How Medicaid Works by Caring.com Editorial Team
in Health (submitted 2010-02-03)
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What is Medicaid?
Medicaid is a federal government program to help provide healthcare coverage to certain categories of people who have low income and few assets (other than the home they live in). Among those covered by Medicaid are people over 65 and those with disabilities. Each state runs its own version of Medicaid, with slightly different rules and coverage.
The Medicaid program has several different parts:
Medicaid medical coverage includes most common forms of healthcare, as explained in this article. Medicaid medical benefits cover at least the same healthcare services that Medicare does, as well as some services that Medicare doesn't cover. Medicaid also pays Medicare premiums, deductibles, and co-payments for people who are enrolled in both programs.
A separate part of Medicaid covers long-term nursing home care. Special Medicaid-funded programs cover long-term, in-home personal care. Income and asset eligibility rules for these long-term, at-home care programs are usually quite a bit looser than for regular Medicaid medical coverage.
In some states, a Medicaid-related program can pay some of the cost of assisted living.
Finding out about your state's Medicaid programs
To find out exactly what Medicaid and Medicaid-related programs operate in your state, what they cover, and who's eligible, contact a local office of your state's Medicaid program. To find a local Medicaid office, go to the federal government's Benefits.gov website and choose your state. This will take you to a page with contact information for your state's Medicaid program and information about local offices.
What's the difference between Medicaid and Medicare?
Their names are similar, but Medicaid and Medicare are two completely different programs. A person can qualify for both Medicaid and Medicare.
Medicare is for almost everyone ages 65 or older, and people with long-term disability, regardless of their income or assets. Medicaid is only for people with low income and very few assets other than a home.
Is Medicaid valuable for someone who also has Medicare?
If someone qualifies for both Medicare and Medicaid, Medicare covers most of that person's medical services. But there are a number of medical services that Medicare doesn't cover, which a state Medicaid program might.
Also, Medicare leaves many of a person's medical bills unpaid, even for services Medicare does cover. This includes Medicare premiums, deductibles, and co-payments, as well as the cost of some prescription drugs not covered by a Medicare Part D prescription drug plan.
If Medicare Part A or Part B covers a medical service but leaves some part of the cost unpaid, Medicaid will pay that extra amount for someone who's enrolled in both programs. Someone with both Medicare and Medicaid must enroll in a Medicare Part D plan in order to get their prescription drugs covered, but Medicaid may cover some drugs not included in Medicare Part D plans.
How much income is allowed for Medicaid medical coverage?
Medicaid medical coverage is available only to people with very low income. Exactly how much income is permitted depends on the state where you live. In all states, if your income falls below the eligibility standard for the federal government's Supplemental Security Income program, known as SSI, you're also eligible for Medicaid medical coverage. This amount is about $700 per month in what's called "counted" income. But quite a bit of your actual income might not be counted toward this figure. So, if your actual income is up to $1,500 per month, you should consider applying for Medicaid. If either spouse in a married couple applies for Medicaid, the income of both spouses (if living together) is counted by Medicaid when deciding eligibility. Also, if a Medicaid applicant receives free housing and regular meals from family or friends, or has bills regularly paid for them, Medicaid may consider this as income when deciding eligibility.
In many states, Medicaid medical care coverage is also available to people whose income is higher than the state's Medicaid eligibility level if they also have regular medical expenses that aren't paid by another program or insurance. This category of people is known as "medically needy." So if you have any regular medical bills that aren't covered by Medicare or other insurance, you may be eligible for Medicaid coverage even if your income is well over the normal Medicaid limit.
How much in assets is allowed for Medicaid medical care coverage? Someone applying for Medicaid medical coverage is allowed $2,000 ($3,000 for a couple) in cash, savings, or other assets, plus a number of other assets that are "exempt" (not counted) from Medicaid eligibility rules. These exempt assets include:
·A house that the applicant lives in.
·An automobile, sometimes limited to a certain fair-market resale value of around $5,000 (this varies from state to state).
·Personal property and household goods for regular daily use, sometimes limited to a certain fair-market resale value (this varies from state to state).
·Wedding and engagement rings.
·Life insurance with a total face value (cash surrender) of no more than $1,500, and term life insurance with no cash surrender value.
·Specially earmarked funeral and burial fund of up to $1,500, plus a burial space.
A person who wants to apply for Medicaid medical coverage can give away or transfer any amount of assets in order to qualify. Medicaid medical coverage eligibility doesn't have any of the rules or penalties regarding transfer of assets that apply to Medicaid nursing home coverage.
State Medicaid programs may choose to cover optional medical services beyond those listed above. If a state Medicaid program covers an optional medical service, it's allowed to charge the patient a small co-payment for it. The optional coverage offered, and the co-payments for each optional service, vary from state to state but may include:
·Eye examinations and glasses
·Hearing tests and hearing aids
·Dental care
·Preventive screenings
·Physical therapy (beyond what is offered under Medicare)
·Nonemergency transportation to and from medical treatment
·Some non-Medicare-covered prescription drugs and some nonprescription drugs, including certain vitamins
·Chiropractic
Are any benefits available if income and assets are a bit too high for Medicaid?
