Editor's note: In last week's column, Carol Marak focused on understanding Medicare. This week, she takes on Medicaid.

The federal and state governments both run Medicaid and the Children's Health Insurance Program.The details of the program differ among the states.Medicaid and CHIP give free or low-cost medical coverage to Americans, including people with small incomes, families, kids, pregnant women, older adults, and individuals with disabilities.Medicaid also offers families with assistance that Medicare does not cover like skilled nursing home care and personal care services.Not all low-income people qualify for Medicaid, and only about 40 percent of America's poor are covered.Medicaid sends payments to the health care providers for the services rendered. The states make these payments based on the fee-for-service arrangement and then receive compensation for a share of the expenditure from the feds.The states may impose minimal deductibles, coinsurance, or co-payments for certain services.The feds control the crucial oversight of Medicaid, but each state:• Sets its eligibility standards,• Regulates the scope of services given: the type, amount and duration,• Controls the amount of payment rendered,• Manages its program.States have the final say on what their Medicaid program and benefits provide. But they must meet several requirements before receiving federal government funding:• Inpatient and Outpatient Hospital services• Physician services• Prenatal care• Vaccines for the young• Skilled nursing home services for individuals 21 or older• Family planning• Rural health clinic services• Home health care for individuals who qualify to receive skilled-nursing services• Laboratory and X-ray services• Pediatric services• Ambulatory services• Early and periodic screening, diagnostic, and treatment for children under age 21The optional Medicaid services offered by states• Diagnostic and Clinic services• Intermediate care facilities for the mentally challenged• Prescribed drugs• Optometrist services• Nursing facility services for individuals under 21• Transportation• Rehabilitation and physical therapy• Home and community-based care to certain people with chronic impairmentsContact Medicaid to learn the rules and benefits in your state at

www.medicaid.gov/to see if you qualify.Who is eligible for Medicaid?Each state sets its eligibility requirements. But the program intends to serve people with the lowest incomes.Other factors include age, pregnancy status, disability status, other assets and citizenship.• People who meet the Aid to Families With Dependent Children requirements• Pregnant women and children under 6 whose household income is at or below 133 percent of federal poverty• Supplemental Security Income recipients• Recipients of adoption or foster care assistance• Other Medicare beneficiariesMedicaid spend-downIf your income exceeds the Medicaid income set by your state, you still may be eligible under the "spend down" process. Check with your state.For example, if you are "medically needy," but have too much income, your state may approve your benefits.This process enables you to subtract the medical expenses from your income.To qualify as "medically needy," your resources must be under the resource amount allowed in your stateIf you have a question or need help, Carol Marak invites you to visit SeniorCare.com and complete the contact form on the site.