Medicaid was created on July 30, 1965, through Title XIX of the Social Security Act. It is a joint federal-state program that provides health insurance coverage to children, pregnant women, parents of eligible children, seniors and people with disabilities. While Congress and the Centers for Medicare and Medicaid Services set out the main rules under which Medicaid operates, each state runs its own program. As a result, the eligibility rules differ significantly from state to state. In general, there are three basic elements in determining eligibility:
Category – E.g. Children, Pregnant Women, Children Seniors and the Disabled. Age limits for children vary by state. Some states determine disability through a state review board. Others depend on the Federal governments to determine disability through the Social Security Administration.
Income – E.g. Wages, alimony, pensions, etc.. All states allow you to deduct some types of income. Some states allow you to meet income guidelines by using unpaid medical bills to meet a deductible (called a Spend Down in most states), so if you appear to be over income for Medicaid it still might be worth applying.
Resources – E.g. Checking and savings accounts, stocks, bonds, cds, etc. States exclude certain resources/assets like your primary residents.
The eligibility rules can be complicated and confusing, so it’s best to go ahead and apply if you are in doubt. Many hospitals look positively at your willingness to apply for Medicaid when making a determination on charity applications.
Below are links to the Medicaid websites for 50 states and District of Columbia.
District of Columbia Medicaid
New Hampshire Medicaid
New Jersey Medicaid
New Mexico Medicaid
New York Medicaid
North Carolina Medicaid
North Dakota Medicaid
Rhode Island Medicaid
South Carolina Medicaid
South Dakota Medicaid
Washington State Medicaid
West Virginia Medicaid