Medicaid とは？ ②

Who is eligible for Medicaid?
Each state sets its own Medicaid eligibility guidelines. The program is geared towards people with low incomes, but eligibility also depends on meeting other requirement based on age, pregnancy status, disability status, other assets, and citizenship.
各州がメディケイドの受給要件を決めます。低所得者に向けたプログラムですが、所得以外に年齢、妊娠、生涯、市民権等も要件に含まれます。

States must provide Medicaid services for individuals who fall under certain categories of need in order for the state to receive federal matching funds. For example, it is required to provide coverage to certain individuals who receive federally assisted income-maintenance payments and similar groups who do not receive cash payments. Other groups that the federal government considers "categorically needy" and who must be eligible for Medicaid include:
* Individuals who meet the requirements for Aid to Families with Dependent Children (AFDC) program that were in effect in their state on July 16, 1996.
* Children under age 6 whose family income is at or below 133% of the Federal poverty level (FPL)
* Pregnant women with family income below 133% of the FPL
* Supplemental Security Income (SSI) recipients
* Recipients of adoption or foster care assistance under Title IV of the Social Security Act
* Special protected group such as individuals who lose cash assistance due to earnings from work or from increased Social Security benefits
* Children born after September 30, 1983 who are under age 19 and in families with incomes at or below the FPL
* Certain Medicaid beneficiaries
政府から助成を得るためには、州は特定のカテゴリに当てはまる個人にメディケイドを提供しなければならない。例えば政府から生活維持の給付を受けているとか、政府が必要と認めた場合です。他にも、政府の定める貧困レベル（FPL）との兼ね合いで決まる要件や、所得の少ない家庭の子供など。


States may also choose to provide Medicaid coverage to other similar groups that share some characteristics with the ones stated above but are more broadly defined. These include:
* Infants up to age 1 and pregnant women whose family income is not more than a state-determined percentage of the FPL
* Certain low-income and low-resource children under the age of 21
* Low-income institutionalized individuals
* Certain aged, blind, or disabled adults with incomes below the FPL
* Certain working-and-disabled persons with family income less than 250 percent of the FPL
* Some individuals infected with tuberculosis
* Certain uninsured or low-income women who are screened for breast or cervical cancer
* Certain "medically needy" persons, which allow States to extend Medicaid eligibility to persons who would be eligible for Medicaid under one of the mandatory or optional groups, except that their income and/or resources are above the eligibility level set by their state.
州は上記以外にも、上記に似た要件のグループに対してより広くメディケイドを適用できます。例えば、21才以下の低所得者、特定の年齢の障害者で所得がFPLを下回る者、結核患者などです。


Medicaid does not provide medical assistance for all poor persons. In fact, it is estimated that about 60% of America's poor are not covered by the program.
メディケイドは低所得者の補助が目的ですが、全員が受給できるわけではないです。試算では米国の低所得者の60％程度がプログラムの対象とされています。

http://www.medicalnewstoday.com/info/medicare-medicaid/