Medicaid is a joint federal and state program that provides health coverage to over 72.5 million Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. It is the single largest source of health coverage in the United States[1]. The eligibility criteria, application process, coverage details, and income limits for Medicaid vary from state to state[3][8][9].
Eligibility Criteria
Medicaid beneficiaries generally must be residents of the state in which they are receiving Medicaid. They must be either citizens of the United States or have a satisfactory immigration status. Federal law requires states to cover certain groups of individuals, such as low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI). States have additional options for coverage and may choose to cover other groups, such as individuals receiving home and community-based services and children in foster care who are not otherwise eligible[1].
The Affordable Care Act of 2010 created the opportunity for states to expand Medicaid to cover nearly all low-income Americans under age 65. Eligibility for children was extended to at least 133% of the federal poverty level (FPL)[1]. As of 2023, 41 states (including DC) have adopted the Medicaid expansion and 10 states have not adopted the expansion[6].
Application Process
You can apply for Medicaid through the Health Insurance Marketplace or directly with your state Medicaid agency[3]. Some states require you to apply in person, while others may allow you to apply by mail, online, by telephone, or at locations in the community, such as health centers and community organizations[5].
Coverage Details
Medicaid provides health care coverage to eligible adults with a low income, children, people who are pregnant, people age 65 or over, and people with disabilities[9]. The specific coverage details can vary from state to state.
Income Limits
The Affordable Care Act’s (ACA) Medicaid expansion expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($20,120 for an individual in 2023)[6]. However, income limits can vary from state to state, and some states have not adopted the expansion[6][8].
Contact Information
For questions related to Medicaid eligibility, application process, coverage details, and income limits, you should contact your State Medicaid Agency[3]. The Centers for Medicare & Medicaid Services (CMS) can also assist with general policy guidance, grants and reimbursements, and technical assistance related to specific initiatives and information systems[7].
For a comprehensive guide to Medicaid in each state, including specific eligibility criteria, application process, coverage details, and income limits, you can visit the Medicaid website and select the specific state you are interested in[2][4].
Citations
- https://www.medicaid.gov/medicaid/eligibility/index.html
- https://www.medicaid.gov/state-overviews/state-profiles/index.html
- https://www.medicaid.gov/about-us/contact-us/index.html
- https://www.medicaid.gov/state-overviews/index.html
- https://www.medicareinteractive.org/get-answers/cost-saving-programs-for-people-with-medicare/medicare-and-medicaid/how-to-apply-for-medicaid
- https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/
- https://www.medicaid.gov/about-us/beneficiary-resources/index.html
- https://www.policygenius.com/health-insurance/a-state-by-state-guide-to-medicaid/
- https://www.usa.gov/medicaid-chip-insurance