Understanding Medicaid: Eligibility, Benefits & How It Works

Medicaid is national health insurance program that is fueled by federal and state funds. The program, which began in 1965, is designed to help needy have better access to health care.

Varying Programs

• Medicaid programs vary from state to state. The federal government sets broad guidelines for the program, and each state is allowed to develop a more defined program from them.

Eligibility

• All low-income and uninsured individuals do not qualify for Medicaid. Eligibility is one of the areas controlled by state rules. Factors that generally affect eligibility include age, pregnancy and income. Even when adults are not eligible, their children or children living with them may be eligible.

Services

• Federal guidelines generally require state programs to cover certain costs. These can include doctors' visits, X-rays and family planning. Some Medicaid programs do require individuals to make co-payments for the medical services that they receive.

Retroactive

• Medicaid can cover bills for services that were rendered before an individual enrolled in the program. This applies for qualified services rendered three months before a person's application if her circumstances would have deemed her eligible at that time.

Automatic Enrollment

• If a woman has Medicaid when she gives birth, the child is automatically covered.