Medicaid is an important government program. By enrolling in this public health insurance initiative, you can make sure you and your children have access to quality medical coverage. No matter where you live in the United States, health insurance is expensive. If you’re part of a low-income family, it can be especially difficult to afford comprehensive health care. For this reason, the Medicaid office was created.
Health care shouldn’t be a luxury, and this program makes it easier for low-earning families to access the care they need. However, before you enroll in this program, you may wonder, “Do I qualify for Medicaid?” It’s important that you understand the criteria you must meet in order to receive program benefits. The following sections explain how you can qualify for benefits, as well as what you need to do to apply for coverage.
What is the difference between Medicare and Medicaid?
You may ask yourself, “What is the difference between Medicare vs Medicaid?” If you’re researching a health insurance program, you may come across both of these terms. While they sound like similar programs, they are actually different. Both Medicare and Medicaid provide health insurance to applicants, but they serve different populations.
For example, Medicare is usually reserved for individuals who are 65 years of age or older. On the other hand, low-income applicants are generally the ones who receive Medicaid benefits. If you qualify for one of these programs, you usually won’t be able to receive benefits through the other one.
Medicaid Eligibility Requirements
“Do I qualify for Medicaid?” is another question you may have. Before you apply for benefits, it’s important that you understand what criteria you need to meet to enroll.
Medicaid is funded by federal and state governments. As a result, this health insurance program is generally the same no matter where you live in the country.
However, states do have some say regarding the eligibility requirements you need to meet to enroll. This means that the specifics of certain enrollment criteria may differ between states.
First, keep in mind that Medicaid is available for different types of individuals. If you’re wondering, “Who qualifies for Medicaid?” remember that this program may offer benefits to:
- Adults and children who live in one household.
- Pregnant women.
- Individuals who were in foster care.
- Non-U.S. citizens who have health care emergencies.
- Individuals who receive SSI.
- Individuals who don’t receive Supplemental Security Income (SSI) but who are disabled or elderly.
Secondly, remember that Medicaid qualifications take into account how much income your household earns. Specific earning limits are different from one state to another. This means you need to contact your program office to learn about your specific income limits.
In general, your family needs to make less than a particular amount of money in order to receive benefits. Keep in mind, though, that the following types of income don’t count when determining your earnings:
- Any educational grants or scholarships you receive
- Money you receive as child support payment
- Worker’s compensation or veterans benefits
How do I apply for Medicaid?
It’s important that you understand how to get Medicaid before you begin the process. In order to be considered for this program, you need to submit an application. Depending on the state you live in, you may be able to:
- Apply for Medicaid online. Regardless of where you live, you can apply for benefits through the Health Insurance Marketplace. However, your state may also have its own Medicaid portal you can use to apply for benefits.
- Submit your Medicaid application by mail. You can obtain a paper program application, which you need to fill out. Then, you must mail your application to the appropriate address so it can be evaluated.
- Apply for benefits by phone. Some states also offer you the option to apply for benefits by phone. This is a convenient option if you don’t want to apply online but still want your application to be processed as soon as possible.
Regardless of how you apply for benefits, it’s important that you’re ready to provide all the information you need with your application. If you want to apply for Medicaid in one sitting, you will need to have the following items ready:
- Social Security Numbers (SSNs) for you and everyone who is applying with you
- Proof of income for everyone in your family who works
- Information about any health insurance options you have available through your employer
- Proof of any health insurance you currently have
- Proof that you’re a U.S. citizen or legal resident
What benefits can I receive through the Medicaid office?
If you meet your state’s Medicaid qualifications, you can begin to receive benefits. Just as eligibility varies by state, so does coverage. However, the following services are usually covered with a traditional Medicaid plan:
- Annual visits to your primary care doctor
- Visits to specialists
- X-rays and lab work for diagnostic purposes
- Certain home health care services
- Speech and physical therapy
- Hospital services
- Educational services, such as family planning
If you have questions about whether specific services are covered, contact your local Medicaid office. Furthermore, keep in mind that benefits usually can’t be transferred out of state.
If you live near a state border, there may be doctors you can use in another state. Confirm this information with your local office before you obtain services. Otherwise, you will be responsible for paying out-of-pocket costs for whoever you see.
Is there a Medicaid office near me?
No matter where you live, there should be a Medicaid office in your area. Since each state is required to have its own Medicaid program, these offices are located in all parts of the country. Major cities and towns have their own offices, which you can easily go to if you have program questions or need to apply for benefits.
However, if you live in a smaller town, you may not have a Medicaid office located right in your community. If this is the case, you should still have a program center located a short drive from you. If you can’t reach one of these facilities, you can still call your local office and ask your questions by phone.