A Guide to Medicaid Health Insurance

Posted on Sep 26 2015 - 7:17am by admin

Medicaid is a very valuable financial assistance program which provides funds for health care costs for individuals and families of low income. It also provides assistance for families with limited resources and families with children who have disabilities.

Anybody who is eligible for Medicaid can receive its coverage as there are no waiting lists. If you qualify you will receive the coverage. Medicaid is jointly operated together by the federal government along with the state which runs it. Like the other programs, each state has a different income level to qualify for the coverage.

Eligibility: You can apply for Medicaid at any time of the year. The eligibility process can be rather confusing since it is done state by state. However there is the Affordable Care Act also referred to as Obamacare distinguishes a minimum standard of 138% of the Federal Poverty Level. It gets complicated as some states have chosen not to use the Affordable Care Act. There are currently 23 states that do not use the Affordable Care Act and the include:

  • Alabama
  • Alaska
  • Florida
  • Georgia
  • Idaho
  • Indiana
  • Kansas
  • Louisiana
  • Maine
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • North Carolina
  • Oklahoma
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Virginia
  • Wisconsin
  • Wyoming

These 23 states that have not instated the Affordable Care Act have an average eligibility level of 49% of the Federal Poverty level. The average eligibility level of the 29 remaining states which have instituted that Affordable Care Act have an eligibility level for parents and adults at 138% of the federal poverty level.

To better illustrate the eligibly requirements consider this; if your state has expanded Medicaid such as Michigan which is used in this example, you most likely will receive coverage if your income is at $21 900 for a family of two. If you have a family of 5 you will qualify for free coverage if your income is below $39250 if you live in the state of Michigan. These amounts of the family incomes vary by state as Michigan was used as an example.

Now, if your state has not expanded Medicaid (such as Florida which will be used to illustrate the point) and your income is at or below $27 910 you will not qualify for Medicaid based on your income alone. However you may qualify based on other factors considered in correlation with your income such as family status, disability etc. If you still do not qualify with all these factors included then you have the option to buy a marketplace plan which will include monthly payments to receive health care. Below are some guidelines on what to do based on your state’s status with Medicaid:

States Using Expanded Medicaid

You have two options which depend on income level and sizeof the family.

  • If you have a family of 4 and make approximately $33 000 or less you will qualify for Medicaid without having to pay any amounts of money.
  • if you make more then $33 000 for a family of 4 then you will have to buy a private health plan. Depending on income size and income you may be eligible for tax credits which will lower your monthly health insurance payments.

States Not Using Expended Medicaid

It is more of a challenge if your state is not using Medicaid. Even if you have a small income you may have a hard time finding health coverage.

  • if your family income is more then 100% of the Federal Poverty Level which would be approximately $27 000 for a family of five, then you will have the opportunity to purchase a private health insurance plan
  • If your family income is lower then 100% of the Federal Poverty Level then you will not be eligible for lower costs of a private health insurance plan.

Applying for Medicaid

If you state has not expanded Medicaid you can still apply as each state does have assorted coverage options that you me qualify for especially if you have children or people in the family with a disability. To apply contact your state Medicaid Office, or you have the option of applying online by filling out the online application in the market place. You can also contact the marketplace call center at 1-800-318-2596.For in depth information and eligibility requirements visit the medicaid official website at healthcare.gov.