How to qualify for Medicaid plans

Medicaid plans

Medicaid has a variety of government-funded health plans for people with low income. However, having a low income is not the only qualification needed to participate in every program. Learn about the wide range of qualifications that you must meet to qualify for Medicaid plans.


Medicaid is primarily designed to provide low-income individuals and families with affordable healthcare services. The main requirement is a low income that falls at or below the 133% average federal poverty level (FPL).

The average number varies by state from 133% to 308%. In addition to being poor, some Medicaid plans require that you meet other eligibility requirements.


The most eligible candidates for Medicaid are children. The Children’s Health Insurance Program (CHIP) is the state and federal program that provides widespread healthcare coverage to children.

For eligible seniors, there are additional benefits related to food delivery, nutrition counseling, medical transportation and hospice services.

The children and their families receive free or low-cost benefits for medical, dental, visual and hospital services. Each state may create other types of healthcare programs for children who come from low-income families.

Medicare is the main program for seniors who are 65 years and older. Medicaid also provides benefits for seniors who need home healthcare and nursing home services. Home health care is provided by doctors, nurses and other professionals, and it is not the same as personal home care that is provided by caregivers or relatives.


Medicaid coverage is extended to people living with disabilities. First, they must have a  proven disability by the Social Security Administration. Disabled recipients are covered for standard benefits that include:

  • Doctor visits
  • Hospital stays
  • Nursing home care
  • Home health care

People with Supplemental Security Income (SSI) Disability may automatically qualify for Medicaid. In other situations, they may qualify but have to sign up. The SSI requirements depend on each state’s guidelines.

Some states have Medicaid plans made for disabled people who are working. They remain eligible as they work, but they must prove that they have a limited income. Other plans provide comprehensive coverage for disabled children and their families. The Medicaid Buy-In program assists the families who earn too much money to qualify for the standard benefits.


There are state Medicaid plans available to pregnant women in need of healthcare, childcare, counseling and other services. They also receive affordable coverage for prenatal and postpartum services. Pregnant women must prove their current health status and prove that their incomes meet the federal poverty level set by their state.


Caretakers who are responsible for children, the elderly or the disabled may qualify for Medicaid. They may complain about not having enough money to meet their clients’ basic healthcare needs. Some states require that you work as a certified provider, while other states require that your client receive Medicaid benefits.

Low income is the main qualification necessary to receive Medicaid plans. In general, recipients have low assets that prevent them from affording basic healthcare services.

Age, disability, profession and pregnancy are additional qualifications that the state considers when accepting new recipients. It’s important to review the full list of eligibility requirements before you apply for a Medicaid plan in your state.