Because Medicaid is free (or very low in cost), you might not think it qualifies as regular health insurance. And because of new laws that require every U.S. citizen to carry health insurance, you might be worried that you will have to pay penalties at the end of the year for failing to obtain appropriate health coverage. But you can put your mind at ease – just because you don’t necessarily have to pay for Medicaid doesn’t mean it isn’t “real” insurance. And it does indeed qualify under the mandated health coverage provision, meaning you won’t have to pay a fee for noncompliance if it happens to be the only health insurance you use. If you’re interested in using Medicaid as your primary form of coverage, here are a few things you need to know.
Medicaid is intended for low-income individuals or families. It is especially concerned with those that are dependent in some way or have more medical needs than the average adult. Children, for example, receive many benefits through the Medicaid program and an adjacent program called CHIP (Children’s Health Insurance Program). Medicaid also provides coverage for pregnant women, elderly adults, and people with disabilities. It is primarily intended as a way to ensure that otherwise uninsured and underserved citizens with limited or no income still have access to the medical services they need to stay healthy and well. For this reason, those who qualify for and receive Medicaid are not required to buy a marketplace or private insurance plan in order to meet the legal requirements for obtaining personal health coverage.
Of course, you first have to apply for marketplace insurance in order to determine if you and your family qualify for Medicaid (and/or CHIP). These programs are partially federally funded, controlled, and monitored, but they are administered by each state individually. As a result, qualifications, cost, and services provided via such health coverage could differ from one state to the next. Whereas some states have denied all but the federally offered portion of Medicaid, others have gone above and beyond to ensure that qualifying, low-income families and individuals receive additional coverage. And states that participate in the Medicaid program are allowed to design the program to suit the needs of their residents, provided they comply with federal guidelines.
So how do you qualify for this free or low-cost coverage? The details of the program may vary from state to state, but the first step is to complete a marketplace insurance application through your state insurance exchange. Your eligibility for Medicaid and its associated programs will depend on your household income, the size of your household, and the dependents in your household (children, elderly family members, family members with disabilities, etc.). If you qualify, you may have to pay a small amount for your health coverage or you may receive it for free. It will depend on the details of your application, as well as the criteria for the state you live in. However, if you are a low-income individual or head of household seeking health coverage in order to comply with the law and avoid penalty, you may discover that you are eligible for Medicaid. You simply have to apply to find out.
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