It's administered by the states, and uses federal funding - and states pick up what they choose to. Yes, of course you have an application. You have that with regular insurance too.
In our state you must find a doctor that takes Medicaid. She is on the phone for hours trying to find one, and leaves messages...to which most don't call back. You have doctor's that will take it for a while, and then they don't take it anymore. You have to drive quite a ways - we drove 3 hours for a dental consultation - because they were the only ones taking the insurance. Then Medicaid turned the down the removal of the wisdom teeth, and that was after Medicaid told her to go there - after then dentist mentioned it. We have had a heck of time trying to find a ears, nose and throat doctor for her tonsil stones. We are still hunting for that one.
You can't just go anywhere, and then submit the bills to the state for payment. I wasn't speaking of red tape. I was speaking of trying to find doctor's. Most lose money taking them, and will only take that loss for so long. Then you have to find another one. It's hard to find them.