Medicaid is health insurance that helps many people who can't afford medical care pay for some or all of their medical bills.

Good health is important to everyone. If you can't afford to pay for medical care right now, Medicaid can make it possible for you to get the care that you need so that you can get healthy – and stay healthy.

Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. Depending on your state's rules, you may also be asked to pay a small part of the cost (co-payment) for some medical services.

Overview of Medicaid

Title XIX of the Social Security Act is a Federal/State entitlement program that pays for medical assistance for certain individuals and families with low incomes and resources. This program, known as Medicaid, became law in 1965 as a cooperative venture jointly funded by the Federal and State governments (including the District of Columbia and the Territories) to assist States in furnishing medical assistance to eligible needy persons. Medicaid is the largest source of funding for medical and health-related services for America's poorest people.

Within broad national guidelines established by Federal statutes, regulations, and policies, each State (1) establishes its own eligibility standards; (2) determines the type, amount, duration, and scope of services; (3) sets the rate of payment for services; and (4) administers its own program. Medicaid policies for eligibility, services, and payment are complex and vary considerably, even among States of similar size or geographic proximity. Thus, a person who is eligible for Medicaid in one State may not be eligible in another State, and the services provided by one State may differ considerably in amount, duration, or scope from services provided in a similar or neighboring State. In addition, State legislatures may change Medicaid eligibility, services, and/or reimbursement during the year.

Basis of Eligibility

Medicaid does not provide medical assistance for all poor persons. Under the broadest provisions of the Federal statute, Medicaid does not provide health care services even for very poor persons unless they are in one of the groups designated below. Low income is only one test for Medicaid eligibility for those within these groups; their resources also are tested against threshold levels (as determined by each State within Federal guidelines).

States generally have broad discretion in determining which groups their Medicaid programs will cover and the financial criteria for Medicaid eligibility. To be eligible for Federal funds, however, States are required to provide Medicaid coverage for certain individuals who receive federally assisted income-maintenance payments, as well as for related groups not receiving cash payments. In addition to their Medicaid programs, most States have additional "State-only" programs to provide medical assistance for specified poor persons who do not qualify for Medicaid. Federal funds are not provided for State-only programs.

The following enumerates the mandatory Medicaid "categorically needy" eligibility groups for which Federal matching funds are provided:

• Individuals are generally eligible for Medicaid if they meet the requirements for the Aid to Families with Dependent Children (AFDC) program that were in effect in their State on July 16, 1996.
• Children under age 6 whose family income is at or below 133 percent of the Federal poverty level (FPL).
• Pregnant women whose family income is below 133 percent of the FPL (services to these women are limited to those related to pregnancy, complications of pregnancy, delivery, and postpartum care).
• Supplemental Security Income (SSI) recipients in most States (some States use more restrictive Medicaid eligibility requirements that pre-date SSI).
• Recipients of adoption or foster care assistance under Title IV of the Social Security Act.
• Special protected groups (typically individuals who lose their cash assistance due to earnings from work or from increased Social Security benefits, but who may keep Medicaid for a period of time).
• All children born after September 30, 1983 who are under age 19, in families with incomes at or below the FPL.
• Certain Medicare beneficiaries (described later).

The Medicaid Planning Handbook : A Guide to Protecting Your Family's Assets from Catastropic Nursing Home Costs Alexander Bove Medicaid planning is essential if you want to leave the bulk of your estate to anyone. Many people are under the impression that Medicare fully covers the cost of a nursing home. This is not true. Under Medicare, for each benefit period, YOU pay: 1. Nothing for the first 20 days. 2. Up to $97 per day for days 21-100. 3. All costs beyond the 100th day in the benefit period. The Benefit Period begins the day you go to a hospital or skilled nursing facility. The Benefit Period ends when you have not received hospital or skilled nursing care for 60 days in a row. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods you can have. Thus, if you stay beyond 100 days or indefinitely, due to an incapacitating illness like Alzheimer's, you will be required to pay out-of-pocket for all nursing home fees. The average monthly nursing home fees are between $6,000-$7000 per month. It doesn't take a genius to realize you could easily run through your life savings in very short order. If it is your intention to eventually transfer your estate to family or friends, without having it all be eaten up by nursing home costs, you need to act while you are still healthy. To qualify for Medicaid, which does pay for full-time nursing home care, the value of your estate needs to be reduced to almost zero, three years prior to you requiring nursing home care. How you reduce your estate to almost zero is what medicaid planning is about. Many of the methods used to reduce your estate involve trust. There is also a little bit of statistics involved that requires you to determine when, if ever, you might begin to need nursing home care. It is highly recommended that you buy one of the books below or visit an elder law attorney who specializes in Estate Planning and Medicaid Planning. Trust me, from my own experience, this is the best ten or twenty bucks you'll ever spend in your life. We highly recommend this book as a first step toward understanding the issues involved in Medicaid Planning.

