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Who Is Eligible for Medicaid?

Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.

Your child may be eligible for coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if you are not (however, there is a 5-year limit that applies to lawful permanent residents). Eligibility for children is based on the child's status, not the parent's. Also, if someone else's child lives with you, the child may be eligible even if you are not because your income and resources will not count for the child.

In general, you should apply for Medicaid if your income is low and you match one of the descriptions below. (Even if you are not sure whether you qualify, if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state evaluate your situation.)

Pregnant Women
Apply for Medicaid if you think you are pregnant. You may be eligible if you are married or single. If you are on Medicaid when your child is born, both you and your child will be covered.

Children and Teenagers
Apply for Medicaid if you are the parent or guardian of a child who is 18 years old or younger and your family's income is low, or if your child is sick enough to need nursing home care, but could stay home with good quality care at home. If you are a teenager living on your own, the state may allow you to apply for Medicaid on your own behalf or any adult may apply for you. Many states also cover children up to age 21.

Person who is Aged, Blind, and/or Disabled
Apply if you are aged (65 years old or older), blind, or disabled and have low income and few resources. Apply if you are terminally ill and want to receive hospice services. Apply if you are aged, blind, or disabled; live in a nursing home; and have low income and limited resources. Apply if you are aged, blind, or disabled and need nursing home care, but can stay at home with special community care services. Apply if you are eligible for Medicare and have low income and limited resources.

Some Other Situations
Apply if you are leaving welfare and need health coverage. Apply if you are a family with children under 18 and have very low income and few resources. (You do not need to be receiving a welfare check.) Apply if you have very high medical bills, which you cannot pay (and you are pregnant, under 18 or over 65, blind, or disabled).

The following websites provide Screening Tools to help you see if you may be eligible for a variety of governmental programs: www.govbenefits.gov and http://www.benefitscheckup.org/

To find specific information regarding Medicaid eligibility in your State, select your state from the list below.

Quick Link


Click on one of the items below to find more technical information about:
Medicaid Eligibility Policy,
Federal Poverty Guidelines,
Medicaid Policy on Transfers of Assets,
Medicaid Policy on Treatment of Trusts,
Spousal Impoverishment Issues,
Third Party Liability, or
Medicaid Index

Last Modified on Thursday, September 16, 2004