Health Care and Medicaid

Topics: Health care, Medicine, Health economics Pages: 7 (2201 words) Published: July 5, 2013
Medicaid
Medicaid is a state administered health insurance program financed and is operated jointly by the federal and state government. The program gears towards helping low-income people of all ages who do not have the money or insurance to pay for health care. This program pays for medical care to assist persons and families who cannot afford it.

History
Medicaid was established under President Lyndon B. Johnson through the Social Security Amendment of 1965, to provide medical coverage to all elderly aged 65 and over and to the poor. In 1972, the social security Act were more developed creating federal Medicaid benefits to disable people and persons in the end stages of renal disease.

Eligibility
Medicaid is the nation’s largest health coverage program for over 60 million Americans including children, pregnant women, parents, seniors and individuals with disabilities. For someone to be eligible for Medicaid one must satisfy federal and state criteria regarding residency, immigration status and documentation of United States citizenship. Medicaid aims at providing medical and other health care services to eligible people so that they are able to remain as self-sufficient as possible. Medicaid payments for medical expenses are paid directly to physicians, hospitals and or treatment facilities. Medicaid eligibility rules are different for each state but similar in numerous areas, however, Medicaid benefits are solely connected to the main factor ‘income’. Each State have its own guidelines that are subject to federal rules and regulations, therefore, certain services must be covered by the state in order to receive federal funding. On the other hand, some services are optional and are elected by states.

Features of Medicaid
Features of Medicaid include medical care and prescription drugs benefits for individuals in full or in portion. In some cases, depending on the individual income they may be asked to pay a portion of the cost of medical coverage insurance depending on their income. Major services that are covered by Medicaid are:

* Home health care services
* Care in nursing homes
* Health screening and services for children and treatment of problem if detected * Inpatients and outpatient hospital and physician services * Laboratory services and x-rays
* Family planning and supplies
* Medical and surgical dental services for adults
* Prescription drugs
* Long term care services and support
* Health clinic services
* Pediatric and Family nurse practitioner services
Other benefits that states must cover for children and may cover for adults are: * Case management
* Personal care services
* Hospice services
* Respite and other in home long term care
* Mental health services
* Prosthetic devices
* Audiology, hearing aid
* Physical, occupational and speech therapy
* Doctor visits, eye care and glasses

Medicaid eligibility is limited to certain factors in almost every state. These factors are: * Low-income children
* Pregnant women
* Families with dependent children
* People 65 or older
* People who are blind and disabled
In some states, people with disabilities qualify automatically if they get Supplemental security Income benefits. Children are automatically eligible and enrolled in Medicaid when they are born until their first birthday if the mother is enrolled in the medical program when baby is born.

Special Medicaid for Women
Pregnant Women Medicaid eligibility is varied by states. Pregnant Women with income up to $20,000 per individual annually must be covered by Medicaid. In some states pregnant women with higher incomes are covered under Medicaid and some under Children’s Health insurance Program (CHIP). The coverage for infants and pregnant women are at little or no cost if their incomes are limited. Breast and Cervical Cancer Prevention and Treatment (BCCPT) Medicaid program are available to...

References: 1. http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx
2. http://ce.columbia.edu/files/ce/pdf/actu/actu-uk.pdf
3. http://www.cia.gov/library/publications/the-world-factbook/geos//uk.html
4. http://www.cia.gov/library/publications/the-world-factbook/geos/us.html
5. http://www.commonwealthfund.org/News/News-Releases/2010/Jun/US-Ranks-Last-Among-Seven-Countries.aspx
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