Medicaid: Legal Definition

Medicaid is a means-tested government benefit program providing health coverage to low-income Americans. Recipients include working adults, older adults, children, pregnant women, and the disabled. While the federal government oversees the program and provides part of its funding, state governments administer Medicaid.

As of July 2018, more than 66 million Americans receive their health coverage through Medicaid across the 50 states plus Washington, D.C.

Benefits Offered by Medicaid

Because individual state governments administer Medicaid to eligible recipients, the benefits available can vary from state to state. The federal government does, however, require each state’s Medicaid program to offer a number of mandatory benefits. These include:

  • Inpatient hospital services
  • Outpatient hospital services
  • Physician services
  • Laboratory and X-ray services
  • Home health services

Depending on what state you live in, you may be eligible to receive additional benefits from Medicaid on top of those required by the federal government. Optional benefits vary between states and include:

  • Prescription drugs
  • Physical therapy
  • Occupational therapy
  • Case management

Eligibility for Medicaid

Not everyone is eligible for Medicaid. In order to qualify, you have to meet one or more needs established by the program. These include:

Financial Need

The number-one reason people qualify for Medicaid is they have a financial need. In other words, their income and total assets fall below certain thresholds set by the program. Just as Medicaid benefits vary from state to state, so do income and asset requirements to qualify.

Medical Need

If your income or assets exceed the program’s requirements for your state, but you have a medical issue that is so expensive to treat that it creates a financial hardship, you may qualify for Medicaid based on a medical need.

Free Disability Case Evaluation With an Attorney

Are you disabled and need help applying for Social Security disability benefits? An attorney from the Disability Advantage Group, is eager to help. We help our clients apply for and receive Social Security disability and other benefits. To get a free case evaluation with a member of our team, call us at 865-566-0800.