Medicaid Eligibility

Senior Series Filling Out A Form

Medicaid is a federally aided, state-operated program that provides medical care for certain low-income individuals and families who have limited resources. Medicaid eligibility is not tied to Social Security benefits; however, if an individual is receiving social security benefits, a part of those funds will go toward your medical expenses. Other than the Social Security benefits deduction, the program provides 100 percent coverage of most medical expenses and does not require payment of premiums or deductibles. In addition, health care providers who accept Medicaid cannot bill for any additional charges as they can with Medicare.

Medicaid Eligibility and Qualifications

Medicaid eligibility and qualifications vary from state to state. Medicaid Asset Limitations are based on whether the individual is single, or married with an at-home spouse. Meeting these limitations is the most difficult criteria when applying for Medicaid. For state-specific information about Medicaid benefits The Henry J. Kaiser Family Foundation has made a database available to the public with state-specific Medicaid information for both acute and long-term care coverage.

Single, unmarried individuals cannot have countable assets* that exceed a certain amount. Additionally, those individuals cannot have an income that exceeds a specified amount per month. Similarly, married persons with an at-home spouse cannot have combined countable assets that exceed a certain amount per month. However, the Medicaid applicant is allowed to keep a specified amount of income per month. Please refer to the Medicaid website at www.cms.hhs.gov for the current limitations.

Countable Assets for Medicaid eligibility are defined as:

  • Checking accounts, savings accounts and CDs
  • Investment accounts, including mutual funds, stock and bonds
  • Credit union accounts
  • Certain life insurance policies, based on amount of face value
  • Annuities that have not annuitized (beneficiary not yet receiving payments)
  • Automobiles, if more than one is currently registered
  • Second homes and non-business properties
  • Revocable trust accounts
  • Promissory notes

Exempt Assets in Medicaid eligibility are defined as:

  • Primary residence, if applicant is married with an at-home spouse, or if applicant intends to return to home
  • Property used in business or trade
  • Pre-need burial expenses
  • Certain life insurance policies, based on amount of face value
  • IRAs
  • Pensions
  • Annuities, if the beneficiary is receiving payments

Note: Some people confuse Supplemental Security Income (SSI) with Medicaid, because people with SSI automatically have Medicaid eligibility. The reverse is not true. SSI is federally funded by tax revenues. It is designed to aid the aged, blind and disabled who have little or no income so they can meet their basic needs for food, clothing and shelter.


almost 4 years ago, said...

I am not understanding. According to each states that is eligible for a caregiver to get paid for taking care of a parent. Is there agencies that are helping. I know here in Philadelphia, PA two (2) of the agencies close their doors because of the funding from the government.


about 4 years ago, said...

I have a question, my mother is currently on medicare and is in the final stages of alzheimers, would it be better to put her on medicaid as far as benefits from hospice. They come in a few days a week and help my father and he wants to continue their care but he is worried that medicare will stop. I am at a loss between the two


over 4 years ago, said...

My wife and I live on my social security disability check. We are both disabled. I have social security And Medicare, she does not. We applied for SSI and Medicade for my wife and were told she did not qualify because my disability check amount exceeded the allowable limit. Our monthly medical expenses take over 50% of my check but North Carolina Rules only allow us to deduct $25.00 per month. We are considering a move to a State that will allow us to deduct our actual medical cost from the SSI application. Does anyone out there know which States allow applicants to deduct medical expenses?