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Health Insurance

Medicaid: Eligibility Requirements
    

Medicaid is state regulated and funded health insurance that helps low-income persons who can't afford medical care pay for some and/or all of their medical bills. If you qualify and don’t have medical insurance, Medicaid can help you stay healthy and assist you till you find other resources. Medicaid is available only to people with limited income and has strict limitations. In order to qualify, you must fall into a group of persons that meet specific criteria. Medicaid pays money directly to your health care providers. Depending on your state's rules, you may also be asked to pay a small part of the cost (co-payment) for some medical services or prescription drugs.

Many groups of people can be covered under Medicaid that will qualify under their own group’s specific guideline. Some examples of group’s requirements can include your age, whether you are pregnant, disabled, blind, or aged or your income and resources. Resources can be cash or any item that can be sold for a substantial amount of money, or bank accounts, or property. Another requirement is whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group, so you should check the requirements that pertain to where you are living.

In addition, for those persons living in a nursing home or at home with disabilities, there are specific rule and guidelines to be met. Your dependent child or children may be eligible for coverage if they are U.S. citizens or a lawfully admitted immigrant, even if you are not. Eligibility for children is based on the child's status, not the parent's. Also, if someone else's child lives with you, the child may be eligible even if you are not because your income and resources will not count for the child.

General eligibility requirements you must meet to obtain Medicaid in your state may vary from other states, but they are pretty mush based on the same criteria. You must meet the income, dependent, resources, and other various requirements asked on the application to qualify. People who qualify are individuals over 65, blind, and disabled for social security disability purposes. Others are families or single parents with children under 21 year old who either don’t make enough money, don’t have health benefits at a reasonable cost, or are on public assistance. Single and married persons with a temporary disability, limited income, special circumstance, or between the ages 59-64 also can meet the criteria. If you need to seek drug or alcohol treatment, or are the victim of domestic violence you are eligible for Medicaid during treatment and possibly after the crisis is over. You can also qualify if you are caring for a child or disabled person.

When applying for Medicaid your eligibility is determined by your income and that can come from various sources. They compare the income and to the size of the family to determine if they qualify. Qualifying income is, and not limited to, earned wages, interest, dividends, social security, veterans’ benefits, pensions, child support, and spouse or partner’s income if living with them. Types of payments that aren’t considered countable income are public assistance, social security benefits, food stamps, low income home energy assistance program benefits, foster care payments, certain housing and utility subsidies, and weatherization payments. There are income limits of course and they are strict, if you exceed them by a penny you don’t qualify. The limits are different depending on the amount of family members living in the home and requesting the benefits.

You will have to have proof of your resources and family size to determine if you have resource limits and are eligible. Different groups of qualifiers will vary in what resources they can have. Resource limits do not apply for those persons with children at home and under the age of 21. Resources that are counted in eligibility determination are cash, checking and/or saving accounts, certificates, Christmas or vacation clubs, stocks and bonds, some types of trust funds, life insurance, vehicles, revocable burial funds, and non-resident property. Items that cannot count against you when determining eligibility are your home, burial space and marker, and one vehicle per household. If you are a student and get federal grants and loans, those cannot be counted either.

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by SolveYourProblem.com : 2006

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