Apply for Medicaid: Learn About Eligibility for Medicaid

Apply for Medicaid: Learn About Eligibility for Medicaid

Get help filling out a Medicaid application form

While Medicare is a federally operated program, Medicaid is a state-operated program that receives assistance from the federal government based on the socioeconomic status of the state's residents. It is important to realize that each state has its own criteria for Medicaid eligibility. Essentially, Medicaid is a program available to specific low-income families that fit specific eligibility restrictions designed by the state and the federal government. Before applying, it may be a good idea to educate yourself on federal and state policy—fortunately, this can easily be done through online coursework.

But there are some other issues you will want to know:

1. Medicaid does not pay money directly to you; rather, in most cases, it sends funds to providers with whom you have had contact.
2. There are a number of qualifications for receiving Medicaid, including your age, whether you are pregnant, disabled, or blind.
3. When applying, honestly evaluate your financial situation as it will appear to the people reviewing your application. If you own a new or relatively new car, your chances of getting Medicaid assistance are decreased. If you own a home, keep in mind that such property is worth money and could also affect your case for receiving Medicaid.
4. Over the past few decades, Medicaid has been one of many federal and state programs that have undergone overhauls. Essentially, until Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act (commonly called the “Welfare Reform” program) in 1996, all immigrants regardless of citizenship were eligible for it. A year later, Congress passed the State Children’s Health Insurance Program, or SCHIP. With respect to these two legislative actions, some general rules govern eligibility. Listed below are some basic rules and requirements:
   • For immigrants who entered the United States before 1996, both Medicaid and Medicaid SCHIP programs are available (with the exception of Wyoming).
   • For immigrants who entered the United States after 1996, specific restrictions apply during the first five years.
   • While it is true that Medicaid is a state-funded program, it is regulated and also funded by the federal government. An excellent website to visit regarding Medicaid and immigrants is The Guttmacher Report.

How do you apply for Medicaid? Can you apply online?

To know how to apply, contact your local Social Security Office, the Welfare Department in your city, or the Department of Health and Human Resources to get an application form. Application methods vary from state to state. Even if you can apply online, for example, sometimes you still must visit an office in person to present your needs.

Here are some other important points to understand:

1. Your child may be eligible to receive Medicaid assistance even if you do not fit the requirements. This is one reason it is very important to check with your individual state’s “Child Medical Services” department.
2. If you have a low income and have children to support, you should check with your local office for guidance.
3. Many states also provide you with a card or some other means of buying food. You should never share this card with anyone else. Like Medicare, there is always a certain risk of fraud, and it is your responsibility to report such fraud if you know of any.
4. If you ever need an ally, ask your health care provider. I have written many letters on behalf of my patients, and almost every time I received a positive response.

Do not forget that education is your best weapon if you ever have to challenge a ruling on your eligibility. If you have been denied for Medicaid coverage or if you think you are not getting the full benefit you deserve, you may want to enroll in online health care policy classes to ensure that you are arguing from a knowledgeable position.