Nevada Medicaid Income Guidelines

Nevada Medicaid is an insurance program that provides quality health care services to low-income residents. Nevada residents must qualify for Medicaid services. Qualifications are based on income and other factors such as medical need. For individuals and families whose income exceeds the required limits to qualify for Medicaid, other Medicaid-sponsored services are available with less restrictive income requirements.
  1. Income Restrictions

    • Nevada Medicaid is available only to eligible individuals. Residents who qualify for cash assistance such as state Welfare services or Supplemental Security Income (SSI) automatically qualify for Medicaid. Other groups such as pregnant women, elderly individuals and children who do not qualify for cash assistance because of income may still qualify for Medicaid. Elderly individuals and disabled children are eligible for Medicaid based on SSI eligibility. Their income cannot exceed 300 percent of the SSI payment level.

    Medicare Recipients

    • Medicare recipients are also eligible for Medicaid. Medicaid pays Medicare premiums, coinsurance and deductibles on eligible services. The income of Medicare beneficiaries cannot exceed 100 percent of the Federal Poverty Level. The Federal Poverty Level for a single person is $10,890 per year. The FPL for a two-person household is $14,710 per year. Medicare recipients whose incomes exceed these levels based on the number of household members are not eligible for Medicaid benefits.

    Nevada Check Up

    • Nevada Check Up is the health insurance plan for children who do not qualify for Medicaid because of income restrictions but may receive similar health services if other eligibility criteria are met. The program covers children through age 18 whose family income does not exceed 200 percent of the FPL. Insurance premiums are charged based on income and family size but premiums do not exceed $50 per quarter. The child or children must be legal residents of Nevada and have been uninsured for the last six months.

    Child Health Assurance Program

    • The Child Health Assurance Program (CHAP) provides Medicaid benefits for pregnant women and children under six. The program is also available to children six and older if income limits are met. To qualify for the Nevada CHAP, the income of pregnant women and families of children under age six cannot exceed 133 percent of the Federal Poverty Level. For example, the FPL for a family of four is $22,350 per year. Income for this family cannot exceed $29,725.50 per year to qualify for CHAP. For families of children age six and older, income cannot exceed 100 percent of the FPL.

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