Medicaid's Role in Helping Low-income Families
Medicaid is a program run by the federal government and the states. It works with the Children's Health Insurance Program to ensure that millions of Americans who couldn't otherwise afford health insurance receive coverage. Today, this program is the country's largest health insurance provider.
Under federal law, states must cover specific groups, including low-income families and qualified pregnant women. Anyone looking for medical care should learn whether they are eligible for the program, as the Affordable Care Act provided states with the option to cover more groups. Many low-income adults might find they now qualify.
Financial Eligibility
The Affordable Care Act established a new methodology for determining Medicaid eligibility based on modified adjusted gross income. This methodology also determines CHIP eligibility and premium tax credits for Obamacare. Using one methodology for all programs makes the application process easier. It looks at the applicant's taxable income and tax filing relationships to learn which program they are eligible for.
In the past, Medicaid eligibility was determined based on the Aid to Families with Dependent Children program methodology. This program ended in 1996. The MAGI methodology doesn't include income disregards, which each state determines. There is no asset or resource test with MAGI either.
Certain people are exempt from the MAGI rules. Their eligibility is based on other factors, such as whether they have a disability or are 65 or older. The program uses income methodologies established by the Social Security Administration to determine if these men and women qualify for Medicaid. Some states have implemented stricter eligibility requirements, so applicants must know the rules for their state. Medicare Savings Programs also use Social Security Administration methodologies when determining whether Medicaid will pay a person's Medicare premiums.
Certain individuals don't have to meet income requirements to qualify for Medicaid. They immediately qualify if they are enrolled in SSI or specific other programs. The same holds for children with an adoption assistance agreement or who were former foster care recipients.
Non-Financial Requirements
To qualify for Medicaid, individuals must also meet non-financial requirements. They must be residents of the state where they apply for the program. Applicants must be citizens or qualified non-citizens. Age, pregnancy, and parenting status also affect a person's eligibility.
Coverage Date
Medicaid backdates coverage to the date the person applied or the first day of the month they applied. If the person qualified for coverage during that period, Medicaid may also offer benefits retroactively for up to three months before the application is submitted. Coverage ends at the end of the month when the person no longer meets eligibility requirements.
Medically Needy Individuals
Certain individuals with significant health needs may qualify for Medicaid even if their income exceeds the allowed limits. Each state establishes a program to help these people cover their excessive medical bills. Another option is a Medicaid spend-down. The individual looks at their income and determines how much it puts them above the Medicaid limit. This amount is referred to as the spend-down liability. Once they spend or owe this amount on medical bills, they become eligible for Medicaid. Many states have these programs in place.
Medical insurance is a necessity today due to rising healthcare costs. Medicaid helps those individuals who cannot afford coverage otherwise. Learn more about Medicaid eligibility requirements today and see if you qualify for this program. Healthcare coverage provides peace of mind, so every person should look into this program today.
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