The Medicaid Program provides medical benefits to groups of low-income people, including some who may have no medical insurance or inadequate medical insurance. Although the Federal government establishes general guidelines and required services for Medicaid, additional program requirements and optional services are actually established by each state. Some of the required services include inpatient hospital, outpatient services at federally qualified health centers, physician and nurse practitioner services, home health services, nursing facility care, laboratory and x-ray, and non-emergency transportation. States can then provide optional services such as community mental health, dental, home and community based waivers, hospice care, intermediate care facility services, prescription drugs, and durable medical equipment and supplies. But remember that these optional services can vary greatly between states.
You may be eligible for home care services through:
- Traditional Medicaid, where eligibility is based on the family's income or
- Home and Community Based Waivers, where some of the strict financial guidelines are set aside and eligibility is based only on the income of the individual receiving services.
- FamiliesUSA has links to specific Medicaid state information as well as information on public and private sources of health insurance.
Some states have expanded Medicaid, under the Affordable Care Act, to cover more people. If you have Medicaid coverage, you’re considered covered under the health care law and don’t have to buy a Marketplace plan. In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults below a certain income level.
- Find out if your state is expanding Medicaid and learn what that means for you.
- If you live in a state that's expanding Medicaid, you'll probably qualify if you make up to $16,104 a year for 1 person ($32,913 for a family of 4).
Some states aren’t expanding their Medicaid programs in 2014. If you live in one of these states, you may not have as many options for health coverage. It will depend on where your income falls. You will be able to buy a private health insurance plan in the Marketplace and may get lower costs based on your household size and income.
Medicaid programs must follow federal guidelines, but they vary somewhat from state to state. Coverage and costs to you may be different from state to state.