Medicaid – Fabian Insurance Services

Medicaid

A joint federal and state program, Medicaid helps pay medical costs for certain groups of people with limited income and resources, such as pregnant women, children, and the aged, blind, or disabled.

Medicaid

What is Medicaid?

Medicaid is a U.S. government program that provides health coverage to low-income individuals, families, children, pregnant women, the elderly, and people with disabilities. It is jointly funded by the federal government and the states but administered at the state level, which means coverage and eligibility rules can vary significantly from one state to another.

Eligibility

Are you Eligible for Medicaid?

Primarily for low-income individuals and families.
Each state sets its own income eligibility requirements within federal guidelines.
Eligible groups include:
- Low-income adults
- Pregnant women
- Children
- People with disabilities
- Elderly individuals (often in combination with Medicare)

Coverage

Medicaid Coverage

Medicaid covers a broad range of health services, such as:

Doctor visits
Hospital stays
Long-term care
Preventive care (e.g., immunizations, mammograms)
Prescription drugs
Behavioral health services
Home health care services

Program

Joint Federal and State Program:

Medicaid is a means-tested program, meaning that eligibility is based on income.
The federal government provides matching funds to states, but each state manages its own program, meaning services and eligibility criteria may vary by location.

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Affordable Care Act (ACA) Expansion:

The ACA allowed for Medicaid expansion, offering coverage to all adults with incomes up to 138% of the federal poverty level (FPL). However, not all states have adopted Medicaid expansion

Premiums

No Premiums for Most Enrollees

Most people who qualify for Medicaid do not have to pay premiums or only pay small co-pays depending on their state program. The goal is to provide affordable healthcare to those who may otherwise not have access.

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What is the Difference Between Medicaid and Medicare?

Medicaid is for low-income individuals, and eligibility is primarily based on income.
Medicare, on the other hand, is primarily for people aged 65 and older or those with certain disabilities, regardless of income.

Medicaid ensures that vulnerable populations have access to healthcare, covering millions of Americans every year.

Medicare FAQ's

Got questions? We've got answers

WHEN CAN I APPLY FOR MEDICARE?

You are eligible to apply for Medicare during your initial enrollment period which is a 7 month window. 3 months before turning 65, the month you turn 65 and 3 months after turning 65.

HOW DO I APPLY FOR MEDICARE?

The easiest way to sign up for Medicare is online through SSA.gov or by Calling Social Security at 1-800-772-1213. You can also visit your local Social Security Office.

WILL I AUTOMATICALLY BE ENROLLED IN MEDICARE?

If you are already receiving Social Security Benefits you will be automatically enrolled into Original Medicare, otherwise you will be eligible to enroll during your initial enrollment period that starts 3 months before your 65th birthday.

WHAT IF I MISS MY INITIAL ENROLLMENT PERIOD?

If you miss your Initial Enrollment Period you can sign up during the General Enrollment period that occurs every year January 1st through March 31st. Coverage becomes effective the month following your enrollment date.

ARE THERE PENALTIES FOR ENROLLING LATE?

Yes, there are penalties for not signing up for Part B of Medicare and will be added to your premium.

CAN I GET A REPLACEMENT MEDICARE CARD?

If you need a new Medicare card you can order a replacement card by phone at 1-800-772-1213, or online at the Social Security Administration web site. Make sure you have your Medicare number ready when you call.