What Is Required to Be on Full Medicaid?

Certain individuals may qualify for health coverage through Medicaid.

If you're unable to afford health insurance, you may be able to qualify for free or low-cost coverage through Medicaid. Medicaid is a federal program that's administered at the state level. As such, the eligibility requirements vary based on your state of residence. In general, to qualify for Medicaid benefits, you must belong to a specified group, be within the income guidelines for your family size and lack substantial financial assets.

Qualifying Situations

Medicaid coverage is only available for individuals in qualifying situations. According to the U.S. Department of Health and Human Services, eligible populations include low-income families with dependent children, low-income pregnant women, children and adults who are blind and disabled, children under age 19, senior citizens over age 65, recipients of adoption assistance and foster care under Title IV-E of the Social Security Act, and certain recipients of Medicare Part A. States may also offer Medicaid for qualifying women pursuing treatment for breast and/or cervical cancer, pregnant women who exceed the maximum income threshold and individuals who are institutionalized.

Income

To qualify for Medicaid, your monthly income must be at or below the limit established by your state. State limits are based on federal poverty guidelines, family size, age and individual situation. For example, as of 2011, senior citizens in Georgia may qualify for Medicaid with a monthly income of $674, while a family of four must have a monthly income of $500 or less to be eligible. If you're applying for Medicaid coverage for your children only, the income limit increases significantly.

Resources

Your financial resources are also considered a part of your Medicaid application. These include cash; money held in checking or savings accounts; stocks, bonds or other investments; real property such as land or a home; motorcycles, automobiles, boats and RVs; and any money you receive regularly that isn't a part of your monthly income, including child support or alimony payments, welfare assistance or cash assistance from friends or family members. Resource limits vary based on family size, age and marital status.

Considerations

If your income or resources exceeds the allowed limit, you may be able to qualify for coverage under a spend-down exception. To qualify for this type of state-sponsored health care, you must spend down the difference between your income and the limit by paying some of your medical bills each month. If you plan to transfer some or all of your assets to a trust to apply for long-term care coverage, be aware that these resources may still be counted in determining your Medicaid eligibility for the 60-month period following the transfer. Obtaining Medicaid by providing false or misleading information is considered fraud and is punishable by fines and/or imprisonment.

References

• U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services: Are You Eligible?
• U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services: Mandatory Eligibility Groups
• U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services: Optional Eligibility Groups
• Georgia Department of Community Health: Eligibility
• Mississippi Division of Medicaid: Eligibility Guidelines for Mississippi Health Benefits
• Family Department of Families and Children: Family-Related Medicaid Income & Asset Limit Chart