if you are getting Medicaid coverage in a particular state, and you plan to travel out of state, or out of the country, you should definitely contact your local Medicaid office and see what they will or won’t cover while you’re out of state.
How Does Medicaid Pay For Your Healthcare?
In most states, you’ll get a Medicaid card that’s similar to an insurance card. If you have to go to the doctor or hospital, you will then present that card to the medical receptionist when you check-in.
After the appointment or procedure, this medical office will attempt to send the bill directly to your state Medicaid provider. Depending on the nature of the appointment or procedure, and how much your state covers for that particular treatment, your Medicaid agency will either pay for the bill in full or, pay a portion of the bill. Then, you may be required to pay a copay or pay a remaining balance to the healthcare provider if Medicaid didn’t pay the amount in full.
Medicaid also covers a wide range of other medical expenses, including prescription drugs, and long-term care facilities. In fact, over 20% of Medicaid’s entire budget is spent on long-term care facilities (for example, nursing homes, or hospice care).
Your Medicaid Benefits
Wondering what Medicaid benefits that you and your family qualify for? The only way to find out what’s covered is to contact your local state agency and apply. What they cover, and don’t cover, all comes down to your financial situation, where you live, and what you are eligible for.
We hope this post has helped you learn more about how Medicaid benefits work. Wishing you and your family a healthy medical journey.
