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What Type of Health Insurance is Medicaid?

What type of health insurance is Medicaid? This is a question that many people find themselves asking. Don’t confuse it with Medicare, which is the medical program for people who are over the age of 65 and primarily retired. Medicaid is a special type of health care program for low income and disabled people. Health insurance is quite expensive in the US, as is healthcare. This is not a skewed opinion but a fact. So, Medicaid is necessary to help people access the care that they need. It’s a great program that helps kids, pregnant women, disabled people and those who are a bit down on their luck. So, it’s not one type of insurance but all types of insurance. Here are the different aspects of Medicaid so that you can learn all about it.

How to Apply

If you think you might qualify for Medicaid there are two ways to apply. First of all, you can go through your state’s health insurance exchange. If you qualify you can sign up there. They have all the tools to make sure you get the coverage you need. Even if you don’t qualify for Medicaid you can still get a subsidy to help you pay for your regular health insurance, which can help even if your income is too high for Medicaid. The other way to apply for Medicaid is to go directly through your state’s Medicaid department. A simple search will bring you to the right place.

Where is It Available

Medicaid is available in every single state. However, some states have opted to have what is known as a Medicaid expansion. This covers ALL people who are below a certain income level, which varies, by which state you’re in. This is a great program because otherwise Medicaid only covers a select few people and it can be a challenge to get it. Every state’s version of Medicaid follows the federal minimums, but some are better than that. 


CHIP stands for the Children’s Health Insurance Program. CHIP provides care to all kids, even in families where the family doesn’t qualify for Medicaid because every kid needs care to grow up big, smart and strong. CHIP can also cover some pregnant women too. If you want CHIP but don’t have Medicaid you can sign up the same way you sign up for health insurance through your state’s or the federal exchange. 

What’s Covered

What’s covered in Medicaid varies by state but there are certain definite things that are covered in each Medicaid program. These include hospital stays for both inpatient and outpatient services, doctor visits, lab tests and x-rays as well as home healthcare services. Other benefit that may be covered depending on your state includes physical therapy and prescription drug coverage. Make sure to check in with your state to see what would be covered for you.

Who Qualifies

As mentioned, all of the different states has different qualifications for Medicaid. If you state has a Medicaid expansion you can qualify based on your income, however, in states without the expansion there are different rules. They are based on your family size, total household income, age and disability. The only way to find out if you can get on Medicaid is to apply and see what the outcome is!

Medicaid and the ACA

If you qualify for Medicaid but you choose to buy a marketplace plan on the ACA you will not qualify for a subsidy and you will have to pay full price for a marketplace plan. A health insurance plan will not actually give you more coverage than Medicaid and it will be a heck of a lot more expensive so you should make sure to get on Medicaid if you qualify. There’s really no added benefit to going with a marketplace plan instead!

Foster Kids

Foster children have a special plan with Medicaid. That’s because under the ACA, a child can remain on their parent’s health insurance until they turn 26. However, foster kids lose out on that benefit majorly. So, they can stay on Medicaid until they turn 26 instead. Foster kids often have a tough time in life so it is a small token of appreciation that they added this back into the mix so they could have health coverage until they are a bit more settled in life and on their feet. However, to qualify they have to have been in the foster care system on their 18th birthday and they have to have aged out of foster care while on Medicaid on or after their 18th birthday. If you’re a foster kid and you move to a new state you’ll have to check on the requirements all over again!

The Sad Truth

In states without expanded Medicaid plans, some people may not qualify for Medicaid, and they may also not qualify for a subsidy on the health insurance exchange. In this case you may not be able to afford health insurance. The Medicaid website itself explains that this is a sad truth that you might find yourself in. They offer some suggestions for what to do in that situation. Unfortunately these suggestions are somewhat inadequate for people who may have severe health problems. 

They suggest going to free community health clinics to get your healthcare. But those are not available everywhere. They also assure you that you will not have to pay the fee for not having health insurance, because that only affects people of a certain income level. Finally, they say that if your income rises you can sign up for a plan on the marketplace. If you find yourself in this situation there is not much you can do unfortunately, but many people are working to change that!

How to Use It

Ok, so you have gotten Medicaid coverage and now you are wondering how to use it. Find a doctor in your community who takes Medicaid. You can use Medicaid’s resources to find one, or just call around and ask. You can contact Medicaid if you can’t find anyone who will take it. You should also call Medicaid to make sure a product is covered under your plan before you go with any extreme or expensive procedures.

Now Get it

Now that you have the answer to what type of health insurance is Medicaid you are well prepared to get coverage for yourself. Just fill out the application either on your health insurance marketplace or through your state’s Medicaid department and you will have a great coverage at no cost to you if you fit the qualifications. Getting health coverage is available to most people who are low income so make sure you find out if you qualify so you can get covered. You and your family will be happier and healthier with Medicaid.

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