WHAT IS MEDICAID?
Medicaid benefits are healthcare for individuals who have a low-income. Medicaid also provides healthcare to some pregnant women, children, elderly individuals, and women with breast or cervical cancer. The Medicaid program is paid for from the resources of the states and the federal government.
Most importantly, Medicaid is a healthcare benefit that is available to you if you are eligible for Supplemental Security Income benefits. However, to qualify for Medicaid, you must not only be disabled. You must also meet the income and asset requirements of the state in which you live.
The Medicaid program was signed into law in 1965 alongside Medicare. Go here to find out more information about Medicare benefits. All states, the District of Columbia, and the U.S. territories have Medicaid programs. The Federal government establishes certain Medicaid rules for all of the states to follow. However, each state administers their own Medicaid program. Therefore, Medicaid coverage rules vary from state to state.
WHO IS ELIGIBLE FOR MEDICAID?
In order to be eligible for Medicaid benefits, you usually have to be a resident of the state in which you receive Medicaid. Additionally, depending on the state in which you live, you may need to be a U.S. citizen, permanent resident, or a legal alien. Likewise, you will need to have a very low income.
Additionally, you may be eligible for Medicaid benefits if you are one of the following:
- Pregnant, or
- Responsible for a child 18 years of age or younger, or
- Blind, or
- You have a disability or a family member in your household has a disability.
If you are a household of one, for example, and your yearly income is less than $17,000 before taxes, then you may qualify for Medicaid. The amount of yearly income goes up depending on how many people live in your household. If you have four people living in your home, for example, then you may eligible for Medicaid if your yearly income is less than $35,000. The bar to receiving Medicaid is very low and hasn’t gone up in years. Currently, there is talk in Congress of raising the income levels, so more people qualify for Medicaid.
MEDICAID COVERAGE DIFFERS BETWEEN STATES
Please remember that eligibility for Medicaid benefits differs between states. So, the amount of yearly income that qualifies you in one state may not be the same if you move to another state.
For example, in 2021 a single adult without children in Utah — a state that belatedly expanded Medicaid under the Affordable Care Act — had to earn less than $1,481 a month to qualify. In Texas, which has not expanded its program, adults without children do not qualify for Medicaid.
Coverage rules may also be different. You may have coverage for certain procedures in Colorado, for instance. But if you move to Nevada, those same procedures may not be paid for. You need to check with Medicaid in the state you live to be sure of your healthcare coverage. Go here to read more about raising income and asset limitations for Medicaid.
MEDICAID BENEFITS EXPANSION UNDER THE AFFORDABLE CARE ACT
The Affordable Care Act gives states the authority to expand Medicaid eligibility to individuals under age 65 in families with incomes below 133 percent of the Federal Poverty Level (FPL). It also standardizes the rules for determining eligibility and provides benefits through Medicaid and the health insurance Marketplace. Some states, however, chose not to expand Medicaid to their citizens under the ACA.
States who elected not to expand Medicaid under the ACA include: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming.
Utah was also one of the states that did not originally expand Medicaid benefits to its citizens. However, in January 2020, full Medicaid expansion in Utah took effect. Now, adults between the ages of 19-64, with household incomes up to 138% of the poverty level are eligible for Medicaid in Utah. As of May 2021, there were more than 60,000 low-income adults covered under Utah’s Medicaid expansion program. The federal government is paying 90% of that cost.
By contrast, Nevada expanded Medicaid in 2014, and as a result, 204,000 people became newly eligible for Medicaid coverage. Most of those newly eligible people were childless adults who were working, but whose employers did not offer health insurance.
Nevada’s acceptance of federal funds to expand Medicaid eligibility to 138 percent of the poverty level has reduced the state’s uninsured population. As of February 2021, average monthly enrollment for Nevada Medicaid/CHIP had grown by more than 436,000 people since late 2013 – a 131% increase.
MEDICAID BENEFITS COVER THESE HEALTHCARE COSTS
While this is not a comprehensive list, below you will find the majority of healthcare costs that Medicaid covers:
- Birth Control
- Case Management
- Home Health
- Lab and X-ray
- Maternity and Midwife Services
- Medical Supplies
- Nursing Home
- Over-the-Counter Drugs
- Personal Care
- Physical/Occupational Therapy
- Speech and Hearing
- Interpreters: If you do not speak English, Medicaid will find someone who speaks your language to tell you about Medicaid. Interpreters are free.
