Medicaid and CHIP are programs that provide health insurance to low-income adults and children.

Medicaid is a federal government program that provides health insurance to over 50 million individuals in the United States. It is a social welfare or social protection program that is means-tested and needs-based. While medicaid is a federal program, it is administered by each of the fifty states, with each state contributing funds to cover medicaid costs. You must apply for medicaid via your home state’s Department of Health and Human Services.

State medicaid eligibility specialists look at numerous factors to establish eligibility, but the major emphasis is on the applicant’s income in the three months before the application date, as well as the number of members in the household.

Adults Only

To be eligible for medicaid coverage, an adult applicant must demonstrate that he or she fits the eligibility criteria, which include earning less than the federal poverty level, not having current or previous health insurance coverage, and having no or little savings or cash on hand. To be eligible in most states, people must earn less than the federal poverty level and fulfill additional conditions.

According to the HHS 2011 Poverty Guidelines, a single adult without a spouse or children would have needed to earn less than $10,890 per year to be eligible, in addition to meeting other requirements, such as a lack of recent health insurance and other state requirements.

CHIP for Pregnant Women and Children

Children and pregnant women, unlike adults, are often eligible for up to 185% of the federal poverty level. In many circumstances, parents are ineligible for Medicaid because their income exceeds 100% of the federal poverty threshold, but their children qualify because their family’s income is less than 185% of the federal poverty limit. Because children are covered by CHIP (Children’s Health Insurance Program), which provides additional funds for children, children and pregnant women have a higher income threshold.

For Senior Citizens

Low-income elderly adults may be eligible for medicaid, which helps pay the cost of nursing home care in addition to Medicare. Be advised that in certain jurisdictions, medicaid may make a claim against the estate after the initial applicant dies. For example, if the applicant has little to no income but a residence with worth, the state may claim an interest in the estate after the applicant’s death. Consult the Medicaid Estate Recovery Policy for more information.