Senior Eligibility Requirements for Medicaid


What are the requirements for Medicaid? Knowing how to qualify for Medicaid insurance coverage is beneficial for residents who need assistance affording health care coverage. Since the program aims to help low-earning applications, petitioners will need to learn what are the income requirements for Medicaid enrollment as well as the additional qualifications. However, determining who is eligible for Medicaid benefits is not as simple as having a low income. The United States government has set forth Medicaid eligibility requirements including residency and citizenship that petitioners must meet for enrollment. State Medicaid programs are required to abide by these mandatory requirements, though some states have established a reduced Medicaid benefits eligibility program called the “medically needy program.” To find out what are the Medicaid application guidelines, review the sections that have been provided below.

An Overview Look at Medicaid for Seniors

Some elderly residents who are eligible for Medicaid benefits also meet the requirements for Medicare. Should you meet both Medicare and Medicaid eligibility requirements, having both could greatly reduce the cost of your monthly health insurance premiums and your out-of-pocket cost. Qualified applicants can have coverage from either programs or from both simultaneously. This is a unique opportunity only available to senior citizens who meet the age requirements and select individuals with certain disorders or disabilities.

If you do qualify for Medicaid and Medicare health insurance, then Medicaid will step in to cover services that your Medicare would not otherwise cover. That means that if you meet Medicaid benefits eligibility and you already have Medicare, you could receive coverage for prescription drugs, dental care and vision care despite not having Medicare Part C or Medicare Part D.

Download our free guide to learn more about obtaining medical insurance from Medicaid and Medicare for comprehensive coverage.

Senior Medicaid Benefits Eligibility

The federal requirements for Medicaid that apply in all states include meeting residency and citizenship qualifications. Petitioners will not qualify for Medicaid if they are not able to prove their citizenship status. Medicaid health insurance services are only available to United States citizens or qualifying non-citizens such as lawful, permanent residents. You must be supply certain documents during the Medicaid application process that establish you meet the citizenship requirement.

In addition to the citizenship and non-citizen Medicaid eligibility requirements, you must be a resident of the state where you are applying for benefits. As part of the Medicaid application guidelines, you will likely be asked to provide proof of state residency. You must provide the necessary documents that establish you meet the requirements for Medicaid with your request for benefits.

What are the income requirements for Medicaid?

The income requirements for Medicaid will depend on if you collect Supplement Security Income (SSI). Medicaid eligibility requirements for those who do not receive SSI will be based on the MAGI system (modified adjusted gross income). The MAGI system includes earn and unearned income such as alimony and child support payments as well as pensions and veteran benefits. During the application process, officials will consider your earnings and qualified deductions as well as the size of your household to determine if you meet the income requirements for Medicaid enrollment. Households with more family members can have higher earning than individual applicants and still qualify for coverage. The maximum amount that a household can earn and still qualify is dependent on the federal poverty level, which considers the number of family members the income must cover. If you do receive SSI, then the income Medicaid eligibility requirements are often lower than the ones calculated by the MAGI system, allowing more seniors to have access to Medicaid.

To learn more about how to qualify for Medicaid coverage, download our comprehensive guide today.

Senior Eligibility for the Medically Needy Program

The last thing you should consider when wondering, “What are the requirements for Medicaid for seniors?” is the Medically Needy Program. This is a program that many states offer to seniors who have significant health issues but have an income level that would not generally meet Medicaid benefits eligibility income requirements. As part of this program, medically needy individuals can incur expenses for medical and remedial care without access to health insurance, a process in which is referred to as “spending down.” Once a medically needy person has received more expenses then the difference between their income and the state’s medically needy income level, that individual would then meet Medicaid eligibility requirements and have Medicaid health insurance moving forward. It is crucial that you keep in mind that this program is only offered through 36 states and the District of Columbia, so you may only be eligible for this program if you reside within a participating state, meet Medicaid benefits eligibility requirements (aside from income) and you meet the Medically Needy Program requirements.