Financial assistance is provided in the Medicaid program. This program helps with medical expenses for those who have a low income, pregnant women, children, disabled people, and elderly people. You can only receive Medicaid if you are a U.S. citizen and meets federal and state income requirements.
Also, Medicaid beneficiaries that have a limited income may be eligible for the program. The program can help them pay for Medicare expenses that you need to pay for on your own — copays, premiums, deductibles. It should be recognized that Medicaid does not mean it can be completely free. Unfortunately, there may be some costs such as copays, but the details will change depending on the state you reside in.
State Medicaid eligibility
Though the federal government funds some of the program, each state determines eligibility for Medicaid for its residents. Like mentioned before, the state requirements may vary based on the income as well as the situation the person is in. Medicaid is determined by income and also the family size with the help of Federal Poverty Level — FPL. The minimum eligibility for 2016 was 133 percent of the FPL. You may qualify for Medicaid for your state if you don’t end up meeting the federal standards.
Whether you think you qualify for Medicaid or not, you should still apply for the program. The determination if you qualify will be made by a caseworker and approvals are made based on information that you provided. This includes personal information such as your income and financial resources. Other circumstances may be considered as well. Generally, Medicaid aims to help low-income groups such as pregnant women, elderly, children and disabled people. Be sure to review the criteria based on the state you live in.
Because of the Affordable Care Act, Medicaid has now expanded to cover low-income adults that aren’t eligible from other criteria. Prior to this, those low-income adults were required to have a waiver that was covered by the state Medicaid. Though you must need the minimum federal income, some states may be more generous than others. If you don’t fit in a category that has been mentioned, but you are a low-income individual, reach out to your state Medicaid program to see if you can still apply.
There are lots of options to being eligible for the Medicaid program. For instance, most states provide Medicaid to anyone who is already getting benefits from the Supplemental Security Income program. A handful of states provide Medicaid to older adults with a disability that has an income that is under 100 percent of the federal poverty level.
Mainly, to be eligible for Medicaid you must qualify for one of the following below:
● 65 or older
● Have a continual disability as that term is explained by the SSA
● Visually impaired
● Pregnant woman
● Child, or the parent/guardian of a child
● Additionally, you need to meet specific requirements, such as:
○ U.S. citizen or meet certain immigration regulations
○ Be a state resident where you apply
○ Have a Social Security number
The amount of income you are allowed to have varies depending on the state you’re in and also the eligibility group you are in. When your state program finally determines your financial eligibility, they will count some of what you make, but not all of it. Your income includes:
● Regular benefits — Social Security retirement or disability
● Veterans benefits
● Interest from bank accounts
● Dividends from stocks/bonds
A medical expert in your state will need to evaluate your needs and decide if your disability will need long-term care. Generally, the doctor will make the decision based on if you need help performing specific activities of daily living (ADL). These include:
● Using the bathroom
● Getting in and out of bed/chair/couch