Medicaid-The Shadow of poor-Eligibility and benefits



The Center for Medicaid and CHIP Services (CMCS) is one of six centers within the Centers for Medicare & Medicaid Services. CMCS serves as the focal point for all national program policies and operations related to Medicaid and Children health. Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements.  The program is funded jointly by states and the federal government.

As per Affordable Care Act of USA, Medicaid is provided to poorest Americans, for states to provide Medicaid eligibility, effective January 1, 2014, for individuals under 65 years of age with incomes up to 133% of the federal poverty level (FPL). For the first time, states can provide Medicaid coverage for low-income adults without children and be guaranteed coverage through Medicaid in every state without the need for a waiver.

Federal Poverty Level(FPL)- FPL is used to determine the eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHIP coverage.

In all states of USA, Medicaid provides health coverage and benefits for low-income people, families, and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults fall under Federal Poverty Level.

  • As per Income Guidelines for CHIP/Children’s Medicaid. If the monthly income is $1,337 or less, or the yearly income is $16,040 or less, you might qualify for Children’s Medicaid.
  • Low-income is considered 200% of the federal poverty level, and poor is defined as 100 % of the poverty level. For 2013, a family of 4 making less than $23,624is considered at the federal poverty level, and $47,248 is considered low income.
  • Spend down program or excess or surplus income program– If a persons who is covered under Medicaid, income cross the limit for fall in Medicaid program in that case on particular month person have to pay his deductible on increased income is called “Spend Down status”.
  • surplus is the amount of an asset or resource that exceeds the portion that is utilized. A surplus is used to describe many excess assets including income, profits, and capital.
  • Medicaid will only pay enrolled providers for unpaid medical claims for covered Medicaid services during the three-month retroactive period.

Three recommended books at  Amazon

1- How to Protect Your Family’s Assets from Devastating Nursing Home Costs: Medicaid Secrets (11th ed.)

2-Medicaid Politics and Policy

3- Medicaid Planning: A to Z (2017 ed.)

Disclaimer- All image and data source Google

3 Replies to “Medicaid-The Shadow of poor-Eligibility and benefits”

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