Medicaid: An overview

Jul 24, 2019 | Firm News | 0 comments

Health care and health insurance remain at the forefront of national discussion. And why wouldn’t they be? Medical care is something we all need at some point in our lives. Many of us take our health insurance for granted until we’re in a position where we don’t have it.

Paying for medical costs on your own can be prohibitively expensive. Luckily, there are programs available to assist people who do not have private health insurance. On the state level, Medicaid offers low-cost health care to those with low incomes.

What is Medicaid?

Medicaid is a federal program run by each state individually. Medicaid provides health-care coverage to certain low-income individuals, regardless of age, who meet state and federal guidelines.

Along with its partner program, the Children’s Health Insurance Program (CHIP), Medicaid provides health-care coverage to 72.5 million people. The 2010 passage of the Affordable Care Act, gave states the opportunity to expand their Medicaid programs, and a majority did, including New Jersey.

In New Jersey alone, Medicaid and CHIP cover more than 1.7 million people, and the number of uninsured dropped 42 percent between 2013 and 2017 thanks to the expansion.

Who is eligible for Medicaid?

Those eligible for Medicaid in New Jersey must meet certain financial guidelines, and must be a New Jersey Resident and a U.S. citizen or qualified immigrant – most immigrants are barred from receiving Medicaid for five years after their arrival.

In addition to the requirements listed above, to qualify for New Jersey Medicaid, a person must fall into one of the following categories:

  • Pregnant women
  • People 65 or older
  • Blind people
  • Those with permanent disabilities
  • Families with dependent children

Those with an urgent medical condition whose income and assets are too high to qualify for Medicaid may be able to apply as a “medically needy” person, and some financial eligibility guidelines are relaxed.

Services covered

New Jersey Medicaid provides many of the same services provided for by private insurance, at little or no cost to the Medicaid beneficiary. Some services include:

  • Both inpatient and outpatient hospital visits
  • Diagnostics including labs and X-rays
  • Preventative health screenings
  • Home health care
  • Nurse-midwife service
  • Family planning
  • Nursing home residency

In addition to Medicaid, New Jersey offers a public insurance plan called New Jersey Family Care. The financial requirements are less strict, and it offers services to a greater number of people.