What is Medicaid? PDF Print

Medicaid is health care assistance that helps people with low incomes and limited resources to obtain medical care for some or all of their bills. Medicaid also helps to pay for nursing home care. Medicaid programs differ from state to state. In the U.S. Virgin Islands, Medicaid is called the Medical Assistance Program (MAP). The Department of Human Services Bureau of Health Insurance and Medical Assistance is the division responsible for administering Medicaid in the Virgin Islands.


Eligibility for MAP is determined by the Certification Units and is based on family income, resources, and other factors. Examples are documents needed for eligibility determination are:


  • Verification of U.S. Citizenship and age and

  • Verification of resources

Other documents may be required as well.


Individuals who receive cash assistance from the Department of Human Services and are classified as "Categorically Needy" are automatically eligible for Medicaid. Assistance (Spend-Down Program) is also available to persons whose incomes and resources are above or in excess of the allowable income level. The excess income is expected to be expended (spent down) before assistance is provided by MAP.


In addition, persons with Medicare who meet the eligibility requirements of MAP can receive assistance from MAP with paying their Medicare Part A deductible, Medicare Part B premium, and the share of allowable costs not covered by Medicare. Persons with both Medicare and Medicaid are called "Dual Eligibles" (DEs).


Starting January 1, 2006, Medicare will begin covering prescription drugs for DEs. MAP will still cover other care that Medicare doesn't cover. MAP will be using Medicare and local funds to assist DEs with paying their premium, deductible, and co-pays for the Medicare prescription drug plan they are enrolled in. In order to get this help, DEs must enroll in a Medicare Prescription Drug Plan by December 31, 2005. For DEs who fail to enroll in a plan by this date, MAP will automatically assign them to a plan. (For more information on how DEs prescription coverage will be affected starting January 1, 2006, click on the link below the subject heading Medicare Prescription Drug Coverage).


For more information, contact the MAP Certification units at (340) 774-2399 or (340) 774-0930 extension 4378 in St. Thomas and (340) 718-1311, ext. 3095 in St. Croix.