Home Health Care Akron Ohio - Medicaid Certified Akron Ohio - Medicare Certified Akron Ohio - RN Nurse Akron Ohio -
LPN Nurse Akron Ohio - Social Services Akron Ohio - Rehabitative Services Akron Ohio - Personal Care Aides Akron Ohio -
Private Duty Care Akron Ohio - Visiting Nurse Akron Ohio - Nursing Care Akron Ohio - Home Health Care Akron Ohio -
Restorative Services Akron Ohio - Home Healthcare Aides Akron Ohio - Personal Care Attendants Akron Ohio -
Home Healthcare Akron Ohio - Healthcare Akron Ohio - HIPAA Akron Ohio
Home Health Care Perry Ohio - Medicaid Certified Perry Ohio - Medicare Certified Perry Ohio - RN Nurse Perry Ohio -
LPN Nurse Perry Ohio - Social Services Perry Ohio - Rehabitative Services Perry Ohio - Personal Care Aides Perry Ohio -
Private Duty Care Perry Ohio - Visiting Nurse Perry Ohio - Nursing Care Perry Ohio - Home Health Care Perry Ohio -
Restorative Services Perry Ohio - Home Healthcare Aides Perry Ohio - Personal Care Attendants Perry Ohio -
Home Healthcare Perry Ohio - Healthcare Perry Ohio - HIPAA Perry Ohio
Home Health Care Columbus Ohio - Medicaid Certified Columbus Ohio - Medicare Certified Columbus Ohio - RN Nurse Columbus Ohio -
LPN Nurse Columbus Ohio - Social Services Columbus Ohio - Rehabitative Services Columbus Ohio - Personal Care Aides Columbus Ohio -
Private Duty Care Columbus Ohio - Visiting Nurse Columbus Ohio - Nursing Care Columbus Ohio - Home Health Care Columbus Ohio -
Restorative Services Columbus Ohio - Home Healthcare Aides Columbus Ohio - Personal Care Attendants Columbus Ohio -
Home Healthcare Columbus Ohio - Healthcare Columbus Ohio - HIPAA Columbus Ohio
Medical Testing - Point-of-Care Medical Testing - Clinical Laboratory Consulting - Medical Practice Assessment -
Medical Personnel Management - Operational and Practice Management - Medical Tests - Respiratory Testing -
Laboratory Consulting - Healthcare Operational Management - Arterial Blood Gas Analysis - Overnight & Exertion Oximetry Testing -
Pulmonary Function Testing - Limited Pulmonary Stress Testing - EKG Testing
Medicaid is the United States health program for individuals and families with low incomes and resources. It is an entitlement program
that is jointly funded by the states and federal government, and is managed by the states. Among the groups of people served by
Medicaid are eligible low-income parents, children, seniors, and people with disabilities. Being poor, or even very poor, does not
necessarily qualify an individual for Medicaid. Medicaid is the largest source of funding for medical and health-related services
for people with limited income.
Medicaid was created on July 30, 1965 through Title XIX of the Social Security Act. Each state administers its own Medicaid program
while the federal Centers for Medicare and Medicaid Services (CMS) monitors the state-run programs and establishes requirements for
service delivery, quality, funding, and eligibility standards.
Each state may have its own name for the program. Examples include "Medi-Cal" in California, "MassHealth" in Massachusetts, and
"TennCare" in Tennessee. States may bundle together the administration of Medicaid with other separate programs such as the State
Children's Health Insurance Program (SCHIP), so the same organization that handles Medicaid in a state may also manage those
additional programs. Separate programs may also exist in some localities that are funded by the states or their political subdivisions
to provide health coverage for indigents and minors.
State participation in Medicaid is voluntary; however, all states have participated since 1982 when Arizona formed its Arizona Health
Care Cost Containment System (AHCCCS) program. In some states Medicaid is subcontracted to private health insurance companies, while
other states pay providers (i.e., doctors, clinics and hospitals) directly.
Another service in the Social Security program under Medicaid are dental services. These dental services are an optional service for
adults above the age of 21; however, this service is a requirement for those eligible for Medicaid and below the age of 21. Dental
services must be given in order to meet standards of dental practice. These standards should be determined by the state, following
discussion regarding the health of the child. Minimum services should include pain relief, restoration of teeth and maintenance for
dental health. EPSDT individuals below the age of 21 are not to be limited emergency services. Oral Screenings are not required for
EPSDT recipients and they do not suffice as a direct dental referral. If a condition requiring treatment is discovered during an
oral screening, the state is responsible for taking care of this service, regardless if it is covered on that particular Medicaid plan.
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is a mandatory Medicaid program for children that aims to focus on
prevention on early diagnosis and treatment of medical conditions.
The Medicaid Drug Rebate Program was created by the Omnibus Reconciliation Act of 1990. This act helped to add Section 1927 to the
Social Security Act of 1935 which became effective on January 1, 1991. This program was formed due to the costs that Medicaid programs
were paying for outpatient drugs at their discounted prices.
Although their names are similar, Medicaid and Medicare are very different programs. Medicare is an entitlement program funded entirely
at the federal level. It is a social insurance focusing primarily on the older population. As stated in the CMS website, Medicare is a
health insurance program for people age 65 or older, people under age 65 with certain disabilities, and people of all ages with end
stage renal disease. The Medicare Program provides a Medicare part A which covers hospital bills, Medicare Part B which covers medical
insurance coverage, and Medicare Part D which covers prescription drugs.
