Medicaid Plans for Seniors in USA

Medicaid plans for seniors in the USA are the nation's largest healthcare programme, providing comprehensive free or low-cost medical insurance to our country's most disadvantaged individuals and families.

75 million individuals in the United States have Medicaid coverage, allowing them access to a wide range of health services, hospitals, and health centres.

What Exactly is Medicaid in USA?

Medicaid is a health insurance programme that serves millions of children, veterans, pregnant women, persons with disabilities, and the elderly. Medicaid also supports millions of individuals who work but do not have health insurance from their employers or do not earn enough to afford it. It also covers 50% of all births in the US.

Medicaid is a combined federal-state programme that provides health care to almost all low-income people. Medicaid programmes, which vary by state, are funded by both the federal and state governments. Eligibility is often established by current income, family size, and residence, which includes qualifying non-citizens.

Many Medicaid recipients have unique healthcare needs, and the programme normally offers treatment and services to meet those needs.
Why Medicaid plans for seniors in USA important?

Medicaid has been a lifeline for many who have lost their health coverage or are unable to find jobs during the COVID-19 outbreak.

The epidemic has put a huge financial strain on many people and families across the country, and unemployment remains high. Right now, more than ever, ensuring access to Medicaid coverage is critical, and Providence is a champion for all Americans who rely on Medicaid for necessary care.

Who is Reliant on Medicaid in USA?

Millions of people rely on Medicaid for health care, including some of our country's most needy individuals and families. How well do you understand Medicaid's role in the lives of your friends, family, and loved ones?

Medicaid plans for seniors in USA provides coverage and assistance with:

  • Six out of ten working adults with modest earnings (who are not disabled or under age 65
  • Four out of every ten people suffering from opioid addiction are obtaining treatment
  • 1 in every 10 veterans under the age of 65
  • 50 percent of all births
  • 60% of older citizens who require long-term care
  • 47% of children with particular healthcare requirements

In compliance with NC Board of Drugstore and State of North Carolina rules, NC Medicaid recipients may get vaccinated at a participating retail pharmacy. Immunization pharmacists may give:

Hepatitis B, Hepatitis A, Pneumococcal Zoster
Serogroup B Meningococcal Vaccination against meningococcal disease
Tetanus, Diptheria, Influenza, and Human Papillomavirus COVID

These immunizations must be provided free of charge to Medicaid-eligible individuals. There may be no other form of cost imposed to a Medicaid or NC Health Choice beneficiary for getting the vaccination(s) at a participating pharmacy.

Medicaid Matters joined over 400 groups nationwide in urging Congress to eliminate the Medicaid coverage gap. Twelve states have not expanded Medicaid in accordance with the provisions of the Affordable Care Act. Advocates in Medicaid expansion states, including New York, are joining this campaign in a push for coverage fairness in Congress's Build Back Better Act.

The worldwide cap will be extended for another two years, according to the budget plan. The original Medicaid Redesign Team arbitrarily set the worldwide ceiling in 2011. It was not intended to allow the programme to evolve and react to New Yorkers' needs.

For more than a decade, the worldwide cap has imposed arbitrary and often opaque Medicaid cuts, often with little clarity into what was happening. These cuts were commonly invoked as a pretext to maintain Medicaid austerity at the expense of much-needed flexibility.

We need a budget that is focused on providing people with the care and services they require, rather than arbitrary figures that transform individuals into money signs.

The budget for this year recommends a modification in the mechanism used to compute the worldwide limit.

The cap would be based on the five-year rolling average of Medicaid spending projections within the National Health Expenditure Accounts produced by the federal Centers for Medicare and Medicaid Services actuary, rather than the ten-year rolling average of the medical component of the Consumer Price Index. While this move is meant to allow for growth and account for enrollee age and acuity, it maintains the cap.

Repeal of the cap would revoke the Division of Budget's power to make mid-year budget revisions while keeping within the cap.

Allow those with impairments and elderly adults equal access to benefits.

