Medicaid is one of the two main health insurance programs supplemented by the U.S. government. Medicaid qualifications are restricted to low-income households and/or individuals meeting specific qualifying conditions. Medicare, the second of the two government-facilitated health care programs, is designed for qualifying senior citizens sixty-five years and older, or for people with certified physical, mental or medical disabilities.
It is important to understand the fundamental differences between the two programs. Medicare is for the qualified elderly and/or disabled. Medicaid is for U.S. residents experiencing financial hardship needing cheaper health insurance during challenging times.
Qualifying for Medicaid is not based on age. The 2010 Affordable Care Act (ACA) requires the majority of financially or otherwise-qualified Americans less than sixty-five years of age to be covered by Medicaid.
Financial qualification requirements for both adults and children are based on applicable individual or household income levels being a limited level above the federal poverty level (FPL). Coverage for low-income adults is currently expanded in some, but not all, U.S. states.
The cumulative income for your entire household is calculated to determine your status. Your household size also affects whether you can enroll, including the amount of working people and minor/disabled dependents living within it. Medicaid is also offered to the medically needy including pregnant women and the qualified disabled.
It is possible to apply for Medicaid online by submitting an application through the Health Insurance Marketplace. It is also possible to apply through the state Medicaid agency where you live. While the federal government funds Medicaid, its programs are run through each individual U.S. state.
It may be a good idea to plan ahead and be prepared to verify your income level and proof of financial hardship or qualified disability. Once approved, Medicaid covers prescriptions, physician visits, hospital stays and more. Out-of-pocket expenses including copays are all determined based on your income level. It is possible to have no out-of-pocket expenses through Medicaid when your income is at or below certain qualifying levels.