Learn the Eligibility Requirements for Medicaid and How They Vary by State

Medicaid is a joint federal and state program that provides healthcare coverage to millions of low-income individuals and families in the United States. The program is administered by each state, which means that the eligibility requirements can vary from state to state. In this article, we will explore the eligibility requirements for Medicaid and how they vary by state.

Basic Eligibility Requirements for Medicaid

Medicaid is primarily designed for low-income individuals and families who cannot afford health insurance on their own. To be eligible for Medicaid, individuals must meet certain income and asset requirements, as well as other eligibility criteria that may vary by state.

The income requirements for Medicaid vary depending on the state in which you live. In general, individuals and families with income levels below the federal poverty level (FPL) are eligible for Medicaid. In 2021, the FPL for a single person was $12,880, while the FPL for a family of four was $26,500. However, some states have chosen to expand Medicaid coverage to individuals and families with incomes above the FPL.

In addition to income requirements, Medicaid also has asset requirements. Individuals and families must have limited assets in order to be eligible for Medicaid. The exact asset limits vary by state, but in general, assets such as a primary residence, personal belongings, and a vehicle are not counted towards the limit.

Other eligibility criteria for Medicaid may include age, disability status, pregnancy, and citizenship or immigration status. Some states also have additional eligibility requirements, such as work requirements or enrollment in certain programs like the Supplemental Nutrition Assistance Program (SNAP).

Medicaid Eligibility Requirements by State

As mentioned, Medicaid is administered by each state, which means that the eligibility requirements can vary from state to state. Some states have chosen to expand Medicaid coverage under the Affordable Care Act (ACA), while others have not. The following are some examples of how Medicaid eligibility requirements vary by state:

• California

California has expanded Medicaid coverage under the ACA. This means that individuals and families with incomes up to 138% of the FPL are eligible for Medicaid. In addition, California does not have any asset limits for Medicaid eligibility.

• Texas

Texas has not expanded Medicaid coverage under the ACA. This means that only certain low-income individuals and families are eligible for Medicaid in Texas. In general, individuals must have incomes at or below 17% of the FPL to be eligible for Medicaid in Texas. In addition, Texas has strict asset limits for Medicaid eligibility.