Medicaid is a state-run health plan for low-income, disabled people, pregnant women and families with children. In order to get coverage you must either be a citizen of the US or be a legal permanent resident in the US.
Each state must provide coverage, but all states are different in what coverage they offer. But they must at least provide hospital and doctor coverage. If you do qualify, Medicaid will help pay for your premiums, coinsurance and deductibles. It also pays 20% not covered by Medicare. You will find information on Medicaid at your local county social services, welfare, or department of human services office.
Medicaid spend down
If your income is too high to qualify for Medicare, then some states let you do something called “spend down” so you’re eligible. To be enrolled in the program, you subtract medical expenses from your income so your income is low enough to qualify for Medicaid.
Dual eligible beneficiaries
If you’re eligible for both Medicare and Medicaid you’re considered a “dual eligible beneficiary”. These are people who are enrolled in Medicare Part A and/or Part B, or an Advantage Plan (Part C) and also Medicaid benefits. If you have Medicare and Medicaid coverage, then you’ll get your Part D drugs through Medicare.
Where to see if you qualify for Medicare:
- Call your state Medicaid office
The information you’ll need to apply for Medicaid:
- Birth certificate or driver’s license
- Proof of citizenship or alien status
- Paystubs or tax return, Social Security, Supplemental Security Income, Veteran’s benefits, retirement accounts, and any other income
- Copies of bank statements or other financial resources to prove assets and other resources, if told so on your Medicaid application
- If you think you qualify because you’re disabled, you’ll need to include documentation that proves your disability
- Rent receipts/landlord statements, or a copy of your mortgage, along with recent mail addressed to you at your current address
- Proof of your other insurance. You will need to include a copy of your red, white, and blue Medicare or other insurance ID card with your Medicaid application
- Check your state’s Medicaid website to see if they need other documents
Once you submit your Medicaid application, states will respond in 45 days, 90 days if it’s for a disability application. If you’re denied, you are allowed to appeal. Many times Medicaid is turned down for missing information. So if you submit the right paperwork the next time you may get coverage.