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How Medicaid Eligibility Requirements Differ in Various States

Medicaid is a federal and governmental health insurance program that pays for a wide range of medical services for people with low incomes and limited resources.

Lambrew (2005) stated that “…Medicaid is the nation’s largest means-tested program and its largest single health coverage program. Today, Medicaid serves around 50 million people, including low-income children, parents, people with disabilities, and seniors” (p. 43).

Thus, this paper introduces the information on how Medicaid eligibility requirements differ in various states. It draws a parallel and compares Medicaid eligibility requirements of two different states, such as Arkansas and Utah.

This is a well-known fact that there are special requirements that identify individuals who are appropriate for the eligibility groups:

  • The elderly who are over 65, disabled and blind people;
  • Low-income families (LIF);
  • Children under the age of 21 living in the family or who are deprived of support, that is, who do not have parents or have incapacitated parents, unemployed or part-time parent;
  • Pregnant women who have no other children, and who do not fall under the category of “LIF”;
  • Recipients of Supplemental Security Income (SSI);
  • People who look after children under the age of 18.

But despite this fact each state has its own specific rules and requirements for obtaining medical assistance.
Since each state takes a decision what category of people is eligible for Medicaid assistance let us focus our attention on Arkansas and Utah Medicaid eligibility requirements.

Speaking about Arkansas Medicaid eligibility requirements, it is possible to say that in order to get full Medicaid benefits a person should be appropriate for the following specific groups:

  • The elderly (aged 65 or over);
  • Pregnant women;
  • Individuals with disabilities;
  • Blind people;
  • Women who have cervical cancer or breast;
  • Persons who live in nursing homes;
  • Children in foster care;
  • Individuals under age 21;
  • Teenagers under the age of 19.

Moreover, Arkansas Medicaid offers the programs, such as “ARKids First-B, Medicaid Spend-Down, Women’s Health (Family Planning), Medicare Savings Programs (QMB, SMB, and QI-1), and Tuberculosis (TB)” (Arkansas Medicaid, 2011, para. 4).

ARKids First-B is a program that is available for teenagers (under the age of 19) who have no medical insurance, which their parents can have on them, or just are not able to use it. For instance, the doctors cannot take health insurance even if a parent has medical insurance on his/her children who reside in Arkansas, but he/she lives outside this state. In this case, a child can use ARKids First-B.Medicaid Spend-Down is available for people who are very sick and need attention and care.
Women’s Health (Family Planning) is available for women who are able to have own children. Besides, other family planning procedures are solved with the help of Arkansas Medicaid.
Medicare Savings Programs is available for individuals who are on Medicare.
Tuberculosis (TB) is available for persons who have tuberculosis.
In turn, Utah Medicaid offers another range of different services and programs, such as LIFC Family Medicaid, Medically Needy Family Medicaid, Pregnant Woman, Utah’s Premium Partnership for Health Insurance, Medicaid Cancer Program, Foster Care Medicaid (Title IV-E), Baby Your Baby, Aged, Blind, Disabled Medical, Children’s Health Insurance Program (CHIP), and others.
Let us pay a specific attention to some of them that differ from Arkansas Medicaid Programs according to its eligibility requirements.

LIFC Family Medicaid is a program that covers families with low incomes and dependent children.
The Foster Care Medicaid Program (Title IV-E) offers full Medicaid benefits for children who are at the disposal of the Department of Human Services, etc.

“Baby Your Baby is a type of temporary medical coverage for pregnant women who are determined presumptively eligible” (Utah Department of Health, 2010, p. 8).

Children’s Health Insurance Program is a special program for children who do not acquire a right for Medicaid or have no other health insurances.

To sum up the above-mentioned information, it is possible to conclude that despite some similarities, Arkansas and Utah Medicaid eligibility requirements have many significant differences that differs them from each other. Moreover, Medicaid is not available to everybody. It requires the submission of an application. To obtain this assistance a person must meet certain requirements for incomes, resources, etc.

Arkansas Medicaid. (2011). Who can get full Medicaid benefits? Retrieved June 23, 2011, from https://www.medicaid.state.ar.us/InternetSolution/consumer/who.aspx
Lambrew, J. M. (2005). Making Medicaid a Block Grant Program: An Analysis of the Implications of Past Proposals. The Milbank Quarterly, 83 (1), 41-64.
Utah Department of Health. (2010, July). Utah Medical Program Summary. Retrieved June 23, 2011, from http://health.utah.gov/medicaid/pdfs/medicalprograms.pdf