Medicaid Eligibility

Who is eligible for Medicaid?

For any United States citizen or legal resident of the U.S., not having health insurance can cause a lot of stress. Not only do you dread getting sick, but you might also be concerned about the well-being of your family in case of an illness or emergency. Medicaid healthcare coverage was implemented for families like yours who need assistance with their healthcare needs.

The Purpose of Medicaid

Medicaid is a healthcare program managed by the state. Its purpose is to provide healthcare coverage for families, individuals and children who are considered to be lower income. Because of the Medicaid program, millions of Americans are able to have access to quality healthcare. Without Medicaid, most of these individuals would go without ever visiting a doctor.

Medicaid Eligibility

In order to be eligible to receive assistance under your state's Medicaid program, a few different eligibility requirements must be met. Because Medicaid is a state-run program, it's important to check with your state's Medicaid office to determine the specific eligibility requirements, as they vary from state to state.

Income Requirements

The main requirement of Medicaid eligibility is determining that a low income situation exists in the home. Currently, the requirement states that the family's income must be below the poverty level. The number of people living in the household is taken into consideration, and all forms of income are counted, including child and spousal support. In 2014, some states will increase their financial Medicaid eligibility requirements to 133% of the poverty level. Therefore, many people who did not previously qualify for Medicaid will find themselves eligible at that time.

Other Categories

Each state has a number of categories that are used to determine Medicaid eligibility. Applicants must answer questions about areas such as:

  • Blindness
  • Disability
  • Pregnancy
  • Assets
  • Resources
  • Age
  • Citizenship

The answers to these categorical questions are paired with the family's combined income to determine eligibility.

Exceptions

In instances of pregnancy or disability, there is an exception that is made regardless of whether or not the individual is a United States citizen or legal immigrant. In these cases, as well as in some cases when the individual is in a nursing home, many states will offer Medicaid coverage.

The best way to accurately determine your Medicaid eligibility is to discuss your case with a Medicaid worker in your state. Medicaid requirements are changing, so it's important to have updated information when you apply.

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