What are the eligibility requirements for Medicaid?


Quick Answer

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.

Continue Reading

Full Answer

The qualification level varies by state, and partially depends on whether the state participates in expanded Medicaid or not. If the state does participate, then the qualification is at least 133 percent of the federal poverty level and below. In other words, a family of four with a modified adjusted gross income of $32,252.50 in 2015 would qualify in states with expanded Medicaid.

The requirements also vary depending on who is in need of coverage. There is usually a higher income limit for children than there is for adults. For example, in California in 2015 adults who need assistance must meet the 133 percent federal poverty level threshold. However, the families of children who need assistance qualify up to 261 percent of the federal poverty level ($63,292.50).

The documentation requirements by state can also vary. States such as New York require proof of expenses and proof of any current or prior health insurance. Other states simply require proof of income. Most states also require those in need to show proof of residency within the state as well as U.S. citizenship. However, those requirements may be waived for pregnant women.

Learn more about Social Services

Related Questions