Public Health Insurance
Public health insurance, also called Medicaid, is a health insurance plan that is funded jointly by both Federal and State governments. As opposed to other types of insurance like car insurance, it is estimated that over 36 million people are covered by public health insurance. This includes disabled people, elderly people, children, and those with low incomes. There are some important aspects of Medicaid that can help you understand how it works and what the benefits are.
How Public Health Insurance Works
The Federal government has set guidelines for Medicaid that give states an outline of coverage to follow. Within these guidelines, each state has the right to set their own rates, types of coverage, length of coverage, and how individuals apply for coverage. Each state is then responsible for administrating its own plan.
Who Is Covered
Coverage is based on income. There are different levels of coverage. Some coverage is full coverage and includes all family members. Other coverage is partial and requires a co-pay, which is usually small, and only children are covered. Each state decides the income requirements based on their state’s per capita income and poverty level. Typically, children will be covered even if adults in the family are not eligible.
What Is Covered
The purpose of Medicaid is to provide quality health care for families who find themselves in a low income situation. In a perfect system, the coverage would produce healthy individuals who in turn could continue to work and provide for their families eventually being able to transfer to private health care through an employer.
In light of this, Medicaid typically covers all major medical conditions and situations. Again, this varies slightly from state to state. Physician visits, specialists, immunizations, wellness visits, lab work, x-rays, medical tests, clinic visits, hospitalization, and typically encountered medical situations are covered by public health insurance.
Dental coverage is optional for adults and this will typically be decided by each state. But for children, dental coverage is mandatory. Children who are covered under Medicaid and who are under the age of 21 must has access to dental care. This coverage provides for cleanings, oral surgery, sealants, caps, fillings, and other typical and situational dental needs that arise in children.
Also optional for adults but mandatory for children is vision coverage. Yearly eye exams and prescriptions for glasses are covered for children. Adults may find coverage for yearly exams and glasses as well, though some states still restrict this. A trickier task for adults is finding a provider for eye care and dental care. Many providers choose to only accept Medicaid for children leaving waiting periods for appointments up to a year.
Some individuals who are not eligible for full Medicaid coverage may qualify for special coverage conditions. These conditions are for the specific diseases of Breast Cancer, Cervical Cancer, and Tuberculosis. This coverage is an option set forth in Federal guidelines but decided on by each state. States with higher percentages of these diseases may be more likely to approve this special coverage.
Prescription Drug Coverage
Medicaid offers a full prescription drug coverage plan to most eligible families and individuals. Like doctor’s visits, there may be a co-pay due when picking up a prescription but this amount is usually under $5. Co-pays with private insurance usually run between $10 and $40 for visits. Having prescription drug coverage is important for the elderly, children, and everyone in between. Following a doctor’s prescription can lead to a healthy resolution to illnesses and medical conditions.
For children, much needed antibiotics and other highly prescribed medications such as inhalers are available at no charge. Going without proper prescriptions can increase medical complications so Medicaid works hard to provide coverage for all prescriptions both generic and name brand.
Outreach And Education
One of the many benefits of having public health insurance is the outreach and education offered through each state. Federal guidelines require states to offer outreach and education programs for those who are on Medicaid. This includes information sent in the mail, free parenting classes and other education classes, disease prevention seminars, and reminders about immunizations and wellness checks for children.
Reaching out to those in need of medical insurance who may not be able to travel to an office or may not know how to apply for public health insurance is also an important part of what Medicaid does. Through public schools, daycares, and community centers Medicaid employees seek out those who may be eligible but have not yet applied for coverage.
Public health insurance is a good option for those who find themselves in a low income situation whether temporary or long term. Going without health insurance is not necessary when every state offers a public health insurance option. However, for many this public insurance is not an option. In this situation, you will want to look into the choices for private insurance.
Use the free quote tool on this page to get information from providers on your options. Also, agents at the number listed above are available to answer any insurance related questions you have. Why not take the first step to getting the best coverage for your needs by putting your zip code into the box above right now?
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