Medicaid 101: Everything You Need to Know

Medicaid 101: Everything You Need to Know

Oct 19 2020

Get the facts about Medicaid and learn how to enroll.

How much do you know about Medicaid, the state and federally-funded health insurance program? Whether you’re currently on Medicaid or looking to get covered, here’s a quick and easy breakdown of this program.

What is Medicaid?

Signed into law in 1965, Medicaid is a state and federally-funded program that provides health coverage to eligible low-income adults (including pregnant women), low-income individuals age 65 and older, children and people with disabilities. As of December 2019, 75 million Americans are enrolled in Medicaid, making it one of the largest sources of health care funding in the US. In Michigan, over 2.3 million people have Medicaid.

Most people on Medicaid get their insurance through a private insurer, like Priority Health. We work with the government to provide Medicaid services through our network of doctors and hospitals. There is a list of services required by law to be covered. States can also choose to cover more services like dental care, vision, and physical therapy.

What’s the difference between Medicare and Medicaid?

It’s easy to get these two programs confused. Medicare is a federal health care program for people age 65 or older or some people with disabilities, regardless of income. Medicaid is a state and federal program that provides health care coverage if you have a low income. In Michigan, there is an expanded Medicaid program called the Healthy Michigan Plan, which offers more benefits than regular Medicaid.

Think of it this way: Medicare is for elder care. Medicaid provides aid to those with a low income.

What is the Healthy Michigan Plan?

The Healthy Michigan Plan is Michigan’s expanded Medicaid program and provides health benefits at a low cost. A Healthy Michigan Plan covers more than original Medicaid. For a list of coverage under the Healthy Michigan Plan, visit the Healthy Michigan Plan Handbook.

To be eligible for the Healthy Michigan Plan, you must:

  • Be 19-64 years old
  • Have an income at or below 133% of the federal poverty level
  • Not be enrolled or qualified for Medicare
  • Not be pregnant at the time of application

Since its adoption is 2014, the Health Michigan Plan has allowed members to access a huge range of health care services, including helping nearly 700,000 members see a primary care doctor. This expanded access has also led to:

  • 5 million preventive care visits performed
  • 4 million dental visits
  • 370,000 mammograms
  • 100,000 enrollees screened for colon cancer

To learn more about Medicaid, check eligibility and enroll, visit the Medicaid section of our website.

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