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Medicaid

Health insurance for the poor. Joint Federal & State program that provides supplemental health insurance to low income persons of all ages with limited savings. 41 million people (10% elderly) $160 billion (27% to elderly) covers long-term care (after spend-down) benefits vary state by state Expenditures: 68% nursing homes 17% hospitals 3% physicians 12% other Most Medicaid programs pay part Medicare part B premiums Some pay Mdicare deductables & co-insurance costs Medicaid covers long-term care, including skilled nursing facility copayment for days 21-100 after qualifying hospitalization [2] Medicaid considers domestic partners as unmarried, thus his/her assets are not included as resources of the partner (GRS9) [2] Tamper-resistant prescriptions required for Medicaid patients Oct 2008 [3,4]. One tamper resistant feature from each category required for all Medicaid prescriptions. [4] Starting Apr 2008, at least one feature required. 1) Copy-resistant 2) Unalterable 3) Counterfeit-resistant. Notes: - Medicaid increases emergency department use [5] - expanding Medcaid under the Affordable Care Act reduces number of uninsured 14% [6] & improves healthcare access [7] - state Medicaid services offer long-term in home care assistance if patient meets criteria - for in-home services, family members caring for Medicaid recipents may be eligible for the Medicaid self-direction program

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Medicaid self-direction program

References

  1. Ouslander, JG: In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  2. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004 - Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
  3. Prescriber's Letter 14(9): 2007 Tamper-resistant prescription requirements for Medicaid patients Detail-Document#: 230914 (subscription needed) http://www.prescribersletter.com
  4. Prescriber's Letter 15(4): 2008 Tamper-Resistant Prescription Requirements For Medicaid Patients: An Update Detail-Document#: 240411 (subscription needed) http://www.prescribersletter.com
  5. Taubman SL et al. Medicaid increases emergency-department use: Evidence from Oregon's health insurance experiment. Science 2014 Jan 17; 343:263 PMID: 24385603 http://www.sciencemag.org/content/343/6168/263?ijkey=2fbf2bb5379b5726faf8c78ee02eb9915bf9fef0&keytype2=tf_ipsecsha
  6. Sommers BD, Blendon RJ, Orav EJ Both The 'Private Option' And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults. Health Affairs. 2016 Jan 35(1):96-105 PMID: 26733706 http://content.healthaffairs.org/content/35/1/96.abstract
  7. Wherry LR, Miller S Early Coverage, Access, Utilization, and Health Effects Associated With the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study. Ann Intern Med. Published online 19 April 2016 PMID: 27088438 - Kullgren JT Injecting Facts Into the Heated Debates Over Medicaid Expansion. Ann Intern Med. Published online 19 April 2016 PMID: 27088778 http://annals.org/article.aspx?articleid=2515051
  8. American Council on Aging. Medicaid and Home Health Care & Non-Medical, In Home Care. https://www.medicaidplanningassistance.org/in-home-care/
  9. Medicaid.gov Long Term Services & Supports https://www.medicaid.gov/medicaid/long-term-services-supports/index.html
  10. Medicaid.gov Home & Community Bases Services. https://www.medicaid.gov/medicaid/home-community-based-services/index.html