Who is eligible?
Medicaid Eligibility Requirements - July 2009
The following is a general outline of Medicaid Program eligibility requirements.
Click for information regarding the Healthy Steps (SCHIP - State Children's Health Insurance Program.
Asset Limits
Asset limits apply to coverage for Aged and Disabled categories. Asset limits do not apply to Children and Family Categories.
For Medicaid the following asset limits apply:
- Aged, Blind or Disabled:
- $3,000 for a one person household,
- $6,000 for two person household, plus
- $25 for each additional person in the household
- Nursing Home Services:
- Institutionalized person: $3000
- Spouse in the Community: is an amount that is equal to the community spouse share, but not less than $21,912, and not more than $109,560 for calendar year 2009. (Increases every January).
Assets that are not counted:
Your home, one automobile, burial plans (with limits), self-employment property (including tools, equipment and livestock), non-saleable property, personal effects and clothing, household goods and furniture, Indian trust and restricted lands, and per capita and judgment funds. Other miscellaneous assets may also be excluded.
Income:
Depending on the amount of net income, individuals may be eligible for full Medicaid benefits or may be responsible for a portion of their medical bills which is called their recipient liability. Children who are not eligible for full Medicaid benefits may be eligible for Healthy Steps or the Caring for Children Program. Medicaid looks at a family's total countable income and subtracts allowed expenses to establish net income.
Some of the more common allowable expenses are:
- Taxes and other work related expenses
- Health insurance premiums
- Dependent care expenses
- Child support paid to a non household member
- Other deductions may apply
Individuals in a nursing home are allowed to keep $50 of their monthly income to meet their personal needs. They also keep enough to cover their health insurance premiums and certain other expenses. If the individual has a family at home with lower income, the individual can give some of his/her money to the family at home.
To Find Out More Information or to Apply For Medicaid...
Medicaid applications can be requested in person, by phone, or by writing to your County Social Service Office. Medicaid applications are also available at certain hospitals. The phone numbers of County Social Service Offices are listed in local telephone directories under "Government Offices - County."
Medicaid Income Levels Effective July 1, 2009
| Family Size | Family Coverage (1931) | Medically Needy 83% of Poverty Level |
SSI | Children Age 6-19 100% of Poverty | Preg. Women Child to Age 6 133% of Poverty | Transitional Medicaid 185% of Poverty |
|---|---|---|---|---|---|---|
1 |
$311 | $750 | $674 | $903 | $1,201 | $1670 |
2 |
$417 | $1,008 | $1,011 | $1,215 | $1,615 | $2247 |
3 |
$523 | $1,267 | $1,526 | $2,030 | $2823 | |
4 |
$629 | $1,526 | $1,838 | $2,444 | $3400 | |
5 |
$735 | $1,784 | $2,150 | $2,859 | $3976 | |
6 |
$841 | $2,043 | $2,461 | $3,273 | $4553 | |
7 |
$947 | $2,302 | $2,773 | $3,688 | $5130 | |
8 |
$1053 | $2,560 | $3,085 | $4,102 | $5706 | |
9 |
$1159 | $2,819 | $3,396 | $4,517 | $6283 | |
10 |
$1265 | $3,078 | $3,708 | $4,931 | $6859 |
Medicare Savings Plan Programs
People with qualifying incomes may be eligible for these services which include payment of their Medicare premiums, deductibles, and co-insurance.
| Family Size | Special low Income Medicare Beneficiaries (SLMB) 120% of Poverty | Qualified Individual-1 (QI-1) 135% of Poverty | Qualified Medicare Beneficiaries (QMB) 100% of Poverty |
|---|---|---|---|
| 1 | $1083 | $1219 | $903 |
| 2 | $1457 | $1640 | $1215 |
| 3 | $1831 | $2060 | $1526 |
| 4 | $2205 | $2481 | $1838 |
These income levels are revised every year.
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