Frequently Asked Questions on Medicaid Eligibility

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Medicaid is a state-sponsored health insurance program designed for needy individuals and families. Federal laws require each state to cover certain groups of people, including those with no or low incomes, the medically needy, Supplemental Security Income (SSI) recipients and children in foster care, among others. States may have their own eligibility criteria in addition to the federal criteria. Therefore, each state has resources to answer your questions about Medicaid eligibility.

How Can I Find Out if I’m Eligible for Medicaid?

The federal government provides online screening tools to assess if you may qualify for Medicaid and other government programs. Visit GovBenefits and BenefitsCheckUp and complete the online questionnaires. After answering questions about where you live, your income and other circumstances, the site will direct you to additional resources, if you qualify for medical assistance. Additionally, every state has social services representatives who can meet with you in person or over the phone to help determine if you're eligible for Medicaid.

How Do I Apply for Medicaid?

Every state has its own application process. Visit your state’s department of insurance website to find out how to apply for Medicaid. The website benefits.gov also has a search-by-state feature with links and phone numbers to apply for each state’s Medicaid programs. Most states allow you to apply directly online. However, for those who prefer to apply in person or by phone, resources are available to help navigate the process. Additionally, for those who need help with translation, reading or writing, the state offers representatives to help with the Medicaid application.

Can My Children Qualify for Medicaid?

Children qualify for Medicaid based on their need, not the need of their parents. Therefore, it is possible for a children to be eligible for Medicaid when their parents are not. Foster children, for example, are eligible for Medicaid, as is a child who lives with someone other than their biological parent. For instance, a child living with family members may qualify for Medicaid because the family member’s income and resources have no impact on the child’s Medicaid eligibility. Many states have state-sponsored children’s health insurance plans, even when the child doesn’t qualify for Medicaid.

Are Illegal Aliens Eligible for Medicaid?

Many states only allow U.S. citizens and illegal aliens with permanent legal status to qualify for full Medicaid benefits. An alien who is in the country illegally or is legal but has been in the United Sates less than five years may not be eligible for Medicaid, depending on the state, though they may be eligible for emergency medical services. Aliens who are not U.S. citizens but who are lawful permanent U.S. residents may qualify for full Medicaid benefits if they have lived in the U.S. for five years. This requirement is often waived for refugees and asylees.

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