How Can You Determine Medicare or Medicaid Eligibility?


Quick Answer

The Medicare.gov provides tool to determine eligibility and premium information, and Medicaid.gov provides eligibility guidelines, according to the programs' websites. The Medicare eligibility tool is interactive, and the Medicaid website provides current information about group and income guidelines to qualify for the program.

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Full Answer

Medicare and Medicaid are two different programs, according to the U.S. Department of Health and Human Services. Medicare is an insurance program that mainly serves people over 65 and disabled people. The program uses Medicare tax funds to pay medical bills for those covered under the program. Medicaid is program designed to assist low-income families with medical care costs. Although most families covered by Medicaid pay no out-of-pocket medical costs, some families in higher income brackets have a co-pay.

Federal regulations determine what groups each state must cover under Medicaid programs, according to Medicaid.gov. Some states only cover the mandatory eligibility groups, but others expand coverage for certain groups, such as children. The income requirements to qualify for the program are based on the Federal Poverty Level, which is updated each year.

Another program that helps families with medical costs is the Children's Health Insurance Program, or CHIP, states HealthCare.gov. CHIP is designed to provide low-cost health care to children in families with income that exceeds the requirements to qualify for Medicaid.

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