Medicaid: Understanding your options and eligibility

medicaid coverage

Medicaid is a public assistance healthcare program available to all low-income Americans. Unlike Medicare, which guarantees coverage for individuals ages 65 and older and with certain disabilities, Medicaid determines coverage based largely on financial need.

Medicaid is paid for with public funds collected through income taxes. Specific eligibility requirements are determined at a state level, but all individuals with financial need are eligible for coverage.

You are eligible to apply for Medicaid if:

  • You’re pregnant and need financial assistance. Both yourself and your child will be covered (single and married individuals may apply).
  • You’re the parent of a child under 18 years old and need financial assistance.  
  • You’re a teenager living alone and in need of financial assistance. Some states allow for coverage for dependents up to the age of 21.
  • You’re over the age of 65 (you may apply for both Medicare and Medicaid coverage).
  • You have certain disabilities (coverage and costs may be different from state to state).
  • You are a low-income individual under the age of 65 without a disability or minor children.

If you are over 65 years of age and/or have certain disabilities you can apply for both Medicare and Medicaid. If you are already receiving Social Security Disability Insurance (SSDI) you are likely pre-qualified to receive Medicaid as well.

Medicaid Coverage For Nursing Homes

Individuals who require a nursing facility may look to Medicaid for additional coverage; including needing a nursing facility beyond the Medicare 100-day limit and approved skilled nursing facilities.

Medicaid also offers additional coverage on prescription drugs, eyeglasses, and hearing aids. Services covered by both health programs are paid first by Medicare, and then Medicaid fills in the difference up to the state-determined payment limit.

How Do I Apply for Medicaid?

Some states have different names for their Medicaid program, and application rules vary with each state. To determine your state’s Medicaid program name, and find out how to apply, visit: https://www.healthcare.gov/medicaid-chip-program-names/

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