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 WyomingAdults 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.

 

Contact Information

 

Alabama

Phone: 1-800-362-1504

Website: http://medicaid.alabama.gov/

 

Illinois

Phone: 1-800-843-6154

 

Indiana

Phone: 1-800-457-4584

Website: http://member.indianamedicaid.com

 

Kentucky

Phone: 1-855-459-6328

 

North Dakota

Phone: 1-800-755-2604

Website: https://www.dhsmed@nd.gov

 

Ohio

Phone: 1-800-324-8680

Website: https://benefits.ohio.gov

 

Pennsylvania

Phone: 1-866-550-4355

 

Tennessee

Phone: 1-800-342-3145

 

Utah

Phone: 1-800-662-9651

Website: https://medicaid.utah.gov

 

Virginia

Phone: 1-855-242-8282

Website: http://www.coverva.org

 

West Virginia

Phone: 1-877-716-1212

 

Wyoming

Phone: 1-855-294-2127

Website: https://health.wyo.gov/healthcarefin/medicaid/