Sign Up Now
Get instant access to over 1 million+ study documents
OR
Already registered? click here to login
By creating your account, you agree to our terms of service, privacy policy and student honor code.
¶ … Eligibility Rules and Agency/Program Policy
The Medicaid Program
Medicaid is a federal assistance program that is administrated at the federal level by the Centers for Medicare and Medicaid Services (CMS) and at the state level by the corresponding state agencies of the individual states. It is a program designed to assist needy individuals with medical expenses. Medicaid eligibility is quite strict and is an example of eligibility by rule and regulation as well as by means testing (Chambers & Wedel, 2005).
The program provides coverage for all of the following healthcare services for program beneficiaries: Inpatient hospital services, Outpatient hospital services, Laboratory and X-ray services including radiation therapy, Physician's services, Podiatric services, Naturopathic services, Vision care, Family planning services, Home health services, Certain chiropractic services, Health clinic services, Early Periodic Screening, Diagnosis and Treatment (EPSDT), Dental services, including orthodontia services, Maternity clinic services, Ambulatory surgical center facility services, Emergency hospital services, Hearing aids and certain hearing aid services, Mental health services, Nursing facility services, Psychiatric hospital services, Some home care services, Prescribed drugs, Medical transportation, Durable medical equipment, Home and community-based services, School-based child health care, Midwives, and Nurse practitioners, soon to be authorized as providers (CMS, 2010).
General Eligibility Issues and...
That is because its means and asset criteria are set so low that individuals who are genuinely in need must first divest themselves of their only income and assets in order to fall below the poverty level for the purposes of program eligibility. While limiting eligibility to those genuinely in need is a perfectly appropriate interest, the eligibility criteria for Medicaid are so low that they unnecessarily exclude many people for whom a very strong argument could be made to support their inclusion without requiring them to spend down their only assets first.
Eligibility Rules Utilized by the Agency
Eligibility for Medicaid coverage requires both that beneficiaries be under the age of 6 or 65 and above and that they be sufficiently economically needy to pay for their own healthcare (CMS, 2010). The financial eligibility requirements are quite strict. While they vary by state, generally, Medicaid beneficiaries may not earn more than $400 to $500 per month; they may not possess savings in a bank account or stocks or bonds that total more than approximately $1,500 for individuals and approximately $2,500 for couples; and they may not own a burial fund or life insurance in excess of approximately $1,000 or maintain more than approximately $5,000 in an irrevocable contract with a funeral home (CMS, 2010). Where only one spouse…
References
CMS. (2010). U.S. Department of Health and Human Services -- Centers for Medicare
and Medicaid Services. Overview: Medicaid Eligibility. Retrieved April 11, 2011
from: http://www.cms.gov/MedicaidEligibility/
Chambers, D.E. And Wedel, K.R. (2005). Social Policy and Social Programs: A Method
Policy Communication: HITECH ACT Health policy communication: HITECH Act Policy description Part of the 2009 U.S. Recovery and Reinvestment Act (ARRA) are the provisions of HITECH (Health Information Technology for Economic and Clinical Health), a major overhaul of the 1996 Health Insurance Portability and Accountability Act (HIPAA). Under HITECH, monetary incentives are delivered to healthcare providers and schemes, for employing electronic health records (EHRs); the target is to ensure EHR implementation in every
The problems facing Medicare recipients and the federal government almost seem to be overwhelming. There are proponents of a plan to privatize Social Security and health insurance, placing the onus on the individual to pay for his own health care through savings specifically for this. Some others would have the program go through the private HMOs who have, in the past, contained the costs of care by having primary
Reduce Medicaid Program Costs and Enhance Utilization and the Quality of Care Through Medicaid Managed Care Medicaid is a type of health insurance provided and funded by the federal government and states to provide coverage to all Americans who are eligible low-income adults, children, elderly adults, pregnant women, and individuals with disabilities. Managed Care is a health care delivery system that was organized to manage cost and quality. The use
New Jersey ChildSupport Program New Jersey ChildSupport Children of immigrant parents who do not have papers that authorize residency in the United States are vulnerable to losing support or receiving support erratically. In 2007, the Office of Immigration Statistics under the Department of Homeland Security estimated that over 11.8 million unauthorized immigrants were residing in the United States. American courts are increasingly confronting cases involving the custody of children where one of
Policy Making Process Welfare Reform Policy Analysis Success of welfare reform is ambiguous. Media and well-known public officials claim to have had achieved welfare reforms. However, after 4 years of new policy regime, majority also accepts that welfare reforms have been successfully achieved. Temporary Assistance for Needy Families (TANF) also validates this by stating that welfare rolls have dropped by 53% to 6.28 million recipients in June 2000 from 12.24 million
TANF? The Congress was exasperated with the AFDC's (Aid to Families with Dependent Children) cost, nature and scope, and thus decided to put an end to it. In 1994, a record number of families (5 million, with over 1/8th of American children) were enrolled in the program. Over 50% of the kids enrolled were born out of wedlock, and around 75% had a physically-fit parent not living with them (Blanche,