Do You Qualify for Medicaid?

By Stephanie Rabiner, Esq. on October 05, 2011 | Last updated on March 21, 2019

If you're wondering whether you qualify for Medicaid, you've come to the right place. Despite a number of systemic changes and budgetary constraints, Medicaid still exists.

Though it is a federal program, Medicaid eligibility is generally state-dependent. There are certain groups of people states must cover. Beyond these groups, each state determines which low-income and disabled residents it serves.

The following are general Medicaid eligibility guidelines, but if you can, consider consulting state-specific rules.

States that receive Federal funds must provide Medicaid services to:

  • Low-income families with children who meet the requirements of the state's Aid to Families with Dependent Children plan;
  • Recipients of Supplemental Security Income (including the elderly, blind and disabled);
  • Infants born to Medicaid-eligible pregnant women;
  • Children and pregnant women whose family income is at or below 133% of the Federal poverty line;
  • Recipients of adoption or foster care assistance; and
  • People who lose SSI payments due to an increase in work or child/spousal support.

Some states also cover persons who don't quite meet income requirements. These people usually receive state benefits, are eligible for institutional care, or are under the age of 18.

States may also cover elderly persons who neither qualify for SSI payments or Medicare. Medicare is only available to persons who have paid into the system and are 62 or older.

If you think you qualify for Medicaid, now is the time to act. If covered, the state will pay for services rendered up to three months prior to your application. The faster you determine your Medicaid eligibility, the faster you can receive medical care.

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