Who is Eligible for Medicaid

Medicaid is a federally funded health insurance program in the United States designed to cover necessary medical care for individuals and families with limited incomes or particular life circumstances.  Guidelines vary from state to state but there are general guidelines that apply across the board.  Medicaid may be available to a variety of people who meet the criteria for eligibility. 

In general, an applicant for Medicaid must be a United States citizen or legal immigrant.  They must also meet the criteria for income limitations.  In order to know if you or someone you know can meet the particular criteria for your state you should contact a qualified caseworker in your area for an evaluation of your particular circumstances.

There are some general requirements for people who fall under the Medicaid umbrella.  In addition to income and financial resource guidelines, these include, but may not be limited to, a person’s age, pregnancy, level of disability, blindness, or being elderly.  Children living in households where the family income falls below the federally determined poverty level may qualify as well.  Income requirements may vary depending on the age of the children involved. The addition of any of these conditions can alter the income restrictions for a particular individual. 

If you think you might qualify for Medicaid coverage, it’s important to apply for benefits as soon as possible.  Retroactive coverage may be available for up to three months prior to an application being filed.  Anything before that time period will not be considered.  When your circumstances change, your coverage under Medicaid may change as well.

Prescription coverage is another aspect of Medicaid coverage that an individual should investigate during the Medicaid application process. 

Medicaid is not an automatic insurance coverage program.  Just because you may qualify based solely on limited income and minimal assets with a cash value, you are still required to submit an application for Medicaid coverage. 

People who may qualify based on other criteria, as mentioned above, may qualify for cash assistance from the Temporary Assistance for Needy Families program or Supplemental Security Income from Social Security in addition to the medical coverage.  That’s why it’s important to have a qualified caseworker on your side when determining if Medicaid options are right for your circumstances.

Medicaid should not be confused with Medicare, which is a federally funded health insurance program for individuals over the age of 65 or those under the age of 65 with qualifying disabilities.