Tuesday, February 10, 2009

Medicaid Eligibility Standards

Medicaid is a joint federal-state program that is overseen by a federal agency called the Centers for Medicare & Medicaid Services (CMS). CMS sets standards and regulations that all state Medicaid programs must adhere to when creating their eligibility requirements.


Residency


The Department of Health and Human Services mandates that to qualify for Medicaid, an applicant must be a U.S.-born citizen or an immigrant who arrived before Aug. 22, 1996. However, the federal law allows individual states to choose to cover immigrants who arrived after this date. Applicants must usually be a resident of the state program they are applying to.


Income


The CMS says Medicaid helps those who can't afford to pay all or some of their bills and is only available to those with limited incomes. The Kaiser Family Foundation's Medicaid reports that income eligibility is often based on the federal poverty guidelines and may often be different depending on the applicant. For example, a pregnant woman's income eligibility guidelines may not be the same as a disabled individual's.








Assets and Resources


In addition to meeting income guidelines, applicants must also meet asset and resource guidelines. Assets and resources are things such as bank accounts, bonds and stocks. In order to qualify, most applicants cannot have assets that exceed a certain amount, to be determined by the state.








Populations


The CMS web site reports that states are required to cover certain populations. This includes pregnant women, the disabled, the elderly and the blind. States may choose to cover additional populations if they meet the resident, income and asset requirements.

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