Q:

Who is eligible for Medicaid?

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Quick Answer

Pregnant women, children, disabled persons and the elderly who meet low-income standards are eligible for Medicaid in every state. In 2014, eligibility expanded in some states to include everyone who earns up to 138 percent of the federal poverty level.

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Who is eligible for Medicaid?
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Full Answer

Medicaid health care programs are operated at the state level according to certain minimum standards set by the federal government. State programs must match the federal minimum eligibility standards, but may choose to expand coverage beyond the minimums in order to cover additional people. Thus, the effective minimum eligibility standards vary greatly by state.

For example, federal standards ensure that pregnant women in families earning 133 percent of the federal poverty level or less are eligible for Medicaid in every U.S. state. However, some states offer Medicaid coverage to pregnant women in families earning as much as 185 percent of the federal poverty level, a difference in eligibility requirements that amounts to household income of nearly $8,200 for a husband and wife expecting their first child.

The Patient Protection and Affordable Care Act, popularly known as "Obamacare," includes a program to expand Medicaid eligibility requirements to include all low-income individuals and families that earn 138 percent of the federal poverty level or less. However, the U.S. Supreme Court ruled this part of the law to be voluntary on the part of the states. As of April 2014, 26 states are participating in the expansion of Medicaid eligibility. The remaining 24 states are not moving forward. In those states, the former federal minimum eligibility standards still apply.

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Related Questions

  • Q:

    What are the qualifications to receive Medicaid?

    A:

    The general qualifications to receive Medicaid are based on state residency, U.S. citizenship, immigration status, income level and asset limit. In each state, Medicaid provides low-cost or free coverage to mandatory population groups such as the elderly, pregnant women, families and children, low-income earners and people with disabilities.

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  • Q:

    What are the eligibility requirements for Medicaid?

    A:

    In order to qualify for Medicaid, a person or family generally must meet state guidelines for income as a percent of the federal poverty level - which, for a family of four, was $24,250 in 2015. There are also federal and state requirements for residency and citizenship status.

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  • Q:

    Who is eligible for Medicaid in South Carolina?

    A:

    Children under age 18, seniors over age 65, the blind or disabled, pregnant women, foster children, women diagnosed with breast or cervical cancer and families with little to no income may be eligible for Medicaid in South Carolina. Each category has income and resource limits that each household must meet.

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  • Q:

    How do you apply for Medicaid in Texas?

    A:

    Apply for Medicaid in Texas through the Health Insurance Marketplace. Texas Medicaid programs include Children's Medicaid, Children’s Health Insurance Program, or CHIP, and Texas Women’s Health Program. Medicaid is typically for people who get Supplemental Security Income or SSI.

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