A health insurance program that serves low-income individuals and families who are not able to afford healthcare costs is Medicaid. Parents, children, seniors, and anyone with disabilities are served by Medicaid (NCDHHS, 2014). Medicaid is a federally mandated, state-administered program and is jointly funded by the federal and state governments to give medical care for qualified individuals (Green & Rowell, 2013). The Federal government comes up with guidelines, but each individual state has their own rules. Each state can require someone to pay a part of the cost for some of their services (MedlinePlus, 2014). People have different needs and so there are different types of coverage for them (NCDHHS, 2014). There are certain requirements in order to receive Medicaid. These requirements include, a person’s age, whether they are pregnant, disabled, or blind, their income and resources, and whether or not they are a U.S. citizen (MedlinePlus, 2014).
Eligibility varies among each state. A person who is eligible for Medicaid in one state might not be eligible in another state. Services can be different in each state also and state legislatures can change the requirements of Medicaid eligibility throughout the year (Green & Rowell, 2013). Someone who is automatically eligible for Medicaid is if they receive supplemental security income, work first family assistance, state/county special assistance for the aged or disabled, and special assistance to the blind (NCDHHS, 2014). It is important to understand that Medicaid does not provide medical assistance for all the poor. There are three groups that qualify for Medicaid eligibility. These three groups are the categorically needy, medically needy, and special groups (Green & Rowell, 201...
... middle of paper ...
...al home strategy to get new Medicaid enrollees into a managed, relationship-based healthcare program (Dickson, 2014).
Works Cited
Dickson, V. (2014, March 17). Oregon offers lessons in serving new Medicaid patients. Retrieved April 18, 2014, from galegroup: http://go.galegroup.com.ezp-02.lirn.net/ps/retrieve.do?sgHitCountType=None&sort=DA-SORT&inPS=true&prodId=PPNU&userGroupName=lirn62668&tabID=T003&searchId=R3&resultListType=RESULT_LIST&contentSegment=&searchType=BasicSearchForm¤tPosition=1&contentSet
Green, M. A., & Rowell, J. C. (2013). Understanding Health Insurance. Clifton Park: Delmar.
MedlinePlus. (2014, February 27). Medicaid. Retrieved April 25, 2014, from Medlineplus: http://www.nlm.nih.gov/medlineplus/medicaid.html
NCDHHS. (2014, April 1). What is Medicaid. Retrieved April 18, 2014, from ncdhhs: http://www.ncdhhs.gov/dma/medicaid/
sponsored programs, such as Medicaid, that try and offset medical problems of the poor youth,
Eligibility for Medicaid programs in Michigan is based on either income only or income and assets. In addition, many of the programs available have age restrictions and/or require applicants to have certain health conditions (e.g. pregnancy). Eligibility requirements for Medicaid in Indiana are similar to those of Michigan. The two programs, however, do contrast in three substantial ways. Two out of three of these ways indicates that Indiana has the better program.
For example, income often determines one’s access to health-care. Researchers have found that low-income families are less likely to fill prescriptions, have dental coverage, and have preventative care visits (Ives et al., 2015, p. 170). Further, Williamson et al. (2006) declared, “professional treatment services…not covered by provincial health care plans, social services, or Indian and Northern Affairs were most frequently cited by respondents…as services that they choose not to use because of their low-income status” (p. 113). In addition to being unable to afford services, low-income individuals are often unable to afford transportation to appointments (Williamson et al., 2006, p. 116). Clearly, although individuals have the right to health, low-income individuals and families face many barriers in accessing and affording health-care services in
Medicare and Medicaid together "are the single biggest contributor to [the United States] long term [budget] deficit." This idea was expressed by President Obama during his 2011 state of the Union Speech. After saying this, the president said that health care costs need to be reduced, including these two services. Medicare and Medicaid are beneficial to those who receive their services, and the criteria for eligibility currently allow many to qualify for either program. This is most likely the cause of the major deficit that the president spoke of. However, downsizing or eliminating these programs to lessen the deficit will affect many people and their ability to receive healthcare.
Implemented (along with Medicare) as a part of the Social Security Amendments of 1965, Medicaid’s original purpose was to improve the health of the working poor who might otherwise go without medical care for themselves and their families. Medicaid also assisted low income seniors with cautionary provisions that paid for the costs of nursing facility care and other medical expenses such as premiums and copayments that were not covered through Medicare. Eligibility for Medicaid is usually based on the family’s or individual’s income and assets. When the ACA came into effect in 2010, it began to work with the states to develop a plan to better coordinate the two ...
In consequence, this will limit poor adults finding the proper treatment since many doctors do not accept Medicaid patients. High rates of uninsured populations were associated with lower primary care capacity (Ku et al., 2011). Thus, expanding insurance coverage can support more primary care practices in rural areas and can help equal the gap in primary care positions. The impact of not expanding affects APRN practice by limiting them to practice in areas where they are needed the most. This not only affects APRNs from practicing without a physician supervision but also limit those that need coverage for basic preventive measures to reduce non-paying visits to the emergency room. Ensuring access to care will be contingent upon the ability to attain progress from insurance coverage and primary
For the state provided insurance the individual or family must qualify for the program. With the state-funded insurance the individual or family may qualify for straight Medicaid or Medicaid Alliance. The states straight Medicaid requires no payment but the individual must receive referral to visit specialist and have to visit certain physicians that are assigned with their particular insurance company. Also, most families automatic qualify when they h...
