Income & Medicaid Eligibility

Medicaid is a U.S. government health insurance program for people who cannot afford health care or adequate health insurance. Each state administers the various insurance plans to residents who qualify for Medicaid. A person's age, income, assets, resources and the number of household dependents are factors used to determine who will get Medicaid benefits.

Benefits

• Medicaid pays for limited health care. Some services are not covered, while others require a co-pay. The plan does not issue payments to patients, but directly to healthcare providers. Recipients get Medicaid benefits to cover hospitalization for inpatient and outpatient care, doctor visits, prescriptions and equipment needed for treatments. Ambulance service and non-emergency transportation are covered, along with family planning and limited benefits for home health care, dental, vision, hearing and aids to stop smoking.

Assets

• Each state uses federal guidelines limiting the assets of those who qualify for Medicaid. Limits apply to individuals, couples and families. California allows $2,000 in assets for individuals and $3,000 for couples. Higher limits are set for senior citizens and those with qualifying disabilities. North Dakota allows $3,000 in assets for individuals who are blind, disabled or over the age of 65. A residential home, one car and life insurance policies are generally not counted.

Income

• Guidelines for Medicaid income qualifications are based on a percentage of the federal poverty level. State limits may be as high as 250 percent of the federal poverty figures for monthly and annual income. California allows individuals to earn $845 and couples to earn up to $1,407.20 monthly and get Medicaid benefits. New York limits individuals to $708 and couples to $883 in monthly income. Check state limits with the online state Medicaid list (see Resources).

Family

• The size of your family plays a role in determining your Medicaid income qualifications. The more people in your household, the more you are able to earn and still qualify. New York allows $99 extra monthly income for each dependent child. North Dakota allows an additional $106 for each child. Children under age 18 may qualify for benefits, although you do not. Children with high health care bills are often given Medicaid benefits apart from the family.