Medicaid is for people who fall into low income groups. Many do not have adequate medical insurance. Others have none at all. The Federal government has established guidelines for Medicaid, but the program is really administered separately by each state. To find out if you are eligible for Medicaid, you must contact your State Agency. KEY ELIGIBILITY GROUPS States are required to include certain types of individuals or eligibility groups under their Medicaid plans and they may include others. Statesa eligibility groups will be considered one of the following: categorically needy, medically needy, or special groups. Following are brief descriptions of some of the key eligibility groups included under Statesa plans. These descriptions do not include all groups. Contact your state for more information on all Medicaid groups in your state. CATEGORICALLY NEEDY To fulfill criteria for this category a family must meet the states eligibility requirements for Aid to Families with Dependent Children (AFDC). This criteria was put in place on July 16, 1996. This category includes women who are pregnant and children under the age of six. The family income must be less than one-hundred and thirty three percent of the Federal poverty level. Also, children from the ages of six to nineteen whose family income is up to one hundred percent of the poverty level qualify to be included in this category. People who live in medical institutions and have a monthly income that is up to three hundred percent of the SSI income standard (Federal benefit rate) also qualify. MEDICALLY NEEDY Children below the ages of nineteen to twenty one or those who are under nineteen and are full time students may qualify to be included in this category. The state may choose not to qualify all of these children. In this case, it can limit services to what is termed areasonable groups of childrena. This category may also apply to people who are over the age of sixty five. It may also include people who are blind as determined by the SSI program standards or the standards of the state. People with disabilities - as determined by the SSI program standards or the standards of the state - may also be included in this category. SPECIAL GROUPS Medicare Beneficiaries may qualify. According to #8221Medicaid will pay Medicare premiums, deductibles and coinsurance for people who are termed as Qualified Medicare Beneficiaries (QMB). Also according to #8221 people who have an income that is at or below a hundred percent of the Federal poverty level and who have resources that are equal to or less than twice the standard that is allowed according to SSI may qualify. Additionally, there are groups in which Medicare related expenses will be paid by Medicaid. Again, according to #8221, Medicare beneficiaries who have an income that is greater than a hundred percent but is less than one hundred and thirty five percent of the Federal poverty level may qualify. Once eligibility has been determined, you may receive retroactive payments for up to three months before your application. This is based on whether or not you would have been eligible during this time. If your circumstances change, your coverage will end at the end of the month in which the change occurred. Many states will have a astate-onlya program in addition to Medicaid. This is to give medical assistance for specific groups of people who have limited resources and income and donat qualify for the Medicaid program. These state only programs do not receive Federal funding. So you can see that the main recipients of Medicaid are those who have a very low level of income or have a low household income that matches with the eligibility requirements and the rules that are set up by your state. If you meet these requirements, you may very well be qualified to receive Medicaid insurance coverage. Call your state first to learn about its laws. Then you can apply for Medicaid fully informed. By knowing the requirements are in advance, you will have an easier time making your way through the process. To learn even more, be sure to can visit: http://www.cms.hhs.gov/medicaid/eligibility or http://www.cms.hhs.gov/medicaid/whoiseligible.asp).
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