The Complete Idiot's Guide to Long-Term Care Planning by Marilee Driscoll How to Care For Your Parents' Money While Caring for Your Parents by Sharon Burns, Raymond Forgue Complete Idiot's Guide to Caring for Aging Parents by Linda M. Colvin Rhodes

The Beneficiary Workbook by Martin M. Shenkman The Complete Eldercare Planner : Where to Start, Which Questions to Ask, and How to Find Help Joy Loverde A Guide to Elder Planning: Everything You Need to Know to Protect Yourself Legally and Financially by Steve Weisman

How to Protect Your Life Savings : From Catastrophic Illness and Nursing Homes : A Handbook for Financial Survival by Harley Gordon Beat the Nursing Home Trap : A Consumer's Guide to Assisted Living & Long-Term Care Long Term Care Planning Guide 9th Ed. 1999 by Phyllis R. Shelton

To find more information about Medicaid programs in your state, or to find a local Medicaid office in your state, click on one of the links below. Email us if you discover a bad link. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Medicaid Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington, D.C. Washington West Virginia Wisconsin Wyoming

To Begin Again : A Journey Toward Comfort, Strength, and Faith in Difficult Times Naomi Levy / Knopf / October 1998 Death & Grief A Broken Heart Still Beats: When Your Child Dies Anne McCracken(Editor), Mary Semel (Editor) / Hazelden Information Education / November 1998 Read more about this title... On Death and Dying Elisabeth, Md. Kubler-Ross, Elisabeth Kbler-Ross / Collier Books / June 1997 Read more about this title... How to Survive the Loss of a Love Melba Colgrove, et al / Prelude Pr / November 1993 Read more about this title... Final Gifts : Understanding the Special Awareness, Needs, and Communications of the Dying Maggie Callanan, Patricia Kelley / Bantam Books / March 1997 Read more about this title... Necessary Losses : The Loves, Illusions, Dependencies, and Impossible Expectations That All of Us Have to Give Up in Order to Grow Judith Viorst / Fireside / January 1998 Read more about this title... 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The Bereaved Parent Harriet Sarnoff Schiff, Sarnoff Schiff / Viking Pr / November 1978 Our Price: $9.56 ~ You Save: $2.39 (20%) Read more about this title... Widow to Widow : Thoughtful, Practical Ideas for Rebuilding Your Life : Challenges, Changes, Decision-Making & Relationships Genevieve Davis Ginsburg / Fisher Books / March 1998 Read more about this title... The Worst Loss : How Families Heal from the Death of a Child Barbara D. Rosof / Henry Holt (Paper) / November 1995 Read more about this title... Losing a Parent : Passage to a New Way of Living Alexandra Kennedy / Harper San Francisco / June 1991 Read more about this title... Seven Choices : Taking the Steps to New Life After Losing Someone You Love Elizabeth Harper Neeld / Centerpoint Pr / June 1997 Read more about this title... The Good Death : The New American Search to Reshape the End of Life Marilyn Webb, et al / Bantam Books / November 1997 Read more about this title... 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Life After Loss : A Personal Guide Dealing With Death, Divorce, Job Change and Relocation Bob Deits / Fisher Books / September 1992 Read more about this title... Talking About Death : A Dialogue Between Parent and Child Earl A. Grollman, Susan Avishai (Illustrator) / Beacon Pr / November 1991 Read more about this title... Safe Passage : Words to Help the Grieving Hold Fast and Let Go ~ Publisher Out Of Stock Molly Fumia / Conari Pr / August 1992 Read more about this title... Helping Children Grieve : When Someone They Love Dies Theresa Huntley / Augsburg Fortress Publications / October 1991 Read more about this title... Reflections on Life After Life Raymond A. Moody / Bantam Books / August 1988 Read more about this title...

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