What is Medicaid?
Unlike Medicare — which primarily serves people age 65 and older — eligibility for Medicaid benefits is based on meeting certain income requirements. People covered by Medicaid usually pay none of the costs for covered medical expenses.
While Medicare is a federal program and basically the same everywhere in the U.S., Medicaid is federal-state program. This means Medicaid benefits and eligibility vary from state to state.
Medicaid is the single largest source of health coverage in the U.S., providing benefits to more than 72.5 million Americans. It provides a broad level of health insurance coverage, including benefits not covered by Medicare such as long-term care costs in a nursing home or at home.
Typically, people on Medicaid do not have to pay health care copays. However, Medicaid alone does not cover as many costs as Medicare. A 2021 research study published in the Journal of Thoracic Disease showed that patients with Medicaid or no insurance are at higher risks of worse survival than patients with Medicare or private insurance.
A person diagnosed with mesothelioma may qualify for Medicaid because they are no longer able to work and can no longer afford private health insurance. Mesothelioma patients 65 and older may be eligible for Medicare and Medicaid. This is called being dual-eligible.
What Does Medicaid Cover for Mesothelioma?
Medicaid may help cover medical costs and long-term custodial care for people diagnosed with mesothelioma. Some coverage may overlap with Medicare benefits such as hospital care and doctor’s services.
Medicaid coverage for mesothelioma may include:
- Inpatient hospital stays
- Outpatient hospital services
- Physician services
- Diagnostic and treatment services
- Laboratory and X-ray services
- Transportation for medical care
- Home health services
- Nursing facility services
States are required to provide these Medicaid services under federal law. Other Medicaid benefits are optional services that states may cover if they choose.
Optional Medicaid benefits include:
- Prescription drug coverage
- Clinical services
- Hospice care
- Chiropractic services
- Private duty nursing services
- Physical therapy
Long-Term Care for Mesothelioma Patients
Mesothelioma patients often need in-home or community-based care such as home caregiving services or assisted-living services. Medicaid can be a used to supplement the amount and kind of services a mesothelioma patient requires.
Each state-based Medicaid program has at least one home and community-based service (HCBS) waiver program to cover these types of services. Medicaid can also cover home care not covered by Medicare.
HCBS services covered through Medicaid may include:
- Personal Care
- Skilled nursing care
- Therapy services
- Homemaker services
- Home modifications
- Hospice services (Respite care)
Medicaid for Veterans with Mesothelioma
Medicaid covers nearly 1 in 10 veterans ages 19 to 64, according to data from the Henry J. Kaiser Family Foundation.
A disproportionate number of veterans are diagnosed with asbestos-related diseases each year compared to the general public. Asbestos was used heavily by the U.S. military from 1935 to 1975. The result is veterans are at an increased risk of developing mesothelioma.
Many veterans are on a fixed income and cannot afford the expensive treatment options of mesothelioma without programs like Medicaid. In a 2015 study from the Kaiser Family Foundation, almost 2 in 5 veterans with Medicaid had no other source of health care coverage.
Three in 5 veterans used Medicaid to supplement other coverage, including VA benefits, Medicare and private insurance.
Medicaid can help veterans with mesothelioma access care that may not be covered under VA benefits. It can also help veterans who don’t live near a VA clinic or hospital.