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About Medicaid Requirements

Medicaid is a government program to help low-income families with their medical expenses. It ensures that affordable health services are available to everyone. While the program is federal, it is administered by the state, which means there may be some variation on the requirements, providers, benefits, etc. There is a link at the end of the article that will take you to your state's Medicaid contact information. You will need this link in order to find out what the specific income levels are for your state since they can change occasionally.

  1. Basic Eligibility Requirements

    • There is a broad range of general categories of people who are eligible for Medicaid. These categories are low-income families with children, children under 21, pregnant women, people with permanent disabilities, people over the age of 65, people on Medicare, people in need of long-term treatment in permanent living facilities and people receiving Social Security. You must also be a U.S. citizen or a legal immigrant.

    Income Requirements

    • The income requirements are one of the items that are affected by where you live. Different states count your income and financial resources differently. If your financial means are limited, it is recommended that you apply.

    Child Requirements

    • A child can be a eligible for Medicaid even if the parents aren't. Eligibility is based on a child's residency status not the parents. A child may also be eligible if she needs nursing care, but you could provide the care if you didn't work. You can receive coverage if your family income is at or below 100 percent of the federal poverty level. This is a minimum and some states may set higher levels. Many states will cover children up to age 21 but federal law requires coverage to at least 19.

    Pregnancy Requirements

    • Medicaid covers pregnancy even as a pre-existing condition, meaning you were pregnant when you applied. Marital status does not affect your eligibility. You can receive coverage if your family income is at or below 133 percent of the federal poverty level. This is a minimum and some states may set higher levels. If you are covered when you give birth, your child will automatically be covered.

    Disability and Age Requirements

    • Medicaid will cover the elderly (65 years old and older). Also, it covers disabilities, including blindness. If you are terminally ill and would like hospice care, you may be covered. The general rule of thumb here is to apply if you are blind, disabled, living in a nursing home, over 65 plus you have limited financial means.

    Other Requirements

    • Welfare recipients would generally be eligible for Medicaid. You might also qualify if you cannot afford to pay your medical bills.

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