Top 10 Most Important Things to Know About Medicaid

Medicaid is the single largest source of health coverage in the United States and provides coverage to over 72.5 million Americans. If you’ve been investigating your own Medicaid eligibility, then there are a few things you should know.

1. Medicaid Covers 1 in 5 Americans

Medicaid is the nation’s public health insurance program for those with low income and is the primary source of long-term care coverage in America.

2. Medicaid is a Joint Federal-State Program

Each state operates its own Medicaid program within the federal guidelines. These guidelines are fairly flexible, meaning that each state can set additional requirements as they see fit. This flexibility means that there can be significant variations in each state’s program.

3. Medicaid Continues to Evolve

When Medicaid was first implemented in 1965, eligibility was tied to cash assistance programs. Over time, the federal program requirements expanded to include new coverage options for pregnant women, children, and people with disabilities. Under the Affordable Care Act, all states were required to revamp Medicaid eligibility and enrollment processes. This has resulted in historic reductions in children without coverage and, in some states, adults without coverage.

4. Medicaid Covers Diverse Populations

Medicaid provides health insurance coverage for a broad range of people. It plays a critical role in providing much-needed health coverage to low-income individuals, those with disabilities, pregnant women, children, and more than 6 out of every 10 nursing home residents.

5. Medicaid Helps Cover Long Term Care Services

When it comes to long-term care solutions, most insurance companies do not pay for more than a minimum period. This can quickly get expensive with nursing homes costing upwards of $90,000 annually. With the help of Medicaid, many of these long-term care costs can be covered for both nursing home options and community-based long-term care services and supports.

6. Most Medicaid Enrollees Get Care Through Managed Care Plans

Over two-thirds of Medicaid recipients are enrolled in a privately managed care plan. Managed-care plans allow Medicaid recipients to have access to healthcare providers within a network and are at financial risk for their costs. While in the past, managed care plans were often limited by states to children and their families, they are now progressively broadening managed care to individuals with complex needs.

7. Medicaid Restores Access to Care

Research has shown that Medicaid recipients have far better access to health care than those that are uninsured. Recipients are also less likely to postpone medical care due to cost. This increase in access has skyrocketed Medicaid recipient’s satisfaction rates to comparable levels to those who have private insurance. Medicaid coverage to low-income pregnant women and children has aided in decreasing infant and child mortality rates, reduced teen mortality, improved educational attainment, reduced disability, and has helped decrease hospitalization and emergency room visits later in life. A little health care can reap huge benefits.

8. Medicaid is Jointly Financed by Federal and State

Medicaid is jointly financed by both the federal government and the state, meaning that the federal government matches each state’s Medicaid spending.

9. Medicaid Spending is Focused on Elderly and those with Disabilities

The elderly and those with disabilities make up 1 in 4 of Medicaid recipients and account for over two-thirds of all Medicaid spending. Being that there are few affordable long-term care options within the insurance industry besides Medicaid, this makes up a huge portion of Medicaid spending.

10. Public Majority Has Favorable Views of Medicaid

Medicaid has gathered broad-based public support. Seven in ten Americans have some kind of connection to Medicaid. Surveys have also shown that most Medicaid recipients also have a positive opinion of their Medicaid experience.

To learn more about planning for Medicaid and avoiding common mistakes while doing so, do not hesitate to reach out to the Law Firm of Christopher W. Dumm either by calling 417-623-2062 or using the contact form on our website.

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