Medicaid is a state medical assistance program that covers most costs for hospital stays, clinic visits, and medication. There are some procedures or exams not covered by Medicaid, and some must be pre-approved. Some Medicaid programs are based on family income, and others are based on medical needs.
Medicaid is a state funded program and is based on need. There are two categories of need determined individually by each state:
Categorically needy: if you fall below the income and resource level designated as the “poverty line” by your State.
Medically needy (spend down): The “spend down” is the process of deducting medical costs from your income until your income level and you become eligible for Medicaid (not in all States).
Some individuals are exempt from the income-based rules, including those whose eligibility are based on blindness or disability, but eligibility requirements vary based on state. Visit your state’s Medicaid website for individual eligibility requirements or contact your financial coordinator at your transplant center for more information.