What is Medicaid Insurance?

A mother and daughter look at the sky while standing in a field.

Photo by Daria Obymaha on Pexels.

Various health insurance options exist on the market, but what if you can not afford to pay monthly premiums? People making a significantly low income might be eligible for government help with Medicaid or Children’s Medicaid, also known as the Children’s Health Insurance Program (CHIP). The federal government works with each state’s government to administer these programs as insurance assistance for low-income individuals.

Who is eligible?

According to the Centers for Medicare and Medicaid Services, people eligible for Medicaid must fall within their state’s definition of low-income or very low-income. Generally, most states also require an applicant to be one of the following: pregnant or responsible for a child 18 or younger, blind, or have a disability, or have a family member in their household with a disability, be 65 or older. Some states have expanded their coverage to include all low-income adults. You can visit the Medicaid website to see your state’s qualifications.

Those who want to enroll in CHIP must also be 18 or younger to qualify for coverage. Additionally, CHIP applicants must be uninsured. They cannot have health coverage from group health plans or other creditable health insurance. A child must also have been determined ineligible for Medicaid.

What services do Medicaid insurance and CHIP cover?

Each state determines Medicaid costs and coverage options while adhering to federal regulations. Let’s look at one state’s covered services similar to many other states. In Texas, Medicaid and CHIP cover regular checkups at the doctor and dentist, medicines, vaccines, hospital care, vision care, hearing care, X-rays, lab tests, access to mental health care, access to medical specialists, treatment for pre-existing conditions, and treatment for special health needs. Also, in Texas, children with disabilities may receive long-term services through Medicaid. Some examples of these services include home care and personal care, a caregiver to help monitor your child’s health and assist the child with daily activities, a caregiver to take the child to medical appointments, nursing home care, a hospital for mental illnesses, a place of care for those with intellectual disabilities.

What is Medicaid unwinding?

Due to the 2020 pandemic, Congress approved continuous Medicaid and CHIP coverage for those already enrolled in these insurance assistance programs. States were required to follow this law to continue to receive federal funds for Medicaid and CHIP. Once the public health emergency ended on March 31, 2023, states began unwinding– disenrolling ineligible applicants. The unwinding affected many people. More than 20 million people lost Medicaid and CHIP coverage during this post-pandemic process.

How can I get insurance coverage after I lost my Medicaid or CHIP?

Did you lose your coverage during the recent Medicaid unwinding? You can reapply for Medicaid or CHIP at any time of the year. Empower Brokerage’s friendly licensed agents can assist you in reapplying to these programs. Have you already found you are ineligible for Medicaid or CHIP coverage? Empower Brokerage’s agents can help you find the right Marketplace insurance to fit your specific needs and circumstances. Call us at (844) 410-1320 to speak with one of our agents today.

Have Health Insurance Questions?

We hope that this information on insurance coverage for self-employed workers is helpful for you.

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About Joey Hinojosa

Joey Hinojosa graduated with a bachelor's degree in broadcast journalism and a master's degree in mass communications. He began working at Empower Brokerage in early 2022 and enjoys being creative in his writing, photography, videography, and other projects.

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