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Medicaid In Texas
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Medicaid is the State and Federal cooperative venture that provides medical coverage to eligible needy persons. The purpose of Medicaid in Texas is to improve the health of people who might otherwise go without medical care for themselves and their children. Medicaid is different in every state. HHSC's Medicaid Office is responsible for statewide oversight of the Texas Medicaid Program. |
Who Is Covered in Texas
The three primary categories of Texas Medicaid eligibles are (see Figure 4.1 below):
• Families and children - Based on income level, depending on age or pregnancy;
• Cash assistance recipients - Based on receipt of Temporary Assistance for Needy Families (TANF) or Supplemental Security Income (SSI); and
• Aged and disabled - Based on income level, age, and physical or mental disability.
The number of Texas Medicaid recipients can be expressed in two ways: annual unduplicated count and the monthly average count. The “unduplicated count” is the number of individual Texans who received Medicaid-funded services at some point during the year. For state fiscal year (SFY) 2005, the unduplicated count was 3,739,465 people. Figure 4.3 shows the trends in the total unduplicated Medicaid recipient count from 1997 to 2005.
The monthly average count is the average number of clients on Texas Medicaid per month. This number best answers the question of “At any one time, how many individuals are enrolled in Medicaid?” Figure 4.4 shows the growth in average clients per month from 1994 through 2005.
People may gain and lose Medicaid eligibility at various points during a year. For example, eligibility status can change due to parent or caretaker income changes, a child reaching adulthood, or after childbirth. Since all clients may not remain eligible for all months of a year, the monthly average count is lower than the unduplicated count. The monthly average was 2,779,373 people in SFY 2005.
You must qualify for Medicaid. Low-income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds. As noted earlier, categorically needy persons who are eligible for Medicaid may or may not also receive cash assistance from the Temporary Assistance for Needy Families (TANF) program or from the Supplemental Security Income (SSI) program. Medically needy persons who would be categorically eligible except for income or assets may become eligible for Medicaid solely because of excessive medical expenses.
Texas Medicaid planners typically advise retirees and other individuals facing high nursing home costs to adopt strategies that will protect their financial assets in the event of nursing home admission. State Medicaid programs do not consider the value of one's home in calculating eligibility, therefore it is often recommended that retirees pursue home ownership.
Texas Medicaid is used a good portion by people unwilling to work, this is true, but it's also a supplement to people that need a little extra assistance when they get hurt or become extremely sick. Medicaid beneficiaries have the right to choose their own physician, hospital, pharmacy, or other medical provider. The provider must be enrolled as a Medicaid provider in order for a payment to be made.
Note: www.medicaid.gov and www.medicaid.com are the official Medicaid websites. Medicaid.org is a parked ad site.
Sources: Public information from government
Texas Medicaide | Houston, Texas
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