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Health Care Reform:

Health Insurance & Affordable Care Act

10 Questions About Medicaid Answered

1. What Is Medicaid?

Medicaid is a state and federal government health care program for people with low incomes. It provides low-cost or free health care to:

  • Low-income adults
  • Low-income families and children
  • People with disabilities
  • Certain older adults who use Medicare

The federal government sets basic guidelines for the types of care you can get with Medicaid and how much, if anything, you pay for them. But Medicaid benefits differ from one state to another. States can offer extra services. In some cases, people must pay something toward the cost of their care, while the same services may be free in another state. There can be other differences too.  

Some states have other special programs to help low-income people who don't qualify for Medicaid.

2. Can I Get Medicaid?

States have different rules to decide who's eligible for Medicaid. You may be eligible if:

You're disabled and younger than 65. Your state may let you use Medicaid no matter how much money you make a year. In other states, a disabled person may only qualify for Medicaid when their income falls below a cutoff level.

You already get Social Security income (SSI). SSI eligibility automatically qualifies you for Medicaid unless your state uses more strict criteria. Those states are commonly called 209(b) states.

You're younger than 65 and don't make much money during a year. The rules are different in each state. In the past, Medicaid has not covered adults without children, or the income cutoffs have been very low.

Check with your state's Medicaid office to get the exact requirements for 2015.

Some states have expanded their Medicaid program to allow more people to qualify. In those states, the income rules have loosened for adults without children. Other states have chosen not to expand Medicaid.

If your state has expanded Medicaid

You're eligible if:

  • You're single, don't have children, and make less than about $16,105 a year.
  • You have a family of four and make less than $32,913 a year.

If your state has NOT expanded Medicaid

  • Check with your state's Medicaid office for the rules and income limits.

In Alaska and Hawaii, you’re able to make a slightly higher income than in other states and still qualify. Your state Medicaid office can help you with the specific income limits based on how many people are in your family.

3. What Does Medicaid Cover?

In each state, Medicaid must cover:

Many states offer more care, such as checkups and cancer screening tests for adults, physical therapy, and occupational therapy.

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