What are Delaware's Medicaid Eligibility Requirements?

Although the majority of Medicaid funding comes from a federal source, the scheme is administered by state governments such as that in Delaware. The respective state also has some control over the precise terms of eligibility for coverage. In Delaware, coverage eligibility is based on a combination of citizenship or residency status, the number and age of people in the household, and the household income level.

  1. Citizenship

    • Only Delaware residents are eligible for Medicaid coverage in the state. Full coverage is guaranteed for US citizens who meet all eligibility requirements. Coverage for legally residing non-citizens can vary depending on overall levels of state funding at the time of application. All non-citizens (including those in the US illegally) are eligible for Medicaid coverage for emergency treatment and childbirth services as long as they meet income requirements.

    Income

    • The specific income requirements depend on additional circumstances of the applicant and the coverage being applied for. In most cases the limits are based on the designated federal poverty level given the size of the household: a family as a whole can receive Medicaid if the household income is less than 100 percent of the poverty level; a child aged 1 to 6 can receive Medicaid if the household income is less than 133 percent; and both a child under 1 and the child's mother, or a pregnant woman, can qualify if the household income is less than 200 percent.

      For the purposes of assessing a household woman, a pregnant woman is counted as two family members, meaning the allowable income level is higher.

    Poverty level

    • The figures listed for 2009 by the Delaware government, which were still listed as current as of 2011, worked on a federal poverty level of $10,830 for a single person household and $3,740 for each additional member. This means the relevant limits for a child aged 1 to 6 are $14,412 plus $4,968 for each extra person, and for infants/mothers of infants/pregnant women are $21,660 plus $7,480 for each extra person.

    Supplementary Security Income

    • Those receiving Supplemental Security Income are automatically eligible for Medicaid.

    Exceptions and conditions

    • Families with young children will normally be eligible for Medicaid despite having a separate private health insurance policy. Other potential Medicaid recipients will not be eligible if they have separate health insurance.

      If someone receiving Medicaid is eligible for Medicare, the Medicaid program will pay the premiums, co-payments and deductibles for the Medicare coverage.

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