Financial Planning in Alzheimer's Disease (cont.)
What Is Medicaid?
Medicaid is a joint
federal-state health insurance program providing medical assistance primarily to
low-income Americans. It also is available to people under 65 if they are blind
The purpose of Medicaid is to provide preventive, therapeutic, and
rehabilitative health services and supplies that are essential to attain an
optimum level of well-being.
How Do People Receive Medicaid Benefits?
There are two ways to receive Medicaid:
- Through Supplemental Security Income (SSI) -- People who receive a cash
grant under SSI and Aid to Dependent Children are automatically eligible for
- Medicaid spend down -- This is similar to a deductible or a co-payment
that you must pay every month. Once you meet your "spend down" amount, you are
eligible for Medicaid for the remainder of the month.
Who Is Eligible for Medicaid?
Medicaid eligibility requirements depend on financial need, low income, and
low assets. In determining Medicaid eligibility, officials do not review rent,
car payments, or food costs. They only review medical expenses. Medical expenses
- Care from hospitals, doctors, clinics, nurses, dentists, podiatrists and
- Medical supplies and equipment.
- Health insurance premiums.
- Transportation to get medical care.
Medicaid coverage varies from state to state. For specific coverage
guidelines, contact your state's Department of Human Services. Generally,
Medicaid benefits include:
- Ambulance services when other means of transportation are detrimental to
the patient's health.
- Transportation to and from the hospital at time of admission or discharge
when required by the patient's condition.
- Transportation to and from a hospital, outpatient clinic, doctor's office,
or other facility when the doctor certifies the need for this service.
- Ambulatory health care centers are often private corporations or public
agencies that are not part of a hospital. They provide preventive, diagnostic,
therapeutic, and rehabilitative services under the direction of a doctor.
Ambulatory services covered by Medicaid include dental, pharmaceutical,
diagnostic, and vision care.
- Inpatient hospital care.
- Private hospital rooms only when the illness requires the patient to be
isolated for his or her own health or the health of others.
- Outpatient preventive, therapeutic, and rehabilitative services.
- Professional and technical laboratory and radiological services.
- Medical Supplies and Medications
- General medical supplies (when prescribed by a doctor).
- Durable medical equipment (such as hospital beds, wheelchairs, side rails,
oxygen administration apparatus, special safety aids, etc.).
- Medications prescribed by a doctor, dentist, or
Home Health Care
Skilled Nursing Facilities
- Skilled nursing facilities and intermediate care facilities (providing
short-term care for a patient whose condition is stable or reversible) are
covered through Medicaid with a physician's authorization.
For More Information:
U.S. Department of Health and Human Services
Health Care Financing Administration
6325 Security Blvd.
Baltimore, MD 21207
WebMD Medical Reference
WebMD Medical Reference Reviewed by Jon Glass on 16, 2009Last Editorial Review: 6/16/2009
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