How Do You Verify Medicaid Eligibility?

A person can verify Medicaid eligibility by accessing a feature on the Centers for Medicare and Medicaid Services website that links to each state's Medicaid program, reports As of 2015, Medicaid eligibility criteria vary by state, depending on whether the state has expanded coverage under the Affordable Care Act.

To verify Medicaid eligibility, go to the main page, select Get Answers in the toolbar at the top of the page, and click on Medicaid & CHIP under Medicaid, CHIP & Medicare, according to In the column on the left side, select Find Out If You Qualify for Medicaid and CHIP, and click on Get Started. Enter your zip code, select your county, put a check mark on Find Out If You're Eligible for Medicaid or CHIP, and click Continue. The site directs you to your local health plan marketplace, where you can initiate an application to determine Medicaid eligibility.

In all states, Medicaid covers certain mandatory eligibility groups, such as pregnant women, the elderly, the disabled and families with children whose income falls below the federal poverty level, states Additionally, all Medicaid applicants must be U.S. citizens or eligible resident aliens. With funding authorized under the Affordable Care Act, states can choose to expand Medicaid programs to cover all adults less than 65 years old with incomes up to 133 percent of the federal poverty level, as of 2015, reports The Children's Health Insurance Program, or CHIP, allows coverage for children at the same or higher income levels.

Most states rely on electronically available data to determine eligibility, states the Medicaid website. Some states such as Nebraska and Louisiana have specific guidelines that require health care providers to verify patient eligibility under Medicaid before providing any services. Providers are also required to verify that patients are enrolled under Medicaid or Medicare through the state Eligibility Verification System or by telephone before processing a claim, according to the Louisiana Department of Health and Hospitals and the Nebraska Department of Health & Human Services.