If you have low countable income, few assets (not counting your home, a car, and other personal possessions), but your income or assets are slightly too high to qualify for Medicaid, you may still be eligible for another program that provides substantial financial help with medical costs. These other programs are called Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI). Here are the basics about these three programs:
QMB: You may qualify as a QMB if your counted income is up to about $950 per month (varying slightly from state to state). You may also have nonexempt assets of up to $4,000 ($6,000 for a couple). If you are eligible to be a QMB, your state will pay all of your Medicare Part A and Medicare Part B premiums, deductibles, and coinsurance amounts.
SLMB: You may qualify as an SLMB if your counted income is up to about $1,150 per month. You may also have nonexempt assets of up to $4,000 ($6,000 for a couple). If you qualify as an SLMB, the program will pay your monthly Medicare Part B premium.
QI: You may qualify as a QI if your counted income is up to about $1,300 per month and your nonexempt assets are no more than $4,000 ($6,000 for a couple). If you qualify as a QI, the program may pay your Medicare Part B monthly premium, but each state's QI funds are limited and there's no guarantee of coverage.
What medical care does Medicaid cover in all states?
Every state's Medicaid program covers basic medical care, to the same extent that Medicare Part A and Medicare Part B do. This includes:
·Inpatient hospital care
·Inpatient short-term skilled nursing- or rehabilitation-facility care ·Doctor services
·Outpatient hospital or clinic care
·Laboratory and X-ray services
·Short-term home healthcare (provided by a home healthcare agency) ·Ambulance service
·Prescription drugs for people not covered by Medicare
·For these basic services, neither Medicaid nor the healthcare provider may charge the patient any co-payment.
Will Medicaid cover medical care from any provider?
In order to have Medicaid cover your medical care, each medical service must be provided by a doctor or other provider who participates in Medicaid. However, because Medicaid doesn't reimburse doctors and other healthcare providers at the same rate as private insurance, many providers don't treat patients who are enrolled in Medicaid. If you're enrolled in Medicaid, make sure to check in advance with any healthcare provider about whether they accept Medicaid patients.
Many Medicaid enrollees receive care through a Medicaid managed care plan, such as an HMO. These Medicaid managed care plans work in the same way that a [Medicare Part C managed care plan does, with restrictions on the doctors and other providers you may use -- except that there's no monthly premium and no co-payments except for optional services beyond what Medicaid is required to provide. In some states, you can choose from several of these Medicaid managed care plans, in addition to regular Medicaid coverage under which you're free to choose any doctors or other providers as long as they accept Medicaid patients. When you enroll in Medicaid, you get information from your local Medicaid office about what Medicaid managed care plans are available to you and how they work.
If a family's or couple's assets would qualify them for Medicaid but their income is over their state's Medicaid limit, in most states they can still qualify for Medicaid coverage if their medical bills add up to more than the amount by which their income exceeds the Medicaid limit. This spend-down provision, called "share of cost" in Medicaid jargon, is similar to a deductible under a typical health insurance policy, because it's the amount they'd have to pay out of their own pocket before Medicaid coverage kicks in.
Drug Rehabilitation in Sunset Malibu by Joseph Warner
in Medicine (submitted 2010-01-08)
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Drug addiction is such a deadly disease, that it not only harms the addict but also each and every person depending on the addict or even those who stay with them. A single person's drug addiction can affect everyone surrounding him or her. But, the main victim is always the addict; it ruins the addict's life from each and every angle. If the addict is a student, then his academic carrier is just destroyed. If he is an employee, then the company will surely kick him out. Apart from these, drugs affect a person's health and mentality a lot. A drug addict isolates himself from the rest of the world, making his or her addiction drug the only friend.
The most common forms of drug addiction are the opiate consumption. Several opiates like heroin, cocaine has been banned in many countries, but the addicts have found a new way for their opiate consumption - the painkillers. Painkillers do not contain large quantity of opiate like the other deadly drugs, but the little amount present in it is enough for making a person feel high. Painkiller addiction has spread like a plague all over the world. Since it is a medicine, it cannot be banned and the addicts utilized this weakness of the govt. it is not hard to get few painkillers, the addicts consult a doctor to complain about their fake ailment and the job is done. Taking the doctor's prescription, he or she can get any amount of painkillers from a medical store.
However, it is lucky for the addicts that suitable treatment is available to cure them. They can survive from this addiction to painkillers by taking proper treatment from an opiate rehab. If you are from United States and currently reading this article for searching a suitable rehab for your close one, then it is to inform you that the Sunset Malibu is the best rehab you can have. Their medical staffs, treatments procedures, luxurious lifestyle are the best for complete drug rehabilitation of the person. It will be better to discuss about the facilities provided by this rehab, so that you can find this article useful.