Medicaid is an entitlement program that is not solely funded at the federal level. Medicaid is a needs-based social welfare or social
protection program rather than a social insurance program. Eligibility is determined by income. States provide up to half of the
funding for the Medicaid program. In some states, counties also contribute funds. The main criterion for Medicaid eligibility is
limited income and financial resources, a criterion which plays no role in determining Medicare coverage. Medicaid covers a wider
range of health care services than Medicare.
Some individuals are eligible for both Medicaid and Medicare (also known as Medicare dual eligibles). In 2001, about 6.5 million
Americans were enrolled in both Medicare and Medicaid.
Medicaid is a joint federal-state program that provides health insurance coverage to certain categories of low-income individuals,
including children, pregnant women, parents of eligible children, seniors and people with disabilities. Medicaid was created to help
low-income individuals who fall into one of these eligibility categories "pay for some or all of their medical bills." Medicaid helps
eligible individuals that have no medical insurance or poor health insurance. While Congress and the Centers for Medicare and
Medicaid Services set out the main rules under which Medicaid operates, each state runs its own program. As a result, the eligibility
rules differ significantly from state to state, although all states must follow the same basic framework.
Having a limited income is one of the primary requirements for Medicaid eligibility, but poverty alone does not qualify a person to
receive Medicaid benefits unless they also fall into one of the defined eligibility categories. According to the CMS website,
"Medicaid does not provide medical assistance for all poor persons. Even under the broadest provisions of the Federal statute
(except for emergency services for certain persons), the Medicaid program does not provide health care services, even for very poor
persons, unless they are in one of the designated eligibility groups."
There are a number of different Medicaid eligibility categories; within each category there are requirements other than income that
must be met. These other requirements include, but are not limited to, age, pregnancy, disability, blindness, income and resources,
and one's status as a U.S. citizen or a lawfully admitted immigrant. Special rules exist for those living in a nursing home and
disabled children living at home. A child may be covered under Medicaid if she or he is a U.S. citizen or a legal immigrant of the
U.S. A child may be eligible for Medicaid regardless of the eligibility status of his or her parents or guardians. Thus, a child
can be covered by Medicaid based on their individual status even if his or her parents are not eligible. Similarly, if a child
lives with someone other than a parent, he or she may still be eligible based on his or her individual status.
Both the federal government and state governments have made changes to the eligibility requirements and restrictions over the years.
Most recently, the Deficit Reduction Act (DRA) of 2005 (Pub.L. No. 109-171) significantly changed the rules governing the treatment
of asset transfers and homes of nursing home residents. The implementation of these changes will proceed state-by-state over the next
The DRA now requires that anyone seeking Medicaid must produce documents to prove that he or she is a United States citizen or
Medicaid does not pay benefits to individuals directly; Medicaid sends benefit payments to health care providers. Medicaid helps
individuals who have no medical insurance or poor health insurance. In some states Medicaid beneficiaries are required to pay a
small fee (co-payment) for medical services.
Unlike Medicare, which is solely a federal program, Medicaid is a joint federal-state program. Each state operates its own Medicaid
system, but this system must conform to federal guidelines in order for the state to receive matching funds and grants. The federal
matching formula is different from state to state, depending on each state's poverty level. The wealthiest states only receive a
federal match of 50% while poorer states receive a larger match.
Medicaid funding has become a major budgetary issue for many states over the last few years, with the program, on average, taking up
22% of each state's budget. According to CMS, the Medicaid program provided health care services to more than 46.0 million people
in 2001. In 2002, Medicaid enrollees numbered 39.9 million Americans, the largest group being children (18.4 million or 46 percent).
It is estimated that 42.9 million Americans will be enrolled in 2004 (19.7 million of them children) at a total cost of $295 billion.
Medicaid payments assist nearly 60 percent of all nursing home residents and about 37 percent of all childbirths in the United States.
Medicaid is also the program that provides the largest portion of federal money spent for home health care on people living with HIV.
Typically, poor people who are HIV positive must progress to AIDS before they can qualify under the "disabled" category. More than
half of people living with AIDS are estimated to receive Medicaid payments. Two other programs that provide financial assistance to
people living with HIV/AIDS are the Social Security Disability Insurance (SSDI) and the Supplemental Security Income.
Medicaid planners typically advise retirees and other individuals facing high nursing home costs to adopt strategies that will protect
their financial assets in the event of nursing home admission. State Medicaid programs do not consider the value of one's home in
calculating eligibility, therefore it is often recommended that retirees pursue home ownership. By adopting the recommended strategies,
many seniors hope they will quickly qualify for Medicaid benefits if the need for long-term care arises.
During the 1990s, many states received waivers from the Federal government to create Medicaid managed care programs. Under managed
care, Medicaid recipients are enrolled in a private health plan, which receives a fixed monthly premium from the state. The health
plan is then responsible for providing for all or most of the recipient's healthcare needs. Today, all but a few states use managed
care to provide coverage to a significant proportion of Medicaid enrollees. Nationwide, roughly 60% of enrollees are enrolled in
managed care plans. Core eligibility groups of poor children and parents are most likely to be enrolled in managed care, while the
aged and disabled eligibility groups more often remain in traditional "fee for service" Medicaid.
Some states operate a program known as the Health Insurance Premium Payment Program (HIPP). This program allows a Medicaid Recipient
to have private health insurance paid for by Medicaid. Often this allows the recipient to have better coverage, and have more doctors
available to them. As of 2008 relatively few states had premium assistance programs, and enrollment was relatively low. Interest in
this approach remained high, however.