Most frequently asked questions about Medicaid - Spokane, North Idaho News & Weather KHQ.com

Most frequently asked questions about Medicaid

What is Medicaid?
Medicaid is a program that pays medical bills for people who have low income and can't afford to pay for medical treatment.  Medicaid is determined by individual states and is run with state and federal tax money.

Can I have both Medicare and Medicaid at the same time?
Both programs can work together.  If you receive Medicare and qualify for Medicaid, the Medicaid program will pay your monthly Medicare Part B premiums for you (this is called "Buy-In").  Medicaid will also pay your Medicare co-payments and deductibles.  If you are 65 or over and have not worked long enough to receive free Medicare Part A (hospital insurance), the Medicaid program will also pay the Medicare Part A premium.  When you apply for Medicare, it is important to let the Social Security Administration representative know that you have Medicaid and may be eligible to have the State pay your Medicare Part A premium. 

Whenever you have both Medicare and Medicaid, you should show both cards to your medical care provider each time you receive services.

If I have private health insurance, can I be eligible for medicaid?
Yes.  If you have private health insurance available to you or a member of your family, your eligibility for Medicaid will not be affected.  Any service not covered or only partially covered by a private health insurance plan and listed as a Medicaid covered service will be paid by Medicaid. Medicaid will pay up to the maximum Medicaid is allowed to pay.  

How do I get Medicaid?
All people who receive money through Supplemental Security Income (SSI) or

Temporary Cash Assistance (TCA) automatically receive Medicaid. 

If you do not get SSI or TCA, you must file an application to find out if you are eligible for Medicaid.  To do this, you must go to the Local Department of Social Services in

the city or county where you live. 

What do I need when I apply?
You will be interviewed by an eligibility worker who will ask for information about your income, assets, and private health insurance coverage.  You will be asked to prove what you say is true. 

If you are too sick to come to the Local Department of Social Services office to apply, you may send someone to the interview for you who is knowledgeable about your money situation and other circumstances. 

How much money can I have and be eligible for Medicaid?
After the eligibility worker determines that you meet one of these eligibility conditions, the value of all your assets will be added up.  Assets are cash, money in checking or savings accounts, credit union accounts, stocks, savings bonds, trusts, annuities, or any other money that you have saved or invested.  Assets also include things like boats, trailers, real estate, and life insurance policies or other expensive items you may own. Medicaid does not count as assets the home you live in or personal property (e.g., clothing, furnishings, car).   

The amount of assets you may have depends on the size of your family and the eligibility group for which you are applying.  This will be determined at the time of application.

How much income can I get and be eligible for Medicaid?
Income is money that you get from working, or money that someone gives you, or checks that you get, like Social Security, unemployment or disability benefits, child support, retirement benefits, or sick pay.  The amount of income you may have depends on the size of your family and the eligibility group for which you are applying.

What if I have too much money?
Income is money that you get from working, or money that someone gives you, or checks that you get, like Social Security, unemployment or disability benefits, child support, retirement benefits, or sick pay.  The amount of income you may have depends on the size of your family and the eligibility group for which you are applying.

What is spend-down?
When a person's income is more than the amount allowed by Medicaid, the eligibility worker will figure out exactly how much greater the income is than the amount allowed.  This is called "Excess Income."  If the person can show that his/her medical bills are equal to or greater than the excess income, the person can still get Medicaid.  This is called "Spend-down." 

Persons who become eligible under a spend-down are only eligible for a limited time, and they will still have to pay some of their own medical bills.

Source: Maryland Medical Programs