I’m fascinated by the connection between poverty and health care. It seems obvious after all – if someone lives in poverty, chances are the amount of time they spend taking care of their health is limited due to other more pressing needs. Less expensive food options are probably throughout low income communities leading to greater temptation to not eat healthy. So I decided to talk to someone in the healthcare space – a resident physician in New Jersey, who works with low income families.
What is Medicaid and What Isn’t Covered?
Medicaid is a joint federal and state program in the United States that provides health coverage to eligible low-income individuals and families. It is the largest source of health insurance coverage in the country, helping millions of Americans access essential healthcare services.
The program was established in 1965 under Title XIX of the Social Security Act and is administered by the Centers for Medicare and Medicaid Services (CMS), a federal agency within the U.S. Department of Health and Human Services (HHS). However, Medicaid is implemented and operated at the state level, with each state having some flexibility in designing and managing its own program, within certain federal guidelines.
Medicaid is primarily targeted towards individuals and families with limited income and resources. Eligibility criteria, including income limits, asset limits, and other factors, vary by state, as states can set their own specific eligibility rules within certain federal parameters. However, there are certain mandatory eligibility groups that all states must cover, including low-income children, pregnant women, parents of dependent children, individuals with disabilities, and low-income seniors.
Under Medicaid, the specific coverage for alcoholism and mental health can vary by state, as each state has some flexibility in determining the scope of services covered. However, all states are required to cover mental health services as part of their Medicaid programs, and many states also cover substance abuse treatment, including services for alcoholism.
Some of the services that may be covered by Medicaid for alcoholism and mental health include:
- Outpatient counseling: Medicaid typically covers outpatient counseling services, such as individual therapy, group therapy, and family therapy.
- Inpatient treatment: Medicaid may cover inpatient treatment for alcoholism and mental health conditions, including detoxification programs and residential treatment centers.
- Medications: Medicaid often covers medications prescribed for alcoholism and mental health conditions, including medications for detoxification, addiction treatment, and mental health disorders.
- Case management: Medicaid may cover case management services to help individuals navigate the treatment system and access necessary services.
- Rehabilitation services: Medicaid may cover rehabilitation services, including vocational rehabilitation, to help individuals recover from alcoholism and mental health conditions.
What are the Implications of some services not being covered?
Follow-up appointments are absolutely essential for low-income families when it comes to healthcare. – yet there is a higher volume of missed appointments with low income families perhaps due to the immediate nature of other concerns. Some issues include the following: