Low-income pregnant women may automatically qualify for Medicaid coverage.
Medicaid is a state and federally sponsored health insurance program to help low-income people pay for medical expenses. Medicaid coverage is available to certain groups such as children, pregnant women, elderly citizens and the disabled. To qualify for coverage, certain criteria must be met within these groups. To enroll in Medicaid, prospective recipients must apply through their state health or economic services department.
Financial Need
To qualify for Medicaid, you must display a financial need. Your income cannot exceed a certain percentage of the federal poverty level. Each state has different income requirement criteria. Furthermore, you cannot have assets that exceed a specific dollar amount. Assets include savings accounts, real property, rental property income, investments and retirement plans.
Individual states receive federal funding to provide financial assistance to low-income families with children, Supplemental Security Income (SSI) recipients and some Medicare recipients. If you qualify for federally assisted income maintenance payments or SSI, you automatically qualify for Medicaid coverage.
Categorical Groups
You can qualify for Medicaid if you belong to a "categorically needy" group. In other words, if you do not qualify for public assistance or SSI, you may still be eligible for Medicaid if you belong to a group that shares similar characteristics of the financially needy. For example, pregnant women and infant children whose income is below 185 percent of the federal poverty level may qualify for coverage. Elderly and disabled adults whose incomes are higher than mandatory requirements but lower than 185 percent of the federal poverty level may be eligible. Low-income women who have been diagnosed with breast cancer or cervical cancer and need medical care may also be eligible for Medicaid.
Medical Need
If your income is too high to meet standard eligibility criteria, some states offer a "medically needy" program. This program allows you to either pay a monthly premium for medical care or "buy down" medical care expenses to offset additional income. In states that offer medically needy Medicaid coverage, plans must include coverage for certain children under age 18 and pregnant women who would otherwise be eligible for Medicaid except for income requirements.
Considerations
Although Medicaid is funded in part by the federal government, each state can make up its own eligibility requirements to determine who may qualify for benefits. You must contact your state's department of health to determine the exact Medicaid eligibility requirements that govern your state.
Tags: Medicaid coverage, pregnant women, eligible Medicaid, federal poverty, federal poverty level
