Your child may qualify for full Medicaid even if you don't.
The Medicaid program provides health care coverage to qualifying individuals who can't afford health insurance. The federal government funds the Medicaid program, and it mandates coverage for certain demographics in every state. However, coverage for medically-needy individuals who don't fall into the federal government's mandatory eligibility group varies by state.
Mandatory Eligibility Groups
All states must provide Medicaid coverage to individuals in mandatory eligibility groups, which include limited income families who qualify for the Aid to Families with Dependent Children program and individuals receiving Supplemental Security Income. Mandatory eligibility groups also include pregnant women and children under age 6 who have incomes that don't exceed 133 percent of the federal poverty level, certain individuals receiving Medicare and individuals receiving adoption or foster assistance under Title IV-E of the Social Security Act.
Optional Eligibility Groups
States may choose to provide coverage to optional eligibility groups, which include pregnant women and infants up to 12 months whose incomes are between 133 percent and 185 percent of the federal poverty level, certain low-income children and certain elderly, blind or disabled individuals who don't qualify for mandatory coverage, but have incomes beneath the federal poverty level. Optional eligibility groups also include low-income women diagnosed with breast or cervical cancer, low-income individuals with Tuberculosis, institutionalized individuals with limited assets and income and recipients of state assistance.
Medically-Needy Individuals
States also have the option of providing Medicaid coverage to individuals who would have qualified for coverage if it weren't for their income. Such individuals may spend-down their assets to meet requirements for Medicaid. States who include provisions for the medically needy can choose the groups they will include, but they must offer coverage to pregnant women and children under 18 years old whose income or resources prevent them from qualifying.
Considerations
A state offers full Medicaid benefits to individuals in mandatory eligibility groups and the state's covered optional eligibility groups. However, the federal government doesn't require states to offer full Medicaid to other medically-needy individuals the state chooses to cover, so the state may offer coverage to individuals who qualify in this way only if they pay premiums.
Tags: coverage individuals, eligibility groups, eligibility groups, federal government, federal poverty, federal poverty level, full Medicaid
