Medicaid is a government program that is designed to provide health benefits to low-income Americans. Many people wonder if they or someone they care for would be eligible for coverage through Medicaid. Because each state operates its own Medicaid program, the answer to this question varies by state.
However, there are certain eligibility guidelines that are true regardless of which state you live in. For example, because the Medicaid program is designed to assist low-income Americans, all applicants must prove that their income falls below a certain level. This level varies by state. However, even if your income falls below the threshold required by your state's Medicaid program, you may still not be eligible for Medicaid. Poverty alone is not enough - you must be low-income AND fall into a Medicaid eligibility category.
Medicaid eligibility categories include:
- Most families receiving benefits through Aid to Families with Dependent Children (AFDC)
- Most Supplemental Security Income (SSI) recipients
- Infants born to Medicaid-eligible women
- Children under age 6 and pregnant women whose family income falls below 133% of the federal poverty guidelines
- Recipients of adoption assistance and foster care
- Certain people with Medicare
States may choose to cover other categories of individuals, including:
- Infants up to age 1 and pregnant women not covered above whose family income falls below 185% of the federal poverty guidelines
- Some aged, blind, or disabled adults whose incomes fall below the federal poverty guidelines
- Institutionalized individuals
- State welfare benefit recipients
Others may be eligible, so if you or someone you care for is a low-income individual, you may want to contact your state's Medicaid program for more information.
Sources:
The Centers For Medicare & Medicaid Services. "Mandatory Eligibility Groups,"accessed May 17, 2009.
The Centers For Medicare & Medicaid Services. "Optional Eligibility Groups," accessed May 17, 2009.
