Medicaid Income Limits 2020
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Medicaid Income Limits & How to Know you are Eligible

 – Medicaid Income Limits – 