Firstly, the treatment process provided here is world class. The treatment procedures are conducted by highly experienced doctors who have got long experience of rehabilitating people. The first treatment undertaken is the opiate detox program, in which the drug particles are eliminated from the addict's body by certain methods. The opiate addicts are treated mainly with buprenorphine or methadone. The buprenorphine treatment has proved to be effective in lessening the pain of the withdrawal effects. Apart from this, various other treatments are provided for the complete healing of the person.
Secondly, the care and comfort provided by the medical staffs are unimaginable. The friendly nature of the staffs can touch anyone's heart. The individualized treatment programs conducted by the medical staffs are also awesome, no other opiate rehab provide this facility.
Thirdly, the luxurious lifestyle maintained in this drug rehabilitation center can compete with any world class hotel. This luxury is provided to see that the patients get proper comfort during the painful treatment process.
Hope this article will help you find the best opiate rehab for any of your close person.
Free Drug Rehab Centers by Dom Rotario
in Addictions (submitted 2009-12-30)
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There are many instances where an addict is in need of free drug rehab centers services. The problem is that with the economy the way that it is today it can be difficult for addicts and alcoholics to find the services that they desperately need. This article will take a look at the options available to the drug addict without medical insurance or money for finding help.
When a drug addict reaches the point where they are ready to accept help many times their bank accounts are not in the best shape. This is only logical. Yet our system expects people to pay thousands of dollars sometimes even more than a hundred thousand for drug rehabilitation services at the point in their life when they are least able to afford it.
Some states in the United States have recognized how this system is flawed and are now offering addicts rehabilitation services at free drug rehab centers. One example of a state that is doing things the right way is the state of Washington where any person who needs help can get addiction counseling at a free drug rehab.
Such rehab centers are saving thousands of lives and turning troubled drug addicts into highly functioning, productive members of society. But, not all states have followed in Washington's foot steps. In many states in the United States, free drug rehab services are woefully underfunded and the vulnerable addicts are left to fend for themselves.
The good news is that many private drug rehabs are now offering hard ship spots at their for profit drug rehabs to individuals who are unable to pay. They do this to help people who are in a time of need, yes. But, they also do it because they were once a troubled addict themselves and they understand that it is possible to turn your life around.
If you are looking for drug addiction help and are unable to pay for rehab do not despair as there are many services available to you regardless of where you live.
Drug Rehab Tips to Help You Get Clean by Scott Byers
in Health (submitted 2009-12-20)
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If you really want to get clean once and for all, then entering yourself into some sort of drug rehabilitation facility is really the best thing you can do for yourself. This article will provide practical information for you regarding what you should know about rehab facilities and how to go about finding a good one. Ultimately the time it takes for your mind and body to heal will be up to you, but finding the right place to go and do that is also of great importance.
For those people who either do not have a job or cannot afford high-end rehab facilities, you will need to know where to go. There are plenty of non-profit organizations across the country which own places that you can go to get help. A simple search online for one of these places will most likely bring up at least one or two locations in your area.
If you cannot find anywhere near you that offers free drug rehab treatment, then you will need to know what else can be done to find help without spending a lot of money. There are also plenty of places which charge you in relation to how much money you make, so you actually don't end up spending that much. These places will offer the same kind of services that you would expect from other facilities and you will be able to get the help you need.
Another good option for those who are desperate and religious is a church mission program, which accepts anyone and is free of charge. You do have to associated with some established religion, but the same services are offered and they combine more traditional rehab methods with spiritual ones. This has been proven to be effective with many people who just don't have any other option and are at the end of the line.
How to find the right drug rehabilitation center? by Steve Ballmer
in Medicine (submitted 2009-12-11)
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There are plenty of drug rehabilitation centers in the country. These drug rehab centers claim to provide the best programs for the drug addicted people. In such a condition, it becomes a bit difficult to find out the most reliable drug rehabilitation center. Rehab centers give a new meaning to patient's life. Therefore, one should be very careful before joining any rehab center.
However, to lessen the problem this article provides some effective points that will help you in finding the most suitable rehab center.
- Medical detox program: This is the first and foremost step for the addiction recovery treatment. So, the center must have well managed medical detox program with 24x7 surveillance facility. - Physicians and other medical staffs: This is one of the important points you need to inquire about. The physicians and other staffs must be board certified and have sufficient experience so that they can provide personal therapy and other medical treatments adequately. - Dual diagnosis treatment program: Generally, the drug addicted person also suffers from other psychological problem; hence the drug rehab center must have drug treatment programs along with psychological disorder treatment programs. - Integrated service: The center must have integrated treatment procedures including latest medical equipments, behavioral therapy, medication, recreational therapy, and individual therapy so that they can holistically treat the body and mind of the patient. - Attractive and prolific facilities: The center must have specific features like - the area should be hygienic, should have individual rooms, separate kitchen and dinning area, recreational facility, well decorated lounge and peaceful environment. - Licensed and Government Certified: The center must have license and should certified by the government.
All these points will insure proper treatment and complete recovery; hence it is essential for you to consider the above give points before choosing a rehab center.
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