State Medicaid Eligibility

Medicaid is a joint state and federal effort to provide health insurance coverage to families and individuals in financial need. Each state has its own individual Medicaid program; in some states, the name will differ. For example, the California Medicaid program is called Medi-Cal. While specific requirements vary among states, the basic guidelines are the same.


Residency and Citizenship

You must apply for Medicaid in the state where you reside. Medicaid does not transfer between states. If you move or relocate, a new application must be submitted through the appropriate agency. Medicaid is only offered to U.S. citizens and legal immigrants with proper documentation. Prepare to supply proof of citizenship for all household members. Adequate verification includes a birth certificate, Social Security card, driver's license or naturalization documents. Illegal immigrants may receive limited Medicaid services in emergencies only.


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Eligibility Groups

Although states have some discretion when limiting the ages and financial limits, states are required to offer Medicaid coverage to certain mandatory eligibility groups. Medicaid is open to pregnant women, infants born to Medicaid-eligible mothers, children, parents with children in the household, people age 65 or older, disabled or blind and SSI recipients. Medicaid can also be used to supplement Medicare benefits by covering premiums and deductibles. Foster children and adoption assistance recipients are also eligible. States are required to extend Medicaid eligibility to the age of 19 for any child born after September 30, 1983. Some states choose to offer Medicaid coverage to children up to age 21.


Income Limits

Medicaid is typically available only to low-income applicants. Your income cannot exceed a certain percentage of the Federal Poverty Level, FPL, determined by your eligibility group. In most states, the income limits are higher for pregnant women and infants up to 12 months than other eligibility groups. For example, in Michigan, pregnant women and infants are allowed 185 percent of the FPL. A working parent is allowed 61 percent of the FPL. In addition to earned income, unearned income such as child support, alimony and Social Security benefits, are also calculated in a household's gross monthly income.


Asset Restrictions

Asset restrictions may also apply, depending on the eligibility group. Countable assets for adults, elderly, blind and disabled are often limited to $2,000 per person or $3,000 per couple. Your home, vehicle, personal possessions, pre-paid funeral and burial expenses and certain life insurance policies are exempt. Cash, bank accounts, real estate, recreational vehicles and boats are examples of assets that can be included in the asset limit.



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