Authored By: Legal Services Alabama
What is Medicaid?
- Medicaid is a state program that gets federal money. It helps low income people.
- It pays for doctor visits, medicines, hospital care, nursing homes and other medical care.
- Medicaid pays doctors, hospitals, druggists and others directly.
- Unlike insurance, if you pay the bills yourself, you can't get paid back.
- Do not confuse Medicaid with Medicare. Medicare is a separate federal program for people who are disabled, over 65 or in need of dialysis.
Who is eligible for Medicaid?
- Everyone who receives SSI
- Everyone who receives Family Assistance. Many call Family Assistance "ADC" or "welfare".
- Some people who can't get Family Assistance because of 1996 changes in the law
- Children who lost SSI in 1996 because of changes in the law
- Babies up to one-year-old who were born to a mother on Medicaid
- Children under six and pregnant women with income below 133% of the federal poverty level. See Free or Low-Cost Health Insurance for Pregnant Women and for Children.
- Children under 19 in families with income below 100% of the federal poverty level. Once eligible, they remain eligible for at least a year. See Free or Low-Cost Health Insurance for Pregnant Women and for Children.
- Families that lose Family Assistance because of an increase in child support. They can get four months of transitional Medicaid.
- Families that lose Family Assistance because of work income. They can get at least a year of transitional Medicaid.
- Someone in a nursing home with total monthly income below three times SSI level
- Someone who is only able to stay out of a nursing home by getting special care
Someone who used to get SSI but got taken off because they:
- got a raise in their Social Security checks; or
- started getting Social Security checks as a widow or widower after 50, but before 65; or
- started getting Disabled Adult Child's benefits when they turned 18.
What other help can Medicaid give me?
- Transportation to medical care
- Prenatal care for pregnant women
- Children can get more benefits after they are screened through the EPSDT program. See A Parent's Guide to Medicaid Screening (EPSDT Benefits)
- Medicaid "QMB Program" pays Medicare premiums, deductible and co-insurance for people on Medicare with income below the federal poverty level.
- Medicaid "SLMB Program" pays Medicare Part B premiums for people on Medicare with income below 120% of the federal poverty level.
- Qualified Disabled Working Individuals can get Medicaid to pay their Medicare Part A premium.
Where do I apply for Medicaid?
- Babies whose mother was on Medicaid get Medicaid automatically for up to one year. During that year, the mother should apply at the welfare department or the health department.
- People who are on Family Assistance or SSI don't have to apply. They get Medicaid cards automatically.
- If you could get Family Assistance, but you decide not to get it, you can apply for Medicaid for your family. You can go to the DHR (welfare) office to apply for Medicaid when you apply for food stamps.
- Children under 19 and any pregnant woman can apply at the county health department or at most hospitals and rural clinics. Call Medicaid to learn the nearest location.
- To apply for Medicaid in a nursing home, call Medicaid to learn the nearest Medicaid District Office.
- People who used to get SSI but got cut off should call Medicaid to learn the nearest Medicaid District Office.
- People on Medicare who want to apply for QMB or SLMB should call Medicaid to learn the nearest Medicaid District Office.
Where can I get more information?
- You can call Medicaid at 1-800-362-1504.
- If you are deaf, call the TDD number: 1-800-253-0799.
- You can visit Alabama Medicaid's website to get A Medicaid Primer (PDF).
Reviewed March 2012
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