Under the Social Security Act, Medicaid is defined as a jointly funded federal and state program that pays for the medical assistance of individuals and families with low income and resources. Medicaid covers approximately 36 million individuals nationally, including children, the aged, the blind and/or disabled, and individuals eligible for Social Security Income (SSI). Medicaid can also help pay for Medicare deductibles and other out-of-pocket costs.
Medicaid is one of two government assistance programs that provide health care benefits. The other program, Medicare, has some distinct differences from Medicaid. Refer to the comparison table on the Guide to Financial Benefits: Medicare to learn the differences.
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States are given broad guidelines by the Federal government concerning which groups their Medicaid programs will cover. However, there are certain groups states are required to provide Medicaid coverage for, including:
Children under six years of age whose family income is at or below 133% of the Federal poverty level (FPL).
Expectant mothers whose family income is below 133% of the Federal poverty level. Services to these women are limited to those related to pregnancy.
Supplemental Security Income (SSI) recipients in most states.
Those who receive adoption or foster care assistance under Title IV of the Social Security Act (allows temporary assistance for needy families).
Specially protected groups (i.e., individuals who lose their cash assistance due to earnings from work or from increased Social Security benefits, but who may keep Medicaid for a period of time).
All children born after September 30, 1983, under the age of 19, and whose family income is at or below the Federal poverty level.
Certain Medicare beneficiaries.
Centers for Medicare and Medicaid Services (CMS), Medicaid General Information
In the publication called "Medicaid General Information" the Centers for Medicare & Medicaid Services has compiled a comprehensive overview of Medicaid. It includes its history, the scope of Medicaid services, and its relationship to Medicare.
Social Security Online, Supplemental Social Security Income (SSI)
Social Security Online hosts a comprehensive section on Supplemental Social Security Income (SSI). From this website, you can determine your eligibility, learn about the law, and read a more comprehensive handbook published by the Social Security Administration.
U.S. Department of Health and Human Services, Understanding Medicaid Home and Community Services
This primer, published and hosted by the U.S. Department of Health and Human Services provides a comprehensive overview of Medicaid coverage for Home and Community Services.
Waivers are tools used by states to obtain federal funding to provide long-term care to patients in settings other than institutions. On this site, you will find information about managed care waivers, home and community-based service waivers, and combination waivers.