Medicaid is a type of medical and dental insurance that is available for those that don’t have the income to pay for such insurance on their own. Medicaid is a government program and the exact requirements for it can be different in each state. There will be an application that has to be completed as well as verification of income and resources. There is an income guideline that is based on the total number of people that reside in the household.
In most states, Medicaid is only available for children under the age of 18 that meet the eligibility criteria. They must also be legal citizens of the United States. Many states also offer Medicaid for pregnant women so that they can get the prenatal care that they need. Their child will automatically be eligible for Medicaid until they turn one year of age. Some states also have Medicaid for those that are disabled and the elderly but it depends on how their regulations are written. If you don’t have medical or dental insurance you should find out if you and your family qualify for Medicaid. In some states you can qualify even if you have other forms of insurance. The Medicaid will be a backup resource and can only be accessed when there are expenses the other insurance won’t pay or co-pays. Not all doctors and medical facilities are willing to take Medicaid though. This can be frustrating when you find that you have been approved for program yet you can’t find someone that will take it. Some states offer an 800 number you can call to find Medicaid providers in your area. Keep in mind though that most of them only allocate a certain amount of slots for patients with this type of coverage. The goal of Medicaid programs is to ensure individuals have a resource to help them get the medical and dental care they need. Too many people don’t seek medical attention when they need to due to not being able to pay for it. While there are still some kinks in the system that have to be worked out, it is a very beneficial program. More providers are added all the time to help ensure those with Medicaid can get services.
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Medicaid providers are those doctor's offices, clinics, and hospitals that have agreed to accept this form of payment for services. Individuals that are approved for Medicaid are often given a list of providers so they can choose who they want to be seen by. It is important to do this early instead of waiting until you need to be seen. Most hospitals accept Medicaid so it isn’t a problem. Yet doctor’s offices and clinics have a set number of slots they will allow to accept this form of payment for.
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Medicaid Fraud. Medicaid is a very good program that is to help those that need medical and dental coverage. In most instances, without the Medicaid they simply wouldn’t be able to afford it. Therefore they wouldn’t get the care they needed, especially when it comes to preventative care. One issue with Medicaid though is that it isn’t always used as it should be. There are problems with fraud both from people approved for the program and by providers. Medicaid fraud happens in many ways from the individual side of things. A person many not report all of the information on their application correctly in order to be eligible. They may end up omitting income or various household members that have a sufficient income to contribute to the household. It also occurs when someone allows another person to use their Medicaid card for services. There are auditors in place to review charges by medical providers. They look for patterns of behavior when it comes to billing of Medicaid patients. They want to make sure they aren’t billing for things that haven’t occurred. They also want to make sure Medicaid patients aren’t being subjected to tests that they don’t need in order for them to make money. There are also fraud hotlines where people can call in to report other people who may be getting Medicaid benefits fraudulently. A person can make such reports anonymously so that they don’t have to tell anyone who they are. Generally it is friends or family members that don’t feel it is right that someone is illegally getting such benefits that turn them in. Most departments of human service agencies have a fraud unit that can investigate such matters.
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