With the cost of private home care service increasing each year, individuals are looking for better alternatives. Currently, there is no better and cost-effective alternative than Medicaid. However, Medicaid is not for everyone. In fact, to enjoy the benefits of this government-funded health care program, you will have to be eligible.
In this article, I explained who need to apply for Medicaid.
What is Medicaid?
Medicaid is a joint federal and state supported program that, alongside with the Children’s Health Insurance Program (CHIP), offers health coverage to more than 72.5 million Americans, including children, pregnant women, parents, seniors, and people with various degrees of disability. Medicaid is the largest source of health coverage in the US.
Participating in Medicaid
To take part in Medicaid, federal law requires states to cover some groups of people. These groups of people include low-income families, qualified pregnant women including children, and people receiving Supplemental Security Income (SSI). States have extra options for coverage and may decide to extend the benefits of Medicaid to other groups, like people receiving home and community-based services including children in foster care who aren’t eligible.
The Affordable Care Act of 2010 brought about the opportunity for state to extend the benefits of Medicaid to low-income Americans under age 65. Medicaid eligibility for children was raised to a minimum of 133% of the federal poverty level (FPL) in all states (most states cover children to higher income levels). Also, states were given the chance to extend eligibility to adults with income at or less than 133% of the FPL. Most states has decided to widen coverage to adults, and those that are yet to expand may decide to do so in the nearest future. Ensure you check if your state has expended Medicaid coverage to low-income adults.
Who should apply for Medicaid?
Medicaid is mainly designed for those who cannot afford the expensive cost of private care and those with certain disabilities. As said earlier, it is also meant for seniors, low-income families, etc.
If you are a senior, it is best you apply for Medicaid. However, before you do so, don’t hesitate to contact a Medicaid attorney in your state, as he should be able to explain, as you will need the help of a professional to better understand how it works.
Worthy to note is that each state has different rules regarding who should apply for a Medicaid, so it will be wrong if you make assumptions based on another state’s requirements.
Here is a breakdown of individuals who needs to apply for Medicaid.
Apply for Medicaid if you are:
- 65 years old or older
- Blind or disabled
- Have limited income and resources
- Seriously ill and need hospice services
- If you are aged, blind, or disabled, reside in a nursing home, and have limited income and resources.
Before applying for Medicaid, you need to understand the requirements. They are highlighted below.
Medicaid Asset Limits and Eligibility Requirements
Though Medicaid is funded by the federal government, it is administered at the state level, and each state has its unique set of regulation of this program. The income and asset level allowed is different from one state to another. Thus, it is best you find out where your balance sheet falls in respect to the threshold.
For singles, you cannot have more than $2,000 worth of cash or other assets outside of your residence, vehicle, including other important items unless your state has a higher threshold.
If you are married and your spouse is able to live independently, you are allowed to keep a certain percentage (50%) of your joint assets up to a threshold of $128,640 as of January 2020. Your single or combined income cannot surpass %133 of the federal poverty level, although a lot of states have higher thresholds.
In almost all cases, you will need to prove through medical documents that you are disabled. But, there are some exceptions and they apply to women with breast cancer or cervical cancer or anyone diagnosed with tuberculosis.
In addition, and most importantly, you must be a U.S citizen or own a green care and prove your residency within the state to eligible for this benefit.
