8 Pros and Cons of Accepting Medicaid


One of the essential aid programs in the United States is Medicaid. It allows families who meet certain income or status qualifications the chance to receive health care services. Each program is managed individually at the state level so that individualized needs have a better chance to be met. As with any national program of support, there are some key pros and cons of accepting Medicaid that must be considered by medical providers.

The Pros of Accepting Medicaid

1. People who can’t afford medical care can still receive it.
Many of the beneficiaries of Medicaid are children. Households that do not meet a certain income standard can enroll their children and themselves at times into the medical program so that annual checkups, needed vaccines, and appropriate medications can be received when necessary. It allows disadvantaged families to have even special care needs met when normally they wouldn’t be able to afford to do so.

2. It gives medical providers a natural customer base.
Every community has households that qualify for Medicaid. This means a medical provider who accepts Medicaid will have a natural base of customers from which to draw so that a business can be established or expanded with ease. There is no need to advertise either as every state has a list of participating providers who accept Medicaid as an insurance option.

3. There are guaranteed payments through Medicaid.
In an era where medical debt is building up for many households, Medicaid provides medical providers with a guaranteed stream of income. It may even be a better stream of income than those who have insurance because not every healthcare insurance policy covers every medical procedure, requiring collection methods that can wind up costing more than the actual debt itself.

4. Patient copays are often lower and more affordable.
The copays for Medicaid can be as low as $2 for some procedures. Certain appointments don’t even have a copay, such as an annual well child visit. This means there are fewer dollars lost to bad debt and that can make all the difference in the world to a medical provider trying to find funding.

The Cons of Accepting Medicaid

1. There is no guaranteed timing on Medicaid payments.
The government can decide to delay payments to Medicaid providers at any time. There have been times when payment for services rendered have been delayed for more than 1 year. To medical providers that rely on Medicaid payments for compensation, this can mean that no money may come in for an extended period of time and there’s nothing they can do about it.

2. It may create doctor shortages in certain regions.
There are many people who qualify for Medicaid and this can overwhelm the care structure that some communities have. This means some households may need to travel over 100 miles to receive the medical care that they need and those costs can be difficult to absorb. It may also mean lengthy delays in receiving care. In the Pacific Northwest, there are areas that have 6 month waiting times for someone to get in to see the doctor for checkups or non-emergency care needs.

3. Some procedures can be refused after services are rendered.
Medicaid can refuse to cover certain services because they are deemed to be experimental or even unnecessary. This can sometimes fly in the face of what the doctor decides is necessary for patient health, which ultimately means a patient doesn’t always receive the care that they need because of money. Even when payment is received for services rendered, the amount of money that providers receive is often much lower than what doctors typically charge.

4. Funding is not always appropriated fairly.
Some states believe that fund matching occurs more frequently in wealthier states, which means more money is handed out to richer populations even though it is poor populations that need the funding more. Some patients even experience discriminatory practices because of being on Medicaid as certain providers don’t accept it or will change the level of care that is provided if a patient changes over to the government funded plan. Some patients are completely rejected for care simply because a provider as reached their “quota” of Medicaid patients.

The Program is Beneficial

The Medicaid pros and cons show that the program is beneficial, but could have some weaknesses shored up to make it even better. It can take some time to find a doctor today, so check the list of local care providers who accept Medicaid today if you’re thinking about enrolling to minimize your wait times.