Medicaid ensures that many U.S. citizens receive healthcare, even if they can't afford it, or if they can't afford private health insurance. Although Medicaid is a government program for low-income families, not all low-income individuals qualify. Also, states can make some of their own rules.
Federal and State Governments Work Together
The federal government helps states fund their Medicaid programs, so federal guidelines address who qualifies. States can offer additional coverage, but they can't provide less than the federal standards. Federal law covers children, parents, the elderly, and people with certain disabilities, so all states must offer health coverage to these groups. But some states go further, usually to address their own demographic concerns. For example, a state with a large immigrant population might cover care for non-citizens in emergency situations.
Strict Income Requirements
Medicaid bases income eligibility on the Federal Poverty Level (FPL). To be eligible for Medicaid, you must earn less than the FPL for families of your size. In 2012, for example, a family of four can earn no more than $23,050. A single parent with one child can earn no more than $15,130.
Medicaid recipients must be U.S. citizens and meet state residency requirements. Legal immigrants are typically covered, but they must provide proof of their immigration status. Medicaid covers children only until h they turn 19 (at the end of that month). Individual states can extend coverage to older children.
The Affordable Care Act
The Affordable Care Act, scheduled to go into effect January 2014, eliminates most age requirements for Medicaid recipients. It requires that states provide Medicaid coverage to all individuals who meet the other requirements, even if they're older than 19 and have no dependents. They must be younger than 65, at which point they become eligible for Medicare. The Act also increases income eligibility to 133 percent of the FPL, so applicants can earn more and still qualify. For example, a single parent with one child could earn up to $20,123, instead of just $15,130.
An Insurance Lawyer Can Help
The law surrounding Medicaid healthcare insurance for the poor is complicated. Plus, the facts of each case are unique. This article provides a brief, general introduction to the topic. For more detailed, specific information, please contact an insurance lawyer.