Question

What are the eligibility requirements and coverage of Medicaid for the categories of low-income adults, pregnant women, and the aging/blind/disabled in the state where you live? Do you consider the eligibility requirements reasonable or restrictive? Do you consider the coverage reasonable or liberal? What are the benefits and drawbacks to keeping these populations insured through Medicaid? Consider both direct and indirect factors.

Answer 1

Medicaid is a healthcare program for persons and families with low income and resources.

# Eligibility criteria for different categories for Medicaid :-

- Supplemental Security Income Recipient's

Supplemental Security Income Recipients are categorically (automatically) eligible for Medicaid benefits. However, there are people who MAY BECOME ineligible for SSI b/c of Social Security cost of living increases. These individuals may still be eligible for Medicaid, even though they are no longer receiving SSI

- Disability Claimaints

If the Social Security Administration has determined that an individual is disabled, Medicaid accepts that determination and the individual is categorically eligible for medical coverage, regardless of their age. However if the SSA hasn't made a determination of disability, Medicaid will have to make a determination of one's disability.

- Medically Needy Claimaints

The Medically Needy are those who would otherwise be eligible for the SSI program except that their income and/or resources are above income and resource limits set by the SSI program. There are persons who are considered "SSI related": those aged 65 or older, or those who are certified blind or disabled. These Medically needy individuals may qualify for Medicaid if they meet the financial income and resource limits set by NYS for the medically needy.

I consider the eligibility requirements reasonable and and also the coverage is liberal because its a healthcare program implemented by government for the people who are really needy and has no resources . These eligibility criteria will make sure that the help is being provided to the right and needy ones without any fraud practices in between .

# Benefits of Medicaid :-

- cost growth

- payment and physician participation

- scope and impact of ACA expansion

- block grants

- improving care efficiency for dual eligibles

# Drawbacks of Medicaid :-

- ethically problematic for some

- may require you to give up rights to your assets

- medicaid laws are complex