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73 Medicaid Coverages




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This article is from the Organ Transplant FAQ, by mike_holloway@hotmail.com (Michael Holloway) with numerous contributions by others.

73 Medicaid Coverages

Medicaid often provides coverage for outpatient medications. There are
several ways to become eligible for Medicaid benefits.

A. SSI - SUPPLEMENTAL SECURITY INCOME

Provides a minimum income level for aged (65 or over), blind, individuals
with disabilities, and couples with limited income and limited resources.
If you are eligible for SSI cash payments, you are likely to also be
eligible for Medicaid coverage for medications. To determine if you are
eligible for SSI, call the Social Security Office at 800-272-1213.

B. MEDICAID
There are two possible categories of need under the Medicaid program.

1. Categorically Needy - Individuals who fall at or below the income and
resource level designated as the "poverty line" by their state must be
covered by Medicaid for their health care, assuming all other eligibility
criteria are met.

2. Medically Needy (Spend Down) - In some states, individuals who are
above the income and resource level designated as the "poverty line"
may be eligible for Medicaid through the medically needy program. In
the states where such a program is offered, individuals are allowed to
"spend down" their excess income (but not resources) to the "poverty
line over a period of time. The "spend down" is like a 'deductible."
It is the process of using medical expenses to reduce the income of an
individual to the level of eligibility for Medicaid.

C. QMB - QUALIFIED MEDICARE BENEFICIARY
You are a Oualified Medicare Beneficiary if you are:

...age 65 or over or a person living with a disability, AND

...entitled to Medicare Part A

...have income that is not over the Federal Poverty level

...have resources that do not go over the limit set for SSI eligibility.

If eligible, there is a possibility of Medicaid coverage for prescription
medication and/or coverage of other Medicare premium costs.

To apply, contact your local public assistance of tics.

Note: For information regarding SSI, Medicaid, Spend Down, and QMB,
call the Social Security Office at 800-772-1213.



 

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