Healthcare Utilization

Submitted By ikeely88
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Pages: 4
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Health Care Utilization
When people are unable to afford their Medical Bills, or even their co-pays or medications, this cause a damper in their life because people can get very sick without their medications or proper treatment. A person can sometimes diagnose and try to treat their own illnesses with the proper symptoms that show. Others may not have symptoms at all, and this will cause people to assume there is nothing wrong, when in fact there may be a lot wrong. Medicaid has been offered to many people who qualify. There may be discrepancies when applying because there are many things that have to be checked before a person will even qualify for Medicaid. If a person does not qualify for Medicaid, there are other insurance or self -pay options to pay for Doctor’s visits, hospital bills, Medications, etc. With certain diseases, whether sexually transmitted, or just something that occurs within the body, not everyone pays attention to all the signs that point to it. It is good to follow these signs in case something is really wrong. If a person does not have the proper funding or insurance to pay for treatment, they will probably run into more medical problems because the problem only gets worse. It is good to have a back-up method of payment in case insurance does not cover all of what needs to be paid for anything medically. “Medicaid and CHIP(Children’s Health Insurance Program) provide health coverage to nearly 60 million Americans, including children, pregnant women, parents, seniors and individuals with disabilities.” (http://www.medicaid.gov/) Medicaid coverage eligibility varies by state due to different state regulations for population groups. There are federal poverty level percentages for each household size that must be reviewed to determine if an individual or family qualifies for Medicaid. For example, a household that consists of 2 people cannot exceed a monthly income of $1,260.83 or $15,130.00 annually. “The Medicaid program is jointly funded by the federal government and states. The federal government pays states for a specified percentage of program expenditures, called the Federal Medical Assistance Percentage (FMAP).” (http://www.medicaid.gov/)

John Q qualified for Medicaid because he is a part-time worker and his income does not exceed the guidelines for a citizen that works. Since it is just John that is applying for assistance, he will need to make sure that his annual income does not exceed $11,170.00. Although John qualifies for Medicaid, he still has to go through the process of applying. This plays a big part in the factors that may affect John Q’s utilization of healthcare because now he will be able to go to his Doctor appointments without having to worry about not being able to afford it. Medicaid will pay for not only his Doctor’s appointments, but also any hospital stay he has and any medications he will have to take; whether it be a long term medication or a onetime treatment. If John was to ever get a new job making more money or start producing more hours at his current job, that will put him above the poverty level to receive Medicaid and he will be responsible for his own medical expenses and medications. Any predisposing or enabling diseases that John may have will not affect his eligibility for Medicaid because they offer additional medical services for people with disabilities and who may need rehabilitation. The need for Medicaid does not make him eligible for it, but the supporting reasons prove that he
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