Is Medicaid an Insurance?
I am at a dilemma right now. I do not believe Medicaid should be classified as an insurance. When I think of insurance, I think of something where the individual, or the individual's employer, pays money to an insurance company. Medicaid is not payed by an individual's employer (it's paid for by me and my employer).
I don't know how many times I have patients who say, "I have insurance," when they have only medicaid. Something they are getting for not working and not being able to stop procreating. Now, don't think I am anti-medicaid/anti-poor people. I'm not. I think someone should be on medicaid only for a max time of 6 months, unless they are under 18 (I have no problem with kids being on medicaid), or someone who has an actual illness/disability (not ADHD/ADD/depression but advanced MS or severe Cerebal Palsy) and are not able to work.
What does everyone else think? Should Medicaid be considered an insurance?
I don't know how many times I have patients who say, "I have insurance," when they have only medicaid. Something they are getting for not working and not being able to stop procreating. Now, don't think I am anti-medicaid/anti-poor people. I'm not. I think someone should be on medicaid only for a max time of 6 months, unless they are under 18 (I have no problem with kids being on medicaid), or someone who has an actual illness/disability (not ADHD/ADD/depression but advanced MS or severe Cerebal Palsy) and are not able to work.
What does everyone else think? Should Medicaid be considered an insurance?
posted by Leon @ 04:33
3 Comments:
At 8:28 AM, September 16, 2006 ,
Anonymous said...
Medicaid is unlike commercial or private insurance in some aspects in that:
Each state operates Medicaid with different rules and covered services. You may be eligible in one state and not in another, depending on program rules. Therefore there is no guarantee Medicaid coverage when you are traveling. This includes emergency services
In NH, you must meet income and resource requirements and certain eligibility categorical criteria: minor children, disabled, or pregnant. You may also be eligible if if you are 65 or older, have a physical or mental disability and have been (or will be) unable to work for more than 48 months, are legally blind, have minor children, are pregnant, are a child with a severe disability, reside in a nursing facility or are in a foster care placement.
If you apply for assistance because of a disability, your disability must be a continuous impairment for 48 months in accordance with NH Administrative Rules.
NH Medicaid is health insurance in that
Medicaid does not pay persons directly, but sends payments directly to health care providers.
If you also have other coverage (health insurance through employment, Medicare, etc.), you must always use that insurance first. Medicaid is considered secondary.
There are no other co-pays required by Medicaid, however, you may be required to pay a co-pay for prescription drugs, depending on the category of assistance you are covered under. Medicaid has very particular lists of what is approved for prescription and service coverage.
If you receive services from a non-enrolled provider or you do not follow the rules of private insurance you carry, you can be held responsible for charges that are incurred.
before using your Medicaid benefits.
At 5:15 PM, September 16, 2006 ,
Leon said...
Why are mothers always practical? Aaahhh...my next blog...
At 9:46 AM, September 18, 2006 ,
Bobby Wales said...
Unfortunately, as you have noticed, what Medicaid is designed to do and how it is actually used are two very different things. I also run into a huge number of people who abuse Medicaid regularly. The problem is the concept that "I am disadvantaged because I'm ________ (unemployed -quit my job, uneducated-dropped out of school, the parent of too many kids- I have no self discipline) and therefore everyone else who is not disadvantaged because they're ________(educated- worked their way through college, employed- they work whether they enjoy it or not) owes me and should take care of me.
Whenever the government tries to take care of those who are truly disadvantaged because of severe disabilities, people crowd in line to take advantage of the situation.
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