What is Medicaid Billing


Medicaid (Medical Assistance) is a health care program for people with low incomes, children, the elderly and people with disabilities in the United States that is organized by the individual states and funded equally with the federal government. A means test is required to receive Medicaid benefits.


Financing and billing

Medicaid is financed by federal, state and local taxes, with mixed financing being regulated in such a way that the federal government bears 50 to 80 percent of the costs, depending on the per capita income of the individual states rich states there. Medicaid is one of the largest budget items in most state budgets, with an average of a quarter of the spending going into this program. In 1994, 33.5 million citizens used Medicaid and the federal government costs $ 77.4 billion and states $ 58.2 billion.

The Centers for Medicare and Medicaid Services determine the remuneration for medical services based on suggestions from the American Medical Association Specialty Society Relative Value Scale Update Committee (RUC).[2]


Even if their names sound similar, they lie Medicaid and Medicare different concepts: While the latter is more aimed at people aged 65 and over within the health system of the United States and knows contributions, deductibles and advance payments like traditional health insurance is Medicaid a social assistance-like benefit, which presupposes a significant impoverishment of the recipient as a criterion for the neediness, but possibly also both criteria can be fulfilled. For example, approximately 6.5 million Americans are on both programs at the same time; i.e., they both meet the inclusion criteria for Medicaid as well as for Medicare.

care insurance

In the USA there is essentially no possibility of insuring yourself against the financial burdens of long-term care. In most cases, those affected finance their care costs, at least initially, from their own resources, as Medicaid can only be used after their own assets have been completely consumed (subsidiarity).

Individual evidence

  1. ↑ http: //www.socialsecurity.gov/policy/docs/statcomps/supplement/2009/medicaid.pdf
  2. ↑ Haley Sweetland Edwards: Special deal, Washington Magazine, July-August 2013

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