What is Medicaid?
Medicaid is a program that may help you or someone in your family access medical care based on income or a disability.
Medicaid was established through the Federal Government’s Title XIX of the Social Security Act (SSA). It is Intended to cover medical, dental and behavioral health services. In Colorado, Medicaid was extended to include those with disabilities who qualify for a Waiver program or buy-in. For more info on the Waiver and Buy-in programs, please see those sections of this training module.
Medicaid was started in 1965 as a cooperative program between the Federal government and the states. Not all states have Medicaid. Currently, the Federal government adds one dollar for every dollar put into the program by the state of Colorado.
Requirements and Restrictions
Medicaid, in general, covers Medical expenses. It also operates within broad national guidelines. Colorado is empowered to determine eligibility standards; amount, type, duration and scope of medical services; and rate of payment for providers.
In-state services are included. Out of state services are also included, but only for treatments that are medically necessary but unavailable in Colorado. However, Medicaid does not transfer state-to-state. For example, Colorado Medicaid may not be used in Vermont.
Medicaid can be used as a secondary insurance to your primary health insurance to cover copays and deductibles.
Medicaid can also cover items not covered by some private health insurance plans, such as:
- behavioral health services
- substance abuse,
- glasses, or
- oral health.
This is just a brief overview of Colorado's Medicaid Program. If you would like to read more about Medicaid, please consult the state office of Health Care Policy and Financing website, the Center for Medicare & Medicaid (CMS) website or the Kaiser Family Foundation website.