- If you use sign language, then Medicaid will have someone who signs your language tell you about Medicaid.
- Utah Relay Services is a free public telephone relay service or TTY/TTD. They will help you if you are hard of hearing. Please call:
- Utah Relay Services at 711 or toll-free 1-800-346-4128
- Spanish Relay Utah toll-free 1-888-346-3162
MENTAL HEALTH SERVICES:
- Case Management Services
- Individual and Group Therapy
- Inpatient mental health services
- Medication Management
- Personal Services
- Psycho-educational Services
- Psychosocial Rehabilitation Services
- Psychological Testing
- Respite Care
As you can see, Medicaid benefits cover a variety of healthcare needs. This includes standard doctor visits and even end of life care. Remember to check with you state to see what services they cover. If you apply for SSI benefits under the compassionate allowances program, you will also receive Medicaid.
HOW TO APPLY FOR MEDICAID BENEFITS IN UTAH
In Utah, you can apply for Medicaid in person, by mail, or online. When the Department of Workforce Services (DWS) receives you application, they will contact you by mail or phone. DWS may need more information to determine if you are eligible for Medicaid. DWS will also tell you the type of paperwork you will need to provide, like a birth certificate.
- Click here to apply for Utah Medicaid Online
Please Note: If you apply online, you do not need to fill out a paper application.
- By Mail
- Download a Medical Application.
- Mail completed application to:
Department of Workforce Services
PO Box 143245
Salt Lake City, UT 84114-3245
- By Fax
- Download a Medical Application.
- Fax completed application to:
Department of Workforce Services
Toll-free Fax: 1-888-522-9505
- In Person
- Download a Medical Application.
- You may apply at any Department of Workforce Services (DWS) office. Please click here and type in your zip code to find an office near you.
For answers to your questions on how to apply, please call the Department of Workforce Services (DWS): Salt Lake County (801) 526-0950 or Toll-free 1-866-435-7414.
UTAH MEDICAID CARD
In Utah, each Medicaid member will get a Medicaid card. The card will have your name on it. It was also have your Medicaid ID number and your date of birth. Obviously, this information identifies you as the only holder of the card. If something happens to your card, call DWS to ask for a new one.
Show your Medicaid card before you receive any doctor’s services. If you have a health or dental plan, the plan may send you a card. Show both your Medicaid card and plan card when you see providers or get a prescription.
Your providers may ask to see photo ID with your Medicaid card. You can use a government issued photo ID like your driver’s license or a state ID card with your photo on it. It is up to your doctor’s office to tell you what other ID they will accept. Find out more about Utah’s free and low-cost heath services here.
HOW TO APPLY FOR MEDICAID BENEFITS IN NEVADA
In Nevada, depending on your income and family size, you may qualify for Medicaid benefits. If you do qualify for Medicaid, there is no limited-enrollment period. This means, for instance, that you can enroll for Medicaid benefits at any time.
Nevada households with annual incomes of up to 138% of the federal poverty level may qualify for Medicaid. This is $16,753 per year for an individual, or $34,638 per year for a family of four. Additionally, it is important for you to know that paper claims are no longer accepted by Nevada Medicaid. Therefore, you will have to apply for Medicaid benefits online.
For more information on Medicaid and to see if you’re eligible for it in Nevada, visit Access Nevada. Access Nevada is the one stop portal for residents of the State of Nevada to apply for Medicaid. You can also report changes in household circumstances, check the status of your case, and use other account management tools. You can learn about the different programs available to you through Access Nevada.
OTHER HEALTH INSURANCE RESOURCES IN NEVADA
- Silver State Health Exchange
Information about exchange planning and start-up operations
- State Exchange Profile: Nevada
The Henry J. Kaiser Family Foundation overview of Nevadaʼs progress toward creating a state health insurance exchange.
- Nevada Governorʼs Office for Consumer Health Assistance
Serves all residents with health-related issues; benefits, denials, insured, uninsured, worker’s compensation, and hospital billing.
(702) 486-3587 / Toll-Free: 1-888-333-1597 (nationwide)
- Also, remember that even if you do not have Medicaid, there are free and low cost services in Nevada. Go here for more information about Nevada’s free and low cost mental health services.
