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Simple English definitions for legal terms

Medicaid

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A quick definition of Medicaid:

Medicaid is a program that helps people who don't have a lot of money pay for medical care. It is paid for by both the government and the state. Medicaid covers things like going to the hospital, seeing a doctor, and getting therapy. People who use Medicaid have to choose from a list of doctors and other medical providers. The program is for people who live in the state and doesn't care how old they are or if they work. Sometimes people try to cheat the program, but there are laws to stop them from doing that.

A more thorough explanation:

Medicaid is a program that helps low-income individuals pay for medical expenses. It was created in 1965 as an amendment to the Social Security Act of 1935 and is jointly financed by state and federal governments. The program is administered by the Centers for Medicare and Medicaid Services.

Medicaid covers a variety of medical services, including:

  • In-patient hospital services
  • Out-patient hospital services
  • Laboratory and x-ray services
  • Skilled nursing home services
  • Physicians' services
  • Physical therapy
  • Hospice care
  • Rehabilitative services

Patients who use Medicaid are limited in their choice of medical providers. They must select from a pre-approved list of physicians and other medical care providers. This is because physicians are not fully reimbursed for services provided to Medicaid patients, so many of them limit the number of Medicaid patients they see.

States are not allowed to reduce other welfare benefits that people receive when they become eligible for Medicaid. Additionally, states cannot impose citizenship or residency requirements other than requiring that an applicant be a resident of the state. Neither the age of the applicant nor the fact that he or she works are restrictions to receiving Medicaid.

Unfortunately, Medicaid has been plagued by fraud from both health care providers and patients. To combat this, Congress passed a law in 1996 making persons criminally liable for committing fraud in order to become eligible for medical assistance.

For example, if a low-income individual needs to go to the hospital but cannot afford it, they may be eligible for Medicaid to help cover the costs. However, they must choose a medical provider from a pre-approved list and may not have access to all medical providers in their area. Additionally, if someone tries to commit fraud in order to become eligible for Medicaid, they may face criminal charges.

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