December 02, 2015
Medicaid Factsheet 2015
What is Medicaid?
Medicaid is a social safety net program that provides health coverage for low-income pregnant women, children, the disabled and seniors.
Who is covered under Medicaid?
About 70 million people receive Medicaid benefits, including:
- 31 million children, including those on CHIP
- 11 million non-disabled 18 to 64 years old
- 8.8 million disabled
- 4.6 million seniors
Beginning in 2014, the Affordable Care Act has provided for the expansion of the Medicaid program to include coverage of individuals not previously covered, such as low-income males, and raises the income eligibility to include individuals with incomes up to 133% of the Federal Poverty Level ($15,521 for individual and $31,721 for a family of four; these figures are expected to rise slightly this spring). Not all states have agreed to expand their Medicaid program. To see if your state has expanded coverage, visit: http://bit.ly/1aP3AAi.
Long-term Care and Support Services
Medicaid is the largest payer of nursing home and home care services, paying for 62% of these services. Seniors with incomes up to 300% of Supplemental Security Income (SSI) qualifying levels ($26,388 for individual) may qualify to receive these benefits. Check with your state to see if you qualify. For state specific eligibility requirements, visit: http://bit.ly/1ffmdAb.
Cost-sharing Assistance for Low-income Seniors
The Medicaid program provides assistance with cost-sharing for low-income seniors, through the Medicare Savings Program (MSP). Under this program, Medicare beneficiaries with limited incomes may be eligible for assistance paying their monthly Part B premiums of $104.90. The Centers for Medicare and Medicaid Services in conjunction with states offer four different programs under MSP.
Medicare Savings Program
The chart below is a summary of programs available. It shows what each program will cover and the maximum income and assets allowed to qualify:
Proposals That Would Dramatically Cut Medicaid
HOUSE BUDGET – It “block grants” Medicaid and slashes its funding by $913 billion over 10 years. Currently, the Medicaid program pays for all Medically-necessary services. Under a block grant program, states would receive a fixed amount, making it difficult for them to continue to offer needed benefits. States will most likely change eligibility or increase cost sharing for individuals.