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Medicaid for Seniors: What you Need to Know

Medicaid is a state and federally run program, which provides medical coverage to low income individuals. Seniors must fall into criteria for their state. Each state’s eligibility requirements vary slightly but all states have the same basic requirements.

Basic Medicaid Requirements for Seniors

Medicaid can help you with your medical costs if you are a senior and have low income. When determining Medicaid eligibility, social services takes into account all sources of income, real property, and bank accounts. If you live in a nursing home, there are special requirements for this situation.

Each state has a specific level of income they use as a cutoff point for enrollment into Medicaid.

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The Benefits of Medicaid

Once you enroll in Medicaid, your benefits are active for three months prior to your application. This means that medical bills that you incurred three months before your Medicaid started are covered.

Each state is required to provide coverage for “mandatory services.” These services include doctors, dentists, hospital inpatient and outpatient, nursing home care, psychiatric or mental health facilities, medical supplies, medical equipment, transportation to medical appointments or reimbursement of gas through car mileage, clinic, ambulance, labs, X-ray, smoking cessation agents, and premiums for some insurance including Medicare.

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Along with the "mandatory services," each state is required to provide 33 additional services to cover. Since each state differs in these additional services, you will have to ask a caseworker at your local social services about detailed coverage.

Managed care plans are also available. These plans set you up with a physician who will take care of all your healthcare needs. If you need any other treatment the physician is unable to provide, he or she will refer you to a specialist. Your physician and Medicaid manage all healthcare services through this plan.

Enrolled in Medicare and Medicaid

Seniors who are eligible for Medicaid and Medicare are able to keep and use both programs. When you seek any type of healthcare service, you will primarily use Medicare. After Medicare pays for what they cover, the remaining bill goes to Medicaid. Your state Medicaid department will process the bill and pay for the services covered under your state’s guidelines.

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