Hurricane Katrina: Legal Issues - Columbus School of Law

MEDICAID, CHIP, WIC
What Is Medicaid?
Medicaid is a system funded by the federal government and the states, but administered by the individual states.
Medicaid reimburses participating health care providers for services rendered to Medicaid recipients. Recipients of
Medicaid should ALWAYS ask the medical provider if they are a "participating Medicaid provider" because it is a
voluntary system.
In light of Hurricane Katrina, the criteria for becoming a Medicaid provider have been lowered so that more health
care service providers can qualify to be reimbursed by Medicaid.
Who Qualifies For Medicaid?
The first requirement for Medicaid recipients is that they must be either a United States citizen or an alien lawfully
admitted for permanent residence. Second, the applicant must be a resident of the state in which they apply.
There are seven possible categories under which a person may be eligible to receive Medicaid coverage: These
include
1.
Supplemental Security Income Category Medicaid (available, based on income criteria, for persons 65 or over,
legally blind, or disabled)
2.
Qualified Medicare Beneficiaries (QMB) (available to presons eligible for Medicare Part A, and who meet the
income guidelines)
3.
Specified LowIncome Medicare Beneficiaries (SLMB) & Qualified Individuals1 (QI1)
4.
Working and Disabled (WD) (Benefits to low-income persons who work at least 40 hours a week but who are
disabled)
5.
Disabled Children Living at Home (DCLAH)(benefits available to children under 18 who are disabled and
cared for at home rather than a nursing facility, also based on income)
6.
Poverty Level, Aged, and Disabled (PLAD) (available to applicants who are low-income and over 65 or
disabled) (continuation of this benefit is currently being litigated)
7.
Breast & Cervical Cancer Category
Each program has separate specific income and resource requirements.
How Do I File For Medicaid?
Applicants must file for Medicaid in person at their local Medicaid office. The telephone numbers for these offices
are set out in the Appendix to this section.
What Is CHIP?
The Children's Health Insurance Program (CHIP) is a joint federal/state program that provides health insurance
coverage to lowincome uninsured children. Benefits under CHIP include all benefits under the State and School
Employees' Health Insurance Plan as well as vision and hearing screening, eyeglasses, hearing aids, immunizations,
preventive dental care, and routine dental fillings. There are no exclusions for preexisting conditions.
How Is CHIP Different From Medicaid?
CHIP is designed to provide health care insurance for children in families without health insurance or with
inadequate health insurance. It does not replace Medicaid; in fact, children on Medicaid are precluded from CHIP
participation. CHIP is a coalition of public, nonprofit and private healthrelated organizations who are committed to