FINDING A DOCTOR THAT ACCEPTS MEDICARE AND MEDICAID BENEFITS
To find a doctor that accepts Medicare payments, you may want to visit the Centers for Medicare and Medicaid Services’ Physician Compare. You can search for a doctor by entering their last name or group practice name. You can also search by medical specialty, a medical condition, a body part, or an organ system. This tool provides you with a list of doctors and group practices in the geographic area you specify. It also offers detailed doctor profiles, maps and driving directions to the doctor’s office.
You will find that Physician Compare only lists doctors that accept Medicare. Although some physicians may also accept Medicaid, the program does not have information about which doctors accept Medicaid. However, the Medicaid agency in each state maintains their own list of doctors that accept Medicaid. Also, you can call your doctor’s office and ask them if they will accept Medicaid as a form of payment.
MEDICAID BENEFITS DURING COVID-19
The COVID Medicaid continuous coverage requirement was enacted under the Families First Coronavirus Response Act. This gave states a 6.2 percentage point increase in federal funds if they agreed to maintain Medicaid eligibility levels in place at the time.
Before the COVID-19 pandemic, states regularly reviewed if people still qualified for Medicaid, based on their income or their disability status. During COVID, Medicaid review has been suspended for the past two years. This means those on Medicaid stayed on Medicaid during the pandemic. Therefore, Medicaid enrollment is currently at a record high.
As of July 2021, 76.7 million people, or nearly 1 in 4 Americans, were enrolled, according to the Centers for Medicare & Medicaid Services. However, when the public health emergency ends, state Medicaid officials will need to reevaluate each person’s eligibility. People could lose their coverage if they earn too much money. They can also lose Medicaid coverage if they don’t provide the information their state needs to verify their income or residency. Typically, most people lose coverage by failing to return their paperwork to Medicaid.
MEDICAID BENEFITS AND CANNON DISABILITY LAW
Cannon Disability knows that Medicaid benefits are not a free handout. In fact, the majority of disabled people who apply for Medicaid are denied health insurance through the program until they prove that they are disabled. Proving disability to the SSA can take up to two years. During that time, people with severe disabilities are living without health insurance and other basic needs. Oftentimes, these are people who have worked their entire lives.
If you have ever suffered a serious accident or sickness, then you know how quickly healthcare costs can eat away at all of your savings. It is one of Cannon Disability Law’s goals to help our clients receive SSI benefits and Medicaid as soon as possible. That way, our clients have the healthcare benefits they need to treat their impairments.
CANNON DISABILITY’S REPRESENTATIVES CAN HELP YOU TODAY
Cannon Disability’s lawyers can help you win SSI benefits. Once you win SSI benefits, then you automatically get Medicaid. If you are looking for a lawyer to help you, then you are in the right place. You can trust us.
If you want to know more about Cannon Disability’s representatives, then go to our About Us page. There you can read about our legal experience. For example, Andria Summers can help you with your Medicare plan. However, she also knows the rules of Medicaid eligibility. Dianna Cannon has been representing disability claimants for thirty years. Likewise, she has also won thousands of disability cases. Brett Bunkall also has significant experience helping people obtain their SSI and Medicaid benefits.
In the past 30 years, we have won over 20,000 disability cases for our clients. Also, we have helped many people receive Medicaid benefits. Our specialists can help you apply for SSI and SSD benefits using the SSA’s website. SSI benefits require you to have minimal assets and low monthly income. Therefore, we will need your input about your finances to complete your SSI application.
CANNON DISABILITY WORKS ON A CONTINGENCY FEE BASIS
If you need SSI and Medicaid benefits, then you may want to hire an attorney to help you with your case. In order to hire Cannon Disability, all you need to do is call or contact us. We offer a free consultation over the phone. And, it doesn’t cost anything to call us.
Better yet, it also doesn’t cost you any upfront money to hire us. Why? Because you only pay us an attorney fee when we win your case. This is a contingency fee. It means if we win your SSI case, you pay the attorney fee out of your back benefits. If you do not win your case, then there is no attorney fee to pay.
If there are costs in your case, then you pay those. In most cases, however, costs are less than $100. Once we win your SSI case, we are paid from your back benefit. However, to hire most lawyers, you have to pay upfront fees. We don’t work like that. You don’t have a job. So, the only way for you to pay us, is for us to win your case.
Finally, we want you to have the SSI and Medicaid benefits you need to take care of yourself and your family. Take advantage of our free consultation. Call now. See what we can do for you. Let our legal team answer your questions about SSI disability benefits and Medicaid benefits.