Medicaid is a state and federally funded health care program that helps people with low income and high health costs get the care they need. Each U.S. state and territory (e.g., Puerto Rico and the U.S. Virgin Islands) administers Medicaid differently, and has particular eligibility guidelines and requirements. However, how you determine your own individual eligibility works the same, no matter where you live.
Instructions
1. Calculate your total income, and assess what percentage it is of the federal poverty limit, using an online federal poverty limit calculator. While each state and territory has its own eligibility requirements, the federal government has bare minimum eligibility guidelines they all must adhere to. All states and territories, for example, must provide Medicaid to qualifying children; pregnant women; and the aged, blind, and disabled. Some states and territories may offer benefits to specific population groups as well.
2. Calculate your average monthly health costs by gathering your health bills over the past three months, adding them up, and dividing that figure by three. Some individuals who are above the income eligibility guidelines can still qualify for Medicaid by obtaining a "spend-down." A spend-down is when Medicaid takes your monthly health costs and subtracts them from your total monthly income. If what is left meets spend-down eligibility limits, you may be qualified for full access to Medicaid benefits for that benefit period.
3. Call your local Medicaid agency to get specific eligibility information for your state or territory. This includes finding out what the maximum monthly income can be and to see if there is a limit on assets you are allowed. Ask if there is a Medicaid spend-down program available in your area and request that the agency send you an application.
4. Compare your income and health costs with the eligibility guidelines provided to you by the agency. If your numbers meet eligibility guidelines, then you may qualify without any deductions or exceptions. If you have either too much income or assets, apply anyway. Each state has particular laws about income that should or should not be counted and about what assets will count against you, if any.
5. Apply, and attend the interview if it's required. The interview is a good chance to speak with a social worker who may have more insight on how you can qualify for Medicaid in your state.
6. Change your income and assets. If you do not qualify for Medicaid and you need it, as long as you are in a population that your state covers, you can always try to reduce your income or liquidate your assets. For some people, this is a cost-effective move, because what they save by having Medicaid coverage is greater than the income or assets they may lose.
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