If you are struggling financially, you may be looking for affordable health care for yourself and your family. Depending on your income, you may be able to get inexpensive health insurance through the Medicaid program.
Medicaid is a low-cost health plan funded by both the federal and state governments. Millions of low-income individuals and families rely on Medicaid to help offset the cost of medical care. If you qualify, you could get free or low-cost coverage. Continue reading to learn more about the program, including how to qualify, apply, and use this type of health insurance.
Medical costs in the United States have been on the rise for years. If you’re looking to find affordable coverage, you may be able to get it through the Affordable Care Act’s Healthcare Marketplace, which subsidizes the cost of health insurance for lower income individuals and families. Or, like many Americans, you might be able to get healthcare through your employer.
However, if you don’t have a job, don’t work enough hours, or don’t have access to employer-sponsored insurance, you might be looking for other options. Affordable insurance may be hard to come by; if you have very low income, you may not be able to afford to pay any monthly insurance premiums at all.
However, that doesn’t mean that you can’t get healthcare coverage. There are low income health care options available, the most popular of which is Medicaid.
Medicaid is a government health insurance plan that provides very low cost or free health insurance to Americans who meet certain criteria. Even though Medicaid is a federal program, it is administered individually by states and U.S. territories, so the qualifications and benefits are different depending on where you live.
However, federal law requires states and territories to cover certain groups of individuals, including:
- Low income families
- Children in foster care
- Low income pregnant women
- Low income children
- People receiving Supplemental Security Income (SSI)
- Disabled individuals
The primary Medicaid eligibility criteria is income. Although the Medicaid income guidelines vary by state and territory, most states require Medicaid recipients to have a modified adjusted gross income (MAGI) of less than 138% of the federal poverty level in order to qualify. MAGI includes adjusted gross income, any untaxed foreign income, non-taxable Social Security benefits and tax-exempt interest, but not SSI.
The 2023 general Medicaid eligibility requirements for income at or below 138% of the federal poverty level (FPL) are listed in the table below, but check your specific state’s requirements to determine if the income threshold may be different:
|Family Size||Annual Income Limit to Qualify for Medicaid Based on 138% of FPL|
If you are older than age 65, blind, disabled or receiving SSI, you are exempt from MAGI income requirements. Instead, your income is calculated based on SSI. You may be subject to asset limits as well.
In addition to income, there are other criteria you must have to qualify for Medicaid. These include:
- Being a resident of the state in which you are applying for Medicaid
- Being a U.S. citizen or legal non-citizen
- Having a Social Security number (SSN)