Health care can be overwhelming, especially when it feels financially out of reach. That’s where Medicaid comes in—a lifeline for millions of Americans, offering health insurance coverage to those who need it most. Whether you’re navigating health issues, managing financial hardships, or simply trying to understand your options, Medicaid provides essential support.

Let’s take a look at what Medicaid is and who can typically access this health insurance plan. By the end, you should have a clearer understanding of how this vital program works and how it just may be able to help you or your loved ones. Ready to dive into Medicaid? Let’s start with an overview of the program itself.

Medicaid is a federal and state program that provides health coverage to low-income individuals and families who meet specific criteria. Established in 1965 under the Medicare and Medicaid Act, Medicaid has since grown into one of the largest healthcare programs in the U.S., covering over 70 million people. 

The program is jointly funded by the federal government and individual states. While the federal government sets broad guidelines, each state runs its own version of Medicaid. This leads to differences in coverage, eligibility, and benefits depending on where you live.

Medicaid’s primary purpose includes the following:

• Providing essential healthcare to individuals who might not otherwise afford it.
• Reducing health disparities by offering coverage to vulnerable populations, such as pregnant women, children, seniors, and individuals with disabilities.
• Focusing on preventive care to reduce the strain on healthcare systems and lower costs by preventing avoidable medical conditions.

A major benefit of Medicaid is its flexibility in addressing the unique healthcare needs of different populations. States are given the option to expand Medicaid coverage beyond federally mandated minimums. 

The Affordable Care Act (ACA) played a significant role in this by allowing states to expand eligibility to cover more low-income adults. As of 2024, 40 states and  Washington, D.C. have expanded Medicaid, providing coverage to millions of additional Americans.

Key Services Covered by Medicaid

• Doctor visits and hospital stays.
• Long-term care, which is often not fully covered by other insurance programs.
• Prescription drugs and medical equipment.
• Preventive care, such as vaccinations, screenings, and checkups.

Medicaid also plays a crucial role in providing coverage for vulnerable populations. This includes low-income families, individuals with disabilities, and seniors who may need long-term care. 

By covering preventive care services, such as vaccinations and annual checkups, Medicaid helps reduce long-term healthcare costs by keeping individuals healthier and preventing medical emergencies.

Medicaid vs. Medicare

While commonly confused, these two health insurance programs have separate eligibility requirements and serve different populations, although some seniors and disabled persons have both Medicaid and Medicare (dual eligibility).

• Medicaid focuses on serving low-income individuals of all ages and often provides comprehensive coverage, including long-term care and support services for individuals with disabilities.

Medicare primarily serves individuals over 65 or those with certain disabilities, with more limited coverage for long-term care.