Medicaid is a government funded health insurance benefit program created in 1965 and designed to provide health insurance to certain low-income families and individuals. To qualify for Medicaid, certain financial criteria must be met. A large number of Americans have applied for, and receive these health insurance benefits. Many other people have no health insurance and live in dread of a medical emergency.
Hospitals are required to provide treatment to patients who have acute medical emergencies. For the individual without health insurance, this can be a stressful situation. However, in certain situations, millions of American may be entitled to Emergency Medicaid benefits.
Just as each state administers its’ own Medicaid program, individual states also administer their Emergency Medicaid programs. Unlike regular Medicaid or private insurance, these benefits are intended to provide payment for certain patients experiencing acute symptoms that could negatively impact the life or health of a patient, or the dysfunction of a body part or organ. A doctor’s report is usually required to substantiate the severity of the problem.
Emergency Medicaid cannot be applied for ahead of time. It is designed to meet a sudden, critical medical need. Most people realize that they need this benefit only after an emergency occurs. Hospitals and clinics can often assist with the application process. To apply, the individual will need to provide recent pay stubs (if available), bank statements, valid identification (such as a driver’s license), and a utility bill to prove residency. For children needing Emergency Medicaid benefits, the eligibility determination is generally based on the financial criteria of the parents or legal guardians.
When individuals are hospitalized with acute critical conditions, families have some options in applying for Emergency Medicaid benefits. They may visit the local social service department to get the eligibility process started. Paystubs, bank statements, proof of residence, and identification are required. The individual will be assigned a case worker to assist in the process. For convenience, many people choose to apply for benefits online. When using the online application process, it is important to review all the information before submitting the application. Errors on the application may result in delays. The Medicaid office in the state of residence has an online application. State offices can also assist individuals who wish to apply by phone.
If time is not critical, applications may be submitted by mail. The time required to complete the process by mail takes considerably longer than the online or telephone process. Once again, emergency Medicaid benefits are intended to pay for urgent, critical medical treatment, so this may not be the best option.
While citizenship or legal immigration plays no part in awarding these benefits, the other benefits for Medicaid must be met. To qualify for regular Medicaid, persons must meet certain income criteria. Other factors, including the individual’s age and the ownership of property are also considered when determining eligibility.
Chronic conditions including heart disease will not be covered unless there is an immediate danger of death or serious health risk. An eligible patient experiencing a heart attack may be covered. However, a person with chronic heart disease would not be eligible for Emergency Medicaid benefits. Uninsured pregnant women may be covered for labor and delivery, but routine prenatal care would not be covered unless a condition arises that might endanger the life of either the unborn child or the mother.
Emergency Medicaid is not a pre-approved benefit. Uninsured and under-insured individuals should apply for regular Medicaid before an emergency arises. However, for those uninsured individuals who find themselves facing a critical emergency situation, Emergency Medicaid is an option to consider. Since states manage their own Medicaid programs, rules for eligibility may vary slightly and persons seeking Medicaid benefits should check with the Medicaid office in their state. The best time to prepare for a medical emergency is before the emergency occurs. When this cannot be done, Emergency Medicaid is available to assist those eligible individuals. It is important to remember that when a medical emergency arises, even without regular Medicaid or private health insurance, treatment is still available. Individuals arriving in emergency rooms without any type of health insurance may still be able to have their costs covered by Emergency Medicaid.