Medicaid Eligibility: Tips to Ease the Qualification Process

Medicaid Eligibility: Understanding the Qualification Process

Medicaid eligibility depends on various factors such as age, income, disability, household size, pregnancy, and the applicant’s role in the household. If you are looking for lifelong care and cannot afford health insurance coverage, Medicaid can be ideal. Read on to understand how Medicaid works and what you need to qualify. 

Understanding Medicaid

Medicaid offers managed care for the disabled or people aged 65 years and above. Often, this group of people has assets and income that falls below some state and federal thresholds. Medicaid also covers pregnant women and low-income earners and their families. The Medicaid program is ideal for every American resident below specific income levels in some states. 

Medicaid eligibility, in this case, depends on whether or not your state has advanced the program. Medicaid was launched in 1965 to provide healthcare for American citizens unable to work. All participating states must meet guidelines laid down by the Center for Medicare and Medicaid Services to receive federal funding. However, states have massive control over Medicaid eligibility and the included healthcare services. 

Medicaid eligibility has diversified after the Trump administration declared it would permit states to enforce work requirements for needy and low-income Americans. Following this declaration, determining your Medicaid eligibility became more challenging. 

Medicaid Eligibility Requirements

Medicaid eligibility
Medicaid eligibility requirements can vary by state.

It is worth mentioning that asset and income levels vary in all the participating states. Before applying, you should establish the classification of your balance sheet in terms of the threshold. For example, married couples whose spouses can live independently are allowed to keep 50% in some states and 100% in others. This percentage covers your joint assets, up to a $128,640 threshold, an obligation that came into effect in January 2020.

Single persons, on the other hand, cannot have over $2,000 worth of other assets apart from their vehicle, residence, or cash. Such a scenario can only happen if your state offers a higher limit. To pass the Medicaid eligibility test, your joint or single income cannot exceed the federal poverty level by 138%. However, the threshold in some states is above this limit. 

Many times you will need to provide medical documents to prove your disability. Again, you must either have a green card or be a US citizen, and provide proof of residency within the specific state.

Embarking on the Spend-down

If your income or assets surpass the laid down thresholds of your state you will have to lower your estate. For example, if you are looking for a minimum of 5 years’ coverage in advance, you can donate your belongings or assets to your children. 

Often, you can develop a spend-down trust based on the regulations in your state. However, some conditions come with this option. In case of death, any funds remaining in the trust will not be transferred to a relative. 

Medicaid Eligibility: Making Your Application

Medicaid Eligibility
Medicaid Eligibility: How to submit an application

You can apply for Medicaid by logging into www.healthcare.gov or www.medicaid.gov. You can also visit Medicaid agency websites for your state. What should you do if you cannot access online services? 

Medicaid has eligibility offices in every state where you can make your application. You can also apply over the phone. Remember, you can be denied coverage due to insufficient information in your application. Before you start the application, make sure you have the following documents.

  • Driver’s license or birth certificate to prove your age
  • Income and asset documentation
  • Proof of citizenship
  • Copies of your rent payment or utility bills receipts and lease or mortgage documents to prove where you reside
  • Prove of any other health insurance coverage you have
  • A medical report indicating your disability if you are disabled

These are the standard documents you will need in all the states. Establish any additional documents that your state may require.  

Consult with Experts

Consulting professionals before and during your Medicaid application process is critical to increasing your chances of qualifying. Seek assistance from an attorney who is conversant with the Medicaid regulations in your state. A financial advisor will also help you create a Medicaid trust and assist you with any spend-down measures you may require.  

Finally

Having Medicaid eligibility can be a challenging process, but you can ease it by consulting experts. Always plan, and adhere to the measures we have discussed here to increase your chances of getting the coverage.

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