Medicaid Eligibility

Medicaid is a social welfare health and medical services program for low income individuals and families. The supervision of the program is at the federal level, but each state institutes their own standards for eligibility, regulates the services they provide (such as the types, amount and duration and scope), determines the equivalent rate for services and manages its own Medicaid program.

Eligibility guidelines differ from state to state, and although the program is aimed at helping people who belong in the low-income bracket, qualification may also depend on other factors such as age, pregnancy status, citizenship and disability status and caretakers of the disabled, elderly and children.

Generally, a person with limited income and resources should consider applying for Medicaid. Should you or a family member match one of the descriptions found below, consider applying for Medicaid. Seek for a qualified caseworker in your state for aid with evaluating your situation if you are unsure whether you are eligible or not, especially if you or someone in your family needs health care coverage.

Pregnant Women

Pregnant women, whether married or single may be eligible for Medicaid. Both mother and child will be covered when the mother is on Medicaid at the time of the child’s birth.

Children and Teenagers

Parents and legal guardians of children 18 years old and below with limited income and resources , parents with children who are sick enough to need nursing home care but are able to stay home with good quality care, are encouraged to apply. A teenager living alone may also be allowed by the state to apply for Medicaid on his or her own behalf. Many states provide Medicaid cover for children until the age of 21.

Elderly, Blind and Disabled Persons

Medicaid may be for you if you are:

  • Aged 65 or older
  • Blind or disabled and have limited income and resources
  • Terminally ill and need hospice services
  • Elderly, blind or disabled, living in a nursing home and have limited income and resources
  • Elderly, blind or disabled, need nursing home care but can stay at home with special community care services
  • Eligible for Medicare and have limited income and resources

Others

If you find yourself in any of the following situations, Medicaid may also be for you:

  • Leaving welfare and in need of health care coverage
  • Families with children under 18 and have limited income and resources

It is important to note that not all individuals or families with limited income and resources are provided with Medicaid coverage. Income is only one of the considerations for Medicaid eligibility. Your assets and resources will also be taken into consideration as your eligibility is evaluated.

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