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Common Medicaid Myths


Access to quality health care is one of the fundamental human needs. In a society where there are differences in economic classes, low-income earners have limited access to medical services, since healthcare providers expend care services at a cost. To include individuals in the low-class in quality health care plans, the government created the Medicaid Program in 1965.

What is Medicaid?

Medicaid is a medical coverage program that aims to provide financial assistance to Americans. It’s a joint program between the federal and state governments that has helped millions of Americans gain access to care services. It covers adults, children, women’s health, elderly, and persons with disabilities.

Generally, an individual has to meet specific requirements and eligibility thresholds such as income and asset level and estates. However, the criteria vary from state to state. Most state health departments continue to amend the criteria. That’s why you can access medical healthcare at a sliding scale, depending on your income, family size, disability, among other factors.

According to data released by Statista, since the Medicaid initiative came in place, 17% of the total healthcare spending in the US was from Medicaid. Additionally, a report by Becker’s ASC Review indicated that Medicaid’s Children Health Insurance Programs makes care services accessible for 95% of children in low-income earning families.

Benefits of Medicaid Health Insurance Program

Under federal law, states health departments are tacitly mandated to offer several mandatory healthcare benefits to individuals covered by the Medicaid insurance program. Some of the benefits include:

  • Inpatient and outpatient services
  • Nursing services
  • Rural medical health services
  • Early and Periodic Screening, Diagnostics, and Testing (EPSDT) services
  • Home healthcare services
  • Doctor consultations
  • Transportation services to care clinics
  • Laboratory and X-Ray services
  • Freestanding birth care facilities

Common Medicaid Myths that May Cost You Significantly

A lot of information available in different media publications have misguided people to have misconceived views and opinions about Medicaid. Counting on friends and families to offer Medicaid information limits your access to the many health benefits of the programs. We’ve dispelled some of the common myths about Medicaid to enable you to understand how it impacts your family’s health.

The Penalty and Look Back Period Cover the Same While

When applying for Medicaid health insurance, there’s always a 5-year “look back time” when Medicaid assesses your finances and assets by examining your bank statements, tax returns, and money transfers and other financial resources. Medicaid does this to ensure that an applicant did not transfer money (exceeding the state’s limit), that could otherwise be used cater to skillful nursing services. Upon discovery that you transferred cash or non-exempt financial resources, Medicaid fines the applicant a penalty period, within which he/she may have to wait to receive benefits.

Most people think that the length of the look-back period is the same as the penalty period. A look-back period is the time taken by Medicaid to examine an applicant’s assets and finances, while the penalty period is the timeframe within which an applicant may no longer access the program’s benefits due to money transfers discovered during the look-back period.

You’ll Give Up Everything You Own for Medicaid

You need not lose everything you own to have Medicaid insurance, mainly if your spouse and children depend on your property for shelter. Most states have both income and asset limits, and a state may use either of the two approaches to determine eligibility. In states that use asset limits linked to SSI, a person needs to prove a $2000 asset limit. With income limits, a state looks at an income limit of $2,205 every month. However, these limits vary from state to state, and it advisable to research on your state-specific requirements.

My assets are under a revocable trust, so they are secure

While a revocable trust may offer security and effective control of your income and assets during its lifetime, you want to have them under an irrevocable trust if you’re going to take the full advantages of the healthcare benefits of Medicaid. An irrevocable trust eliminates any links or connections you have with the assets or properties you require to meet the Medicaid requirements.

I may not retain any of my income in case my spouse receives Medicaid nursing services

That not true. In fact, you can retain your income, and if you require additional finances, you may be entitled to keep your spouse’s income too. In the case of an at-home spouse, a minimum monthly maintenance amount is expended to their account. The amount ranges between $2,000 to $3,000. The bottom line is: Medicaid does not consider the monthly upkeep amount to determine whether or not you’re at-home spouse is eligible for Medicaid services.

I’ve learned all I need about Medicaid from my friend who’s also under Medicaid

One thing you need to understand that your friend or colleague in another state is subject to different Medicaid requirements. It’s also worth noting that even your neighbor has a unique Medicaid experience to yours.

According to elder law attorneys, the uninformed is the no. 1 problem to the expansion of Medicaid services, because they’ll tell you that you can’t apply for Medicaid since your spouse or parent may not qualify.

An individual’s successful application to Medicaid depends on their age, income, real estate, marital status, level of care needed, and their residential area. These factors determine eligibility, and they vary from one person to the other.

Contact Us

Does any of your family members require financial assistance for medical care, but you’re unsure on whether to apply for Medicaid? You can contact our elder law lawyers at The Mattar Firm for professional, legal help on Medicaid eligibility and benefits.


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