Medicare and Medicaid programs and policies

Medicare and Medicaid

An important part of health care delivery within the state of Pennsylvania involves access to services such as Medicaid and children's insurance programs. These programs help families in need to obtain health services in order to maintain a high level of health and well-being. There are certain strengths and weaknesses exhibited by the population of Pennsylvania that may influence the consumption of insurance services.

According to the United Health Foundation (2012), Pennsylvania demonstrates strengths such as a low rate of uninsured population, high availability of physicians involved in primary care, as well as a high rate of high school graduation. In regard to weaknesses, the state of Pennsylvania has exhibited high air pollution levels, low funding for public health per capita, as well as a high prevalence of diabetes (United Health Foundation, 2012). Also, obesity as increased dramatically in the past decade, from 21.2% to 29.2% of the adult population within the state (United Health Foundation, 2012). These weaknesses may contribute to greater access to health services within the state.

Medicaid is available as a program that provides healthcare services to eligible individuals in need. In order to receive benefits from the program, individuals must meet certain eligibility criteria, such as income status and resource accessibility (Pennsylvania Department of Public Welfare, 2012). Categories for eligibility include the following: individuals over the age of 65 and are blind and disabled; families that have children who are under the age of 21; single and married people who have a temporary disability, individuals age 59 to 64, and people with limited income or have other special circumstances; and people who have special medical assistance conditions (Pennsylvania Department of Public Welfare, 2012).

In regards to income, eligibility for Medicaid in Pennsylvania is determined through the comparison of household size and income to limits of income, and age and disability are also factored into the equation in the determination of income limits (Pennsylvania Department of Public Welfare, 2012). Income is calculated including wages, interest, social security, dividends, pensions, veterans' benefits, and spousal income (Pennsylvania Department of Public Welfare, 2012). Certain types of income are not included in the determination of eligibility. These include temporary assistance benefits, supplemental security income, foster care payments, and housing and utility subsidies to name a few (Pennsylvania Department of Public Welfare, 2012).

Resource limits are also used in the determination of eligibility for Medicaid (Pennsylvania Department of Public Welfare, 2012). Resources counted include cash, savings and checking accounts, stocks and bonds, as well as life insurance among others (Pennsylvania Department of Public Welfare, 2012). Certain resources such as one's home and one motor vehicle are not included in the determination of eligibility.