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An Advocate's Guide to the Medicaid Program

Author: Perkins, Jane; Melden, Michele
Date Published: 1993

Medicaid is a federal program of medical assistance for the poor established by Title XIX of the Social Security Act and funded by the federal government and the states. As with other federally-assisted public assistance programs, eligibility is not provided to all low-income persons. Instead, eligibility is limited to low-income people who fall into one of several categories or groups specified in the federal statute. Generally, these groups include the elderly, blind, disabled, pregnant women, dependent children in single-parent families and in families in which the principal wage earner is unemployed. At the same time, Congress has recently taken steps to expand Medicaid eligibility by "unlinking" eligibility from the cash-assistance programs, and instead, basing eligibility for certain groups on federal poverty guidelines. The Medicaid program does not directly provide health care services to eligible individuals, nor does it provide recipients with money to purchase health services directly. Rather, Medicaid is a vendor payment program, wherein medical providers--including hospitals, nursing homes, pharmacies, doctors and dentists--are reimbursed by the program. Participation by providers is voluntary. As a result, neither the federal government nor the states guarantee that care will be available or accessible. Medicaid recipients usually receive a Medicaid identification card which they show participating providers. Providers participating in the program generally must agree not to charge the Medicaid recipient for services provided these services are paid for by Medicaid. This publication is a guide for acquainting oneself with the basics of the Medicaid program and for finding cites as a jumping off point for further research.

Price: loan
Number of Pages: 81