How Medicaid works

Medicaid is a federal and state government program that pays for medicalcare for people who meet specific technical, income and asset criteria. Thefederal government sets guidelines for services and pays part of the cost.Each state designs and operates its own Medicaid program based on federaland state guidelines

For Example.

The Medicaid Program is administered in Florida by the Agency for HealthCare Administration (AHCA).
The Department of Children and Families and the Social SecurityAdministration administer the determination of recipient eligibility for Medicaid

Medicaid Funding

The Florida Legislature appropriates funds to pay for Medicaid services; andby legislative authority Medicaid sets the reimbursement, coverage andlimitations policies. The policies that govern Medicaid allow for the paymentof a variety of medical services.

Who Pays Medicaid Claims

Medicaid contracts with a private company to pay claims. This company iscalled the “Medicaid fiscal agent.” The fiscal agent also performs a variety ofother functions for Medicaid including enrollment of providers andmanagement of the recipient eligibility system.

Who is Eligible to Receive Services

Low income families and children and aged and disabled adults who meetspecific eligibility requirements such as citizenship or resident alien status,Florida residency, and income and asset criteria can be eligible for Medicaid.All individuals who receive a Supplemental Security Income (SSI) check areautomatically eligible for Medicaid.

Medicaid address and phone number
Billing Medicaid patients
Medicaid EOB and denial reason
What is Medicaid insurance

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