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Who is eligible?

Medicaid Eligibility Requirements - January 2007

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:

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:

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 April 1, 2007

Family Size Family Coverage (1931) Medically Needy SSI Children Age 6-19 100% of Poverty Preg. Women Child to Age 6 133% of Poverty Transitional Medicaid 185% of Poverty
1 $311 $500 $623 $851 $1132 $1575
2 $417 $516 $934 $1141 $1518 $2111
3 $523 $666   $1431

$1903

$2648
4 $629 $800   $1721 $2289 $3184
5 $735 $908   $2011 $2675 $3721
6 $841 $1008   $2301 $3061 $4257
7 $947 $1083   $2591 $3446 $4794
8 $1053 $1141   $2881 $3832 $5330
9 $1159 $1200   $3171 $4218 $5867
10 $1265 $1250   $3461 $4603 $6403

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 $1021 $1149 $851
2 $1369 $1541 $1141
3 $1717 $1932 $1431
4 $2065 $2324 $1721

These income levels are revised every year.

 

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