Health Insurance Articles

How to Determine If You Qualify for Medicaid

2010-06-02

Determining if you qualify for Medicaid insurance is not always as simple as it sounds. Truthfully, there are several criteria that must be met in order to start benefiting from this type of coverage. Medicaid is specifically reserved for those with a low socioeconomic status and should not be confused with Medicare, which is granted to the elderly. However, an individual can obtain both Medicare and Medicaid in some situations.

What does Medicaid Cover?

Before addressing how to know if you quality for this type of insurance, it is essential to understand the services offered through Medicaid. Most programs provide partial to full support for everything from office visits and prescriptions to transportation, mental health, hospital stays, nursing home and home-based care services, and outpatient needs. The individuals plan and the state's rules determine the amount of coverage allotted to each individual for the services needed. Medicaid tends to cover more services than Medicare and many private health insurance policies.

Who Receives Medicaid?

Anyone who receives the assistance of Aid to Families with Dependent Children (AFDC) or Supplemental Security Income (SSI) is automatically enrolled into the Medicaid system and instantly qualifies. The specific qualifications for Medicaid insurance vary depending on the situation and individual need.

When determining your qualification, it is pertinent that you determine the specific rules and regulations revolving around eligibility for your state of residence. Each state has different qualification criteria that must be met across a variety of categories (including age, disability, income, resources, pregnant, etc.). Therefore, there is not a single qualification list that remains consistent across the country.

Can Children Receive Medicaid?

The short answer is yes. Even if you do not specifically qualify for Medicaid, it is possible that your child may qualify, providing you a financial break from having to purchase private health insurance coverage at an increased rate. In the Medicaid arena, children are taken into consideration separate of the parent's income in some situations. Plus, they do not have to claim resources that may prevent the parent from qualifying.

Should I Apply?

Even though the qualifications vary across states, you should apply for Medicaid if you have a relatively low socioeconomic status and are in need. If you or someone in your family is expected to require in-home or nursing home care but you are working off of limited income, it may be in your best interest to apply. If in doubt, apply and a caseworker can assist you with other insurance alternatives if you and your family do not qualify for Medicaid coverage. Plus, there are a variety of screening tools available online to assist with determining whether or not you qualify.

In short, Medicaid can greatly assist those with low income levels.