Medicaid is the United States health program for individuals and families with low incomes and resources. Who funds Medicaid? Well, it is jointly funded by the states and federal government, and is managed by the States. Medicaid is basically for low-income individuals that include,

  • Children,
  • Pregnant women
  • Parents of eligible children
  • Seniors
  • People with disabilities

Medicaid was created through Title XIX of the Social Security Act on July30, 1965. Individual states monitor their own Medicaid programs and may also have their own names. Thus, Medicaid also helps eligible individuals that have no medical insurance or poor health insurance.

Medical Billing of Medicaid and Medicare are very different processes. The main difference between these two programs is that while Medicare is entirely funded at the federal level, Medicaid is not solely funded at the federal level. It is more of a needs-based social protection program than a social insurance program.

Medicaid payments assist nearly 60 percent of all nursing home residents and about 37 percent of all childbirths in the United States. The biggest chunk of the federal money that is spent on the HIV positive people is provided by the Medicaid program. Poor people who are HIV positive must progress to AIDS before they become eligible. Over 50% of the people living with AIDS are estimated to receive Medicaid payments.

During the 1990s, many states created the Medicaid Managed Care programs. Under this scheme Medicaid recipients are enrolled in a private health plan, which receives a fixed monthly premium from the state. Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is a mandatory Medicaid program for children that aims to focus on prevention on early diagnosis and treatment of medical conditions. In some states Medicaid is subcontracted to private health insurance companies, while other states pay directly to the health providers. The poor children and parents are usually enrolled in managed care, while the aged and disabled eligibility groups go for the “fee for service” Medicaid.

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