Low income earners, in the neighborhood, continuously face dwindling health care resources. This is a great concern that has to be addressed and mitigated, failure to which they will continue to get poor quality health care and will also be reluctant to seek health care services over and over again. The poor and the disable within the community are economically unstable which makes them unable to access the existing insurance plan. It is of importance to note that they are the most vulnerable and the marginalized groups of people in the society. They lack economic capacity to access the existing plan making them lack better care as they require (Huntingto...
Medicaid is a broken system that is largely failing to serve its beneficiary’s needs. Despite its chronic failures to deliver quality health care, Medicaid is seemingly running up a gigantic tab for tax payers (Frogue, 2003). Medicaid’s budget woes are secondary to its insignificant structure, leaving its beneficiaries with limited choices, when arranging for their own health care. Instead, regulations are set in order to drive costs down; instead of allowing Medicaid beneficiaries free rein to choose whom they will seek care from (Frogue, 2003)
Medicare has several advantages. For starters, an individual who has subscribed for Medicare can still use their own private insurance plan for routine check. Therefore, one is not absolutely tied to the Medicare program only. However, every member is assigned a Primary Care Physician, who one must consult, to enjoy the full benefits. Better still, if one needs special attention, a specialist is assigned by Medicare, who is usually proposed by the Primary Care Physician (Berwick, 2011). In addition, the monthly payments are highly subsidized, or in some cases, there are no monthly payments. Moreover, medication is included in the kitty. However, one has to chip in a little to cover for part of the medication cost. Medicare advantages are similar in the whole country. This is not the case for Medicaid. Medicaid’s policies change according to the different states. Nonetheless, there are strengths of Medicaid which are common across the board. Medicaid tends to give a lot of specialized attention to expectant mothers. It offers nurse midwife services, family...
What exactly is Medicaid? Medicaid is the largest health insurance in the United States, and it services many low-income families. This government health program is state regulated and varies among states due to having their own guidelines. Medicaid was signed into law on July the 30th, 1965. Medicaid’s guidelines come from the old Welfare law. “Medicaid has never matched that of food stamps, for which eligibility standards are linked to financial need alone. As Smith and Moore explains, the federal government, using its extraordinary demonstration powers under section 1115 of the Social Security Act, has allowed states to experiment with “decategorization” over the years, but Medicaid’s statutory bar against coverage of poor adults remains perhaps its most obvious failure” (Rosenbaum). Regardless of the many faults of this programs design, Medicaid helps close to 60 million low-income families in the United States. The people it helps would include: pregnant women, young children and their parents, the disabled, and the elderly, and other members of society that have low income. Medicaid is involved in many pregnancies and newborn care from a financial standpoint. It allows parents to have medical care for the child while in a low-income household. Medicaid has a huge impact on each states health systems and is used in a wide variety of ways.
Health reform and health policy has taken over in the United States in recent years. Medicaid is one of the top policies being implemented throughout our nation today. To understand how Medicaid and federalism cross paths with each other one must understand the basic definitions and concepts each one brings. Federalism is “system of government in which the same territory is controlled by two levels of government. Generally, an overarching national government governs issues that affect the entire country, and smaller subdivisions govern issues of local concern.” In short, federalism is a government system that has an overseeing central government over state government. While, “Medicaid is a health insurance program for low-income individuals and families who cannot afford health care costs. Medicaid serves low-income parents, children, seniors, and people with disabilities.” Medicaid is a test based welfare program for United States Citizens. Now the question is how does Medicaid intersect with federalism? These two intersect because Medicaid is a need-based program that is funded by the federal government and the state government and administered at the state level. The issue with Medicaid is that if it expands then a crowding-out effect may occur. Meaning, that the more the government spends on Medicaid then less they would be able to spend on other programs such as: education, transportation, or other state priorities. Medicaid is supposed to provide access to health insurance for approximately half of our nations uninsured citizens. Without Medicaid a vast amount of low-income citizens will go without having a healthcare insurance plan.
Medicaid is an assistance program for low-income people regardless of age. A federally mandated program, Medicaid is run by state and local governments under the established federal guidelines. Income and resource levels are the primary means for each state to determine eligibility with the level varying from state to state. Eligibility is also affected by other factors such as age, whether you are pregnant, if you are blind or have other disabilities, and U.S. citizenship or lawful immigration status. Some states req...
The United States passed bill that health insurance should be mandatory in the year 2014. Under the Patient Protection Affordable Care Act, each person is required to have at least a minimum level of health insurance failure to, the individual will face a penalty. The mandatory health insurance issue has faced reactions from both sides with some people supporting while others opposing. It is mandatory for every individual to purchase a health insurance depending on their earnings. The health care insurance is mandatory for all US citizens, and all legal residents in America. It is considered as an individual responsibility requirement, and those without this insurance are subject to a tax penalty of $750 per year up to a maximum of three times that amount ($2,250) per family. However, there are exemptions for financial hardships, incarcerated persons, religious objections, and undocumented immigrants. Mandatory health insurance is important, and should be applied in all states because, everyone gets ill and at one time, they have to visit a health care facility for medical services. In addition, it protects the health future of families, and protects people from unexpected high medical costs because they are covered.
Under the Affordable Care Act one of the most important provisions is to expand health care to low income families through Medicaid. This could have an effect on over eight million people who do not have access to health care currently. However 25 states have decided against expanding Medicaid benefits, leaving 13.5 million people less likely to receive basic health care and preventative ...