Medicaid for Brain Injury

Medicaid provides health coverage for people living with disabilities

Medicaid is a public health insurance program that helps people with limited income and certain disabilities get medical care. It is funded by both the federal government and individual states, so programs can vary depending on where you live. Medicaid covers a range of health services for eligible individuals, including people with disabilities, low-income families, and people receiving Supplemental Security Income (SSI). Because Medicaid is run by each state, eligibility rules and covered services may be different depending on where you live. Some programs also have additional requirements based on age, pregnancy, parenting status, or disability.

In general, to receive Medicaid, you must:

• Live in the state where you are applying
• Be a U.S. citizen or a qualified non-citizen (such as a lawful permanent resident)
• Meet income and other eligibility requirements

Types of Medicaid programs

Medicaid is not one single program. In many states, Medicaid services are provided through managed care. This means the state works with private health plans to coordinate and deliver care for Medicaid members.

There are several types of coverage, depending on your needs:

Traditional Medicaid: Covers basic healthcare like hospital visits, medical appointments, and lab tests. It usually does not cover long-term care services.

Institutional (Nursing Home) Medicaid: Helps pay for care in a nursing facility, including room and board, nursing care, and therapy services.

Long-term Care Medicaid: Supports people who need help with daily activities, either in a facility or at home.

In many states, people with disabilities may need to apply for Social Security disability benefits as part of the Medicaid application process, especially for long-term care services.

Medicaid home and community-based services

Medicaid waivers, often called Home and Community-Based Services or Long-Term Services and Supports, allow people to receive care in their homes or communities instead of facilities or institutions. These programs may support:

• People with brain injury
• Older adults
• People with physical disabilities
• People with intellectual or developmental disabilities

Some states also have specific brain injury or traumatic brain injury waivers. These programs may include services like rehabilitation, case management, and supported employment. The types of services and how long they are available depend on the state.

Some programs offer financial support for caregivers of people living with brain injury

Some programs, including some state Medicaid programs and insurance providers, pay family or friends of people with disabilities to help with daily activities. This can include personal care, giving medicine, cooking, and cleaning.

Learn more about programs and options for caregivers

• Get paid as a caregiver for a family member
• Careforth

The Children’s Health Insurance Program

The Children’s Health Insurance Program (CHIP) offers low-cost health coverage for children and, in some states, pregnant women whose families earn too much to qualify for Medicaid. Each state manages its CHIP program and coordinates it with Medicaid.

Compassionate answers. Real support. Every step of the way.

Contact the National Brain Injury Information Center at 1-800-444-6443 to speak to a specialist about:

• Help with care needs
• Legal and financial resources
• Services in your community