What Are the Requirements to Be Eligible for Medicaid?


Quick Answer

All Medicaid applicants must be U.S. citizens or qualified resident aliens; other requirements for Medicaid eligibility vary from state to state depending on whether states have opted to expand Medicaid coverage. Criteria for eligibility include income level and whether applicants fall into mandatory or optional eligibility groups.

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Full Answer

According to federal law, all states participating in the Medicaid program must provide Medicaid for low-income mandatory eligibility groups such as children, pregnant women, parents, the elderly and the disabled. In most states, elderly, blind and disabled individuals who receive Supplementary Security Income also receive Medicaid. The Affordable Care Act gives states the option of providing expanded Medicaid coverage. As of 2015, this allows everyone with incomes under 133 percent of the federal poverty level to be eligible for Medicaid regardless of family status or disability. The only criteria in states with expanded Medicaid coverage are household size and income.

The only way an applicant can be sure that he meets the requirements for Medicaid coverage is to fill out an application. Applicants may apply online through the Health Care Marketplace at HealthCare.gov or by contacting their state Medicaid office. Medicaid does not have a limited enrollment period; people are able to apply all year and coverage begins immediately upon acceptance.

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