Skip links

What is Medicaid?

Young man pulling himself up with a lift device

Since our last blog post on Medicaid received such positive feedback, we brought in an expert to create an entire series and answer your questions. We’re here to make Medicaid easy!

 

Hi Joshin Community,

I’m excited to host a blog series to break down Medicaid, how to get started, and what it can do for you. Over the years, I’ve had the opportunity to learn so much, make great contacts, and provide support to thousands of individuals with disabilities either directly or indirectly.  I’ve provided direct care, supervised caregivers, and spent over 11 years working at the Capitol trying to change laws to support people with disabilities. I’ve also worked with the MN Department of Human Services as a voice for both providers and individuals needing support.

I take great pride in taking challenging and confusing information and explaining it in a way any reader can understand and use to empower getting the resources they need. The goal of this blog series is to make Medicaid easier for people with disabilities and their families.

 

What is Medicaid?

We’ll start with the backbone of many of the services to people with disabilities in Minnesota – Medicaid. While I’ll focus first on Minnesota, note this applies to a lot of states in America. But I will use Minnesota as a starting point of this blog series.

Medicaid is a federal program managed by the United States Department of and Human Services that is available in all 50 states, but does not look exactly the same in any two states. 

Medicaid provides free or low-cost coverage to those who meet the eligibility requirements. In Minnesota you must be:

  • A United States Citizen, permanent resident or legal alien
  • A resident of MN
  • Pregnant
  • Be responsible for someone 18 years old or younger
  • Blind
  • Have a disability or a family member in your household with a disability
  • 65 years of age or older

 

There are income limitations which are based on a Modified Adjusted Gross Income.  

The Medicaid program is a Federal and State match program. Most often the Feds match the State 50/50, although there are some programs that have a higher Federal match.

The complex Medicaid program became even more complex when the Affordable Care Act was passed. It created even more differences between each state as there are requirements in for a state to participate in Medicaid and that the state can opt in to. 

 

Now, let’s focus on people with disabilities

Your county of residence will be the primary point of contact as you begin your journey for services for an individual with disabilities.  You should keep in mind that there are over 87 counties and tribes in Minnesota and none of them operate exactly the same. A great first step is to contact the Human Services Department in your county. They will be able to answer your questions or will direct you to the appropriate resource. If you are just beginning this journey my advice is to be patient but persistent, and to be kind to yourself as you learn to navigate this new world. 

  • In Minnesota the Medicaid program is Medical Assistance or MA
  • To be considered a person with a disability for MA, your child must be certified as disabled through the Social Security Administration or the State Medical Review Team. You may have heard of this as having your child “SMRTed”. 
      • SMRT performs disability determinations for individuals seeking a disabled basis of eligibility for Medical Assistance (MA). A SMRT disability certification establishes a basis of eligibility for MA programs, including home and community-based service (HCBS) waivers, MA under the Tax Equity and Fiscal Responsibility Act (MA-TEFRA), and MA for Employed Person with Disabilities (MA-EPD). A SMRT disability certification also gives people access to state funded programs including the Consumer Support Grant (CSG), Family Support Program (FSP), and Special Needs Basic Care (SNBCS). SMRT completes disability determinations for people not certified disabled by SSA. SMRT certifies disability using the same disability criteria as the SSA.
      • People certified disabled by SMRT need a continuing disability review every 1 to 7 years. Disability standards are different for children and adults, so at age 18, a child must be evaluated under the adult standards. Newborns certified disabled due to a low-birth weight must be reviewed prior to age 1.
      • Contact your county of residence to request a SMRT referral.
  • The income limit and whose income is counted depend on:
      • Your child’s age
      • What services your child needs
      • Who lives with you
  • Individuals with a disability who are approved for Supplemental Security Income (SSI) will receive Medicaid.
  • If your income exceeds approved limits your child with a disability may still be eligible for Medicaid/MA through Tax Equity and Financial Responsibility Act (TEFRA) or Home and Community Based Waiver programs.
  • There are no asset limits for children under 21.

I have pages and pages of topic ideas that I can’t wait to share with you! Here’s what you can expect to learn in this blog series:

  • Medicaid waiver
  • Self-direction vs traditional services
  • of services for children and adults with disabilities
  • Rights and appeals
  • Resources
  • Best practices
  • Helpful tips
  • FAQs

Follow along to learn new information and tips to make your journey a bit easier! If you don’t see something on this list, please feel free to reach out to hello@joshin.com to submit your topic request.

Meet Barb Turner! She’s an expert on Medicaid, has spent over 35 years in the field of disability services, and works closely with the Minnesota State Capital advocating for improvements to services for people with special needs. She is thrilled to share her knowledge with the Joshin community and make Medicaid easier to navigate for all!

A woman in a black suit jacket smiling