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In order to qualify for Medicaid, applicants must first fit into a certain category. These categories include children, parents of eligible children, pregnant women, and the disabled or elderly. If an applicant fits one of these categories, then the household must meet the requirements for income and resources. These limits vary according to the category of Medicaid and are the basis for determining whether Medicaid will pay for all or some of the health coverage needed. Verification of citizenship and identity is required and immigrants who are permanent residents but not yet citizens must meet certain criteria before they can qualify, including having been in the country for six years and having a minimum number of work quarters earned from Social Security.

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Medicaid is a health program that is funded by the federal government but administered by the state, so each state may have its own particular requirements and guidelines. Medicaid was created in 1965 and gradually adopted by all states. The program provides nursing home assistance and complete health coverage including dental care to qualified applicants for no charge, except in some cases where a spend-down (increment) or small co-pay may be required.

Benefits of Medicaid:

Full benefits under Medicaid are generally available only to children and the elderly or disabled. These benefits include dental and vision services, but use of these services is low compared to regular medical services. There are fewer providers of dental and vision care who will accept Medicaid as a payer, so these are underutilized. It may be difficult for Medicaid recipients to find providers in these areas in their state.

A valuable benefit of Medicaid is that there is a 3-month period in which a person can apply to have past medical bills paid by the program. This retroactive coverage means a family can apply for assistance after a medical event occurs and they realize they need the assistance. The household still must meet all requirements for the program, but it may cover bills for services incurred up to 3 months before the application date.

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