Requirements for Emergency Medicaid

Emergency Medicaid assistance pays for medical treatment a person may need following the sudden onset of a medical emergency. The insurance does not pay for the treatment of chronic health conditions, even if the condition has the potential to be life threatening in the future. Current symptoms must be severe enough that not receiving medical treatment would seriously endanger the person's health or impair bodily function.

Pregnancy

• Low-income pregnant women who meet the income and asset eligibility requirements may qualify for Emergency Medicaid if they have no health insurance. It doesn't matter whether you are married or single. Medicaid will cover the cost of labor and delivery. Emergency Medicaid does not cover the cost of prenatal care unless a woman has pregnancy-related complications or the unborn baby is at risk. However, if you are pregnant and uninsured, you may qualify for regular Medicaid benefits that will cover all care related to the pregnancy and up to 60 days postpartum. Talk to your local human services agency if you are pregnant and your income level is at or below 133 percent of the federal poverty level. Even if your income is too high to qualify you in the categorically needy group for your state, you may qualify in the medically needy Medicaid group. When you apply you will need to show proof of pregnancy, proof of income and identifying information such as your birth certificate or Social Security card.

Children Under Age 19

• Low-income families with children under age 19 can apply for Medicaid. You don't need to receive other forms of public assistance to qualify. Some states cover children up to age 21. You can apply for Emergency Medicaid at your local human or social service agency. The date of eligibility depends on when the agency receives the signed application. If your child is uninsured but needs medical services, family income and resource requirements used to determine eligibility include both earned and unearned income. Medicaid to cover emergency services for eligible applicants can be backdated up to three months prior to the month of application. Eligibility is based on family size and monthly household income. If you do not qualify for Medicaid but cannot afford to pay for private insurance, your children may be eligible for low-cost health insurance under your state's children's health insurance program.

Disability

• If you are blind or disabled and have limited income and resources, you may qualify for Medicaid. Eligibility is determined on an individual basis. Individuals who receive Medicaid coverage for emergency services must contact the doctor, hospital or clinic where they received care. The health care provider will need the Medicaid ID number to bill the Medicaid program. If accepted, Medicaid will pay the medical costs from the time an individual first receives treatment for a medical emergency until the condition is no longer considered to be an emergency.

Noncitizens

• A noncitizen, regardless of legal immigrant status, can qualify for Emergency Medicaid if he meets the income and assets limits for the state in which he resides. A noncitizen who legally resides in the U.S. must provide a photocopy of her Alien Registration card when she applies for Emergency Medicaid coverage. Applicants must meet the same income requirements as citizens who apply for medical assistance.