What Is a Medicaid Specialist?

Medicaid, also known as medical care, refers to illness medical services that the insured can enjoy. The types of medical services provided by the sickness insurance for the insured person vary from country to country, but generally include the treatment of ordinary doctors, certain hospitalizations, and the supply of necessary drugs. Some countries also provide for the availability of specialists, surgery, obstetric care, dental treatment, as well as a wider range of medicines and certain assistive devices for patients. [1]

Medicaid

Medicaid, also known as medical care, refers to illness medical services that the insured can enjoy. The types of medical services provided by the sickness insurance for the insured person vary from country to country, but generally include the treatment of ordinary doctors, certain hospitalizations, and the supply of necessary drugs. Some countries also provide for the availability of specialists, surgical procedures,

With regard to the conditions for receiving medical assistance, there is usually no qualifying period requirement, and if required, it is generally slightly shorter than the qualifying period for sickness cash assistance. In most countries, dependent relatives of insured employees provide the same medical services as insured employees. There is no difference in the qualification requirements for the two categories of personnel. Dependants include spouses and young children, and sometimes other adults or young relatives living with the insured and relying on the insured to support them. ^[1]

The Medicaid under the Convention on Minimum Standards of Social Insurance shall include at least the following: ^[2]

1. In case of illness

(1) Consultation and treatment of general practitioners, including visits;

(2) Outpatient or inpatient treatment by specialists in the hospital, and if possible provide such specialist treatment outside the hospital;

(3) the supply of essential medicines prescribed by a doctor or other qualified practitioner;

(4) Hospitalization if necessary.

2. Pregnancy, childbirth and its consequences

(1) Prenatal, childbirth and postnatal care by a medical practitioner or qualified midwife;

(2) Hospitalization if necessary. The Convention stipulates that beneficiaries or their dependants may be required to share medical expenses, but rules on sharing expenses shall be formulated in order to avoid economic difficulties.

The 1969 Medical Care and Disease Subsidy Convention stipulates that medical care should be committed to maintaining, restoring or improving the health of the insured, and the ability to work and handle personal needs. Medical care should include at least the following:

(1) Physician's care, including home visits;

(2) expert care for inpatients or non-residents in hospitals and out-of-hospital care that experts may give;

(3) Provide necessary medicines according to the prescription of a doctor or other qualified medical personnel;

(4) Hospitalization if necessary;

(5) Dental care in accordance with regulations;

(6) Medical rehabilitation, including the provision, maintenance and replacement of limb replacement or correction equipment in accordance with regulations.

There are three main ways to pay for medical services provided by the disease insurance in each country:

(1) The medical expenses are paid directly to the provider of medical care by the public health system or social insurance agency. Patients generally have little or no economic relationship with the provider of medical services.

(2) Reimbursement of the patient's treatment costs or reimbursement by the patient. Patients usually pay medical fees to doctors, pharmacies, or hospitals according to the medical services they receive, and then the social insurance agency reimburses the patients for the fees they pay. There is generally a maximum limit when reimbursing.

(3) Provide medical care directly to patients. In some countries, social insurance agencies or governments own and operate medical facilities. These facilities are generally run by salaried personnel who provide medical services directly to qualified insured persons. Patients do not pay for most medical services. Part of the insurance premiums they pay are set aside for medical expenses.