Medicaid Frequently Asked Questions

By AGIS Staff, AGIS Network

Medicaid is a government health insurance program that helps pay for the medical needs of lower-income people. Although the program was founded by the federal government, it is administered separately by each state, so coverage and eligibility rules vary depending on where your loved one lives. Nevertheless, answers to a few commonly asked questions can help you figure out whether Medicaid might be right for your loved one.

What's the difference between Medicare and Medicaid?

Medicare is a federal health insurance program available to almost anyone 65 years old and over and those with certain disabilities, regardless of income or assets. Medicaid is a joint state-federal program that serves financially needy people regardless of age. At minimum, Medicaid covers the same services as Medicare; some state Medicaid programs offer additional benefits.

My older loved one has Medicare. Why should she apply for Medicaid?

Older adults who are on Medicaid don't have to pay their Medicare premiums or deductibles. Unlike Medicare, Medicaid pays for nursing home costs, which can quickly become very expensive. For some medical services, Medicare pays for a maximum of 80 percent; Medicaid may cover the remaining 20 percent.

What services does Medicaid cover?

Medicaid programs in all states are required to cover:

  • Inpatient and outpatient hospital services
  • Physician services
  • Nursing home care in approved facilities
  • Home care services
  • Lab services
  • Rural health clinic services
  • Transportation to and from treatment

Most state Medicaid programs cover a range of additional services, which may include dental services, physical therapy, prescription medications, eye exams and glasses, hearing aids, prosthetic devices, dentures, and more. Check with your state's Medicaid program for details.

How do Medicaid payments work?

Medicaid makes payments directly to health care providers, not to you or your loved one. Depending on the state your loved one lives in, he or she may have to make a small co-payment for some medical services.What are the financial requirements for eligibility?For your loved one to qualify for Medicaid, he or she must not exceed certain limits on income and assets. The exact limits vary by state, but as a rough guide, the maximum monthly income is about $300 to $500, and total assets are limited to about $2,000 (not including your loved one's home, car, or personal possessions). Check with your state's Medicaid program office for details and to learn how gift-giving and other factors can affect eligibility.

How can my loved one apply for Medicaid?

Contact your loved one's local Department of Social Services to learn where and how to apply. Applying for Medicaid often involves plenty of paperwork, as well as appointments with staff. If possible, gather financial records and fill out paperwork before appointments. An elder law attorney or a financial planner who specializes in elder care can be very helpful.

Where can I find my loved one's state Medicaid office?

In most cases, you can quickly find a state's Medicaid website by searching the Internet for "Medicaid" and the state name. The federal government's Medicaid website is at

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