Understanding Medicaid
What is Medicaid?
Medicaid is health insurance that provides coverage for Americans with limited income and resources. This includes low-income adults, children, pregnant women, elderly adults, and people with disabilities.
How does Medicaid work?
The federal and state governments share the costs to provide low-cost health coverage to eligible individuals. Medicaid is administered by the states, so each state has its own eligibility criteria. Individuals can apply at any time to see if they are eligible for their state Medicaid health coverage. Most Medicaid members get services through a managed care health plan, and members have the right to pick the plan that works best for them.
What services does Medicaid Cover?
All state Medicaid programs must provide inpatient and outpatient hospital services, physician services, laboratory and x-ray services, and home health services. Many states also provide optional benefits like prescription drugs, case management, physical therapy, and occupational therapy.
Medicaid may also cover costs while in a nursing facility or home/ community-based services if the individual is medically approved for services in addition to the financial evaluation.
What is a Medicaid Waiver?
The Medicaid Waiver program allows states to waive certain Medicaid eligibility requirements to provide care for individuals who may not otherwise qualify. You can learn about the different state waiver programs here.
What is Medicaid called in my state?
There are many Americans who do not know they are Medicaid recipients because Medicaid has an alternative name in their state. In fact, most states have a unique, state specific name for their Medicaid program, which you can find here. It is important to know who your health insurance provider is so you can make the most of your health insurance benefits.
Can I get Medicare AND Medicaid?
Yes. Many individuals who are approved for Social Security Disability Insurance (SSDI) and receive Medicare are also eligible for Medicaid, or a Medicare Savings Program.
Why is Medicaid important for the HD Community?
First, Medicaid is the ONLY insurance that covers nursing facility costs. Most individuals impacted by HD receive Medicaid at some point in their healthcare journey, either to cover nursing facility costs or to help with in-home care costs.
Second, Huntington’s disease can be expensive to manage. It often requires specialty medications, like Austedo and Xenazine. HD medical care requires a diverse care team, including neurologists, psychiatrists, physical and occupational therapists, and even speech therapists.
Third, Medicaid helps fill in care gaps by providing in-home care options and assistance. This can include home modifications, vehicle modifications, adult day care, and some states pay families to be caregivers.
Fourth, many individuals impacted by HD rely on Medicaid while they are waiting for their Social Security disability approval. This allows them to continue their medical care, which is essential for an SSDI approval.
What can you do to help protect Medicaid?
If you, a friend, a family member, or other loved one are receiving Medicaid, share your story! Please tell Congress how your family relies on Medicaid Benefits so we can protect these benefits for decades to come. Take Action Here!
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