New York State raised Medicaid eligibility for most individuals to 138% of the federal poverty level under the Affordable Care Act. This extension did not include those with impairments or elderly adults (those with the income eligibility category "aged/blind/disabled," or ABD).

Medicaid Matters is pleased that the budget contains an increase in Medicaid income eligibility for persons with disabilities and older adults, expanding their eligibility from 84% of the federal poverty threshold to 138%, the same level as other adults.

We also thank the Governor for abolishing the asset condition for ABD recipients. These measures are critical steps toward resolving the present inequality in Medicaid eligibility in New York.

Unfortunately, the Governor's budget does not contain income eligibility expansion for the Medicare Savings Program (MSP), which is a critical component of the eligibility fairness agenda suggested by Medicaid Matters and other advocacy groups.

There are three Medicare Savings Programs that offer vital financial assistance to low-income older persons and adults with disabilities by offsetting Medicare premium payments. Qualified Medicaid Beneficiary (QMB), one of the MSP schemes, also pays Medicare coinsurance and deductibles.

All MSP members are immediately enrolled in the federal government-funded Full Low-Income Subsidy (LIS) for Part D, often known as "Extra Help." According to the US Social Security Administration, "Extra Help" saves customers $5,000 per year. Paying this monthly payment is a big hardship, especially for people of colour and persons with disabilities, who are more likely to have limited income and assets.

Increase coverage for immigrants under Medicaid plans for seniors in USA

Medicaid Matters applauds the Governor for raising the eligibility for the Essential Plan from 200% to 250% of the federal poverty threshold. This would grant access to the programme to tens of thousands of uninsured New Yorkers. However, the proposed budget does little to improve access to healthcare for immigrants.

Medicaid Matters supports the Coverage for All campaign, which advocates for all New Yorkers, regardless of immigrant status, to have access to affordable health coverage. A state-only coverage option would give about 150,000 New Yorkers affordable health insurance coverage.

We are also pleased that the Governor intends to pursue the federal option of extending post-pregnancy Medicaid coverage from 60 days to a full year. By giving much-needed access to coverage, this long-overdue measure will assist address parental health and mental health challenges.

This change, however, will exclude 3,500 immigrants who presently get state-only paid coverage through the Medicaid for Pregnant Women programme for the course of their pregnancy until 60 days after delivery.

Excluding immigrant women from Medicaid for Pregnant Women, coverage expansion would be the first time New York's Medicaid programme discriminates against immigrants. By excluding a group of post-pregnancy adults, the state would be undoing rather than advancing our mutual aim of lowering maternal death and morbidity for all New Yorkers.

The Legislature should guarantee that the Medicaid for Pregnant Women programme is expanded to include all presently eligible persons, including immigrants. Providing $24 million in state-only money would ensure that immigrants, like their citizen counterparts, get Medicaid coverage for 12 months after giving birth.

By sponsoring the workforce, you can promote community-based services and support.

New York has one of the nation's most severe home care worker shortages. People with disabilities and seniors who rely on home care to live independently in their homes simply cannot find caregivers willing to work at the salaries provided by Medicaid.

The Governor's budget includes one-time incentives ranging from $500 to $3,000 for all healthcare employees, including those in-home care. While incentives encourage employees to stay in employment, they do little to alleviate the workforce issue that threatens the right to reside in the community.

New York must invest in its employees by boosting salaries to remain competitive in the healthcare industry, especially home care. Medicaid Matters advocates for the inclusion of Fair Pay for Home Care in this year's budget, which would raise pay to 150% of the area minimum wage.

By recovering an across-the-board decrease made in last year's budget and giving an extra 1% across-the-board boost, this year's budget shields providers from Medicaid cuts incurred in past years.

Hospitals can also benefit from health facility transformation grants, which are budgeted for around $2.4 billion. To guarantee that safety-net hospitals are treated fairly in the allocation of this financing, we require openness, the use of health equality principles, and regional planning in the awarding process.

The distribution parameters for these monies must promote better access to health care for medically marginalised individuals and communities. The Department of Health should be obliged to show how each grant will address an identified need in the regional healthcare system.

By Sam Peterson | Oct 14 2022

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