Medicaid Eligibility

Medicaid Coverage

This paper is for informational purposes only. The best way to determine if you are eligible for Medicaid is to contact the applicable Medicaid office or to apply.

Who is eligible for Medicaid?

The eligibility requirements for Medicaid are not the same in every state and may depend on your age. Generally, your income has to be below a certain amount in order to be eligible for Medicaid. Below are two charts that give general information about eligibility for Medicaid. There may be other programs available with different requirements that vary by state.

*Medicaid Eligibility for Adults under* Age 65**
State of Residence		Yearly Income Limit In general your yearly income must be at or below this amount to be eligible.
Illinois, Indiana, Kentucky, Ohio, Pennsylvania, Colorado, North Dakota, Utah, Virginia & West Virginia		One Individual: $16,612 Family of two: $22,491 Family of three: $28,369 Family of four: $34,248 If an individual is pregnant or a related caretaker of a child, then more generous income limits may apply. Income amounts very slightly by state.
Alabama, Tennessee and Wyoming		Adults under Age 65 are generally not eligible unless they are pregnant, a related caretaker of a child, disabled, and/or blind (as well as have income under a certain amount that varies by state). However, other state programs may apply.
*Medicaid Eligibility for Adults over* Age 65**
State of Residence	Monthly Income Limit In general your monthly income must be at or below this amount to be eligible. *Amounts very by state.*		Resource Limit Resources are generally things you own that can be turned into cash. However, there are some things you may exclude, such as your home, life insurance policy, and burial plot.
Alabama, Kentucky, Tennessee & West Virginia	One Individual: $771 Couple: $1,157		One Individual: $2,000 Couple: $3,000
Illinois, Indiana, Pennsylvania, Utah	One Individual: $1,041 Couple: $1,409		One Individual: $2,000 Couple: $3,000
North Dakota	One Individual: $517 Couple: $694		One Individual: $3,000 Couple: $6,000
Virginia	One Individual: $833 Couple: 1,068		One Individual: $2,000 Couple: $3,000

* There are also other Medicaid programs that may be available to individuals in some states, such as nursing home programs, long-term care programs, breast and cervical cancer treatment programs, and certain Medicare Savings Programs (which can provide assistance with Medicare premiums or cost-sharing).

How do you apply for Medicaid?

You can apply for Medicaid at any time (there is no requirement to wait for an open enrollment or special enrollment period). The effective date for coverage is generally either the date of application or the first day of the month of the application.

An individual who is not enrolled in Medicare can apply for Medicaid by filling out an application on the health insurance marketplace online at www.healthcare.gov. You can also apply for Medicaid by contacting their state’s Medicaid office directly. Below is contact information for various states’ Medicaid offices.