In order to qualify for Medicaid, an individual must be a United States citizen or a legal permanent resident, and must meet their state’s income and resource requirements. Medicaid is a needs-based program, meaning that coverage is available to those who can not afford private health insurance. In some states, Medicaid provides coverage for children and pregnant women with incomes up to 133% of the federal poverty level (FPL), while in other states the income limit is lower. Adults without dependent children generally do not qualify for Medicaid coverage unless they are disabled or have another qualifying factor such as being elderly or pregnant.
To learn more about your state’s specific requirements, you can contact your state’s Medicaid office or visit www.medicaid.gov.
65 years of age or older
Medicaid is a federal and state program that helps with medical costs for some people with limited income and resources. Medicaid pays for a wide range of medical services.
There are many ways to qualify for free or low-cost care through Medicaid. The most common way to qualify is by having low income and few resources. You may also qualify if you are pregnant, have children, are 65 years or older, or have a disability. Some states have expanded their Medicaid programs to cover more people. If you think you might be eligible for Medicaid, the best way to find out is to apply through your state’s program using this tool from the Centers for Medicare & Medicaid Services (CMS). If your state has not expanded its program, you can still apply for coverage through your state’s regular program following these instructions: To apply for Medicaid coverage, contact your state’s Medicaid office. Find contact information here by selecting your state on this map from CMS or by visiting www.
Look under “Health Care & Insurance” in the list of topics on the left side of the page; OR
Search using key words such as “Medicaid application” or “apply online for health insurance.”
An individual under 65 years of age who has a disability, or is visually impaired according to Social Security guidelines
To be considered disabled by Social Security, your condition must meet certain requirements and prevent you from doing substantial work. In order to be eligible for Medicaid due to a disability, an individual must first be receiving benefits from Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). If you are not currently receiving benefits from either of these programs, you can still apply for Medicaid through your state’s medicaid office.
In addition to being disabled, another way to qualify for medicaid is if you are blind according to social security guidelines. To be considered blind by social security standards, your vision must be 20/200 or worse in your better eye with the use of corrective lenses or if your central visual acuity is limited such that the widest diameter of your field of vision subtends an angle no greater than 20 degrees. If you meet either of these requirements and do not have any other means of health insurance coverage, you may qualify for Medicaid coverage through your state’s program.
An individual 18 years of age or younger
In order to qualify for Medicaid, an individual must be 18 years of age or younger. There are income requirements that must be met in order to qualify for Medicaid. These requirements vary from state to state. In some states, the income limit is higher for children than it is for adults. In other states, there is no difference between the two.
To learn more about qualifying for Medicaid, contact your state’s Medicaid office.
A pregnant woman
Medicaid is a state and federal partnership that provides health care coverage for low-income Americans, including pregnant women. To be eligible for Medicaid, your income must be at or below 138% of the poverty line. In some states, Medicaid expansion has extended eligibility to include people with incomes up to 400% of the poverty line.
If you are a pregnant woman, you may qualify for Medicaid if your income is low enough. Medicaid covers all pregnancy-related medical expenses, including doctor visits, hospital stays, prenatal care, and delivery. You will likely need to renew your Medicaid coverage after your baby is born; in some states, coverage continues automatically after childbirth while in others you will need to re-apply. If you are enrolled in Medicaid before getting pregnant, you should notify your state’s Medicaid office as soon as possible so that they can help you plan for your pregnancy and ensure that you have continuous coverage.
A parent or caretaker
To be eligible for Medicaid, adults must have an income that is below a certain level. In most states, this is 138% of the federal poverty level (FPL), which is about $17,000 for an individual or $36,000 for a family of four in 2020. However, some states have expanded their Medicaid programs to cover adults with incomes above this level. Children and pregnant women may also be eligible if their income is below a certain level; in most states this is at least 143% FPL ($19,000 for an individual or $39,000 for a family of four in 2020). People who are blind or have another disability may qualify even if their income is higher than these levels.
In addition to meeting the income requirements, individuals must also meet certain non-financial criteria to qualify for Medicaid coverage. These criteria vary by state but typically include things like being a U.S. citizen or legal resident (some exceptions apply), being under the age of 65 (with some exceptions for people with disabilities), and not currently being enrolled in Medicare coverage.
A former foster care youth
A former foster care youth may qualify for Medicaid if they meet certain criteria. For example, they may need to be under the age of 26 and have income that is at or below 133% of the federal poverty level. Additionally, they may need to be enrolled in school or working at least 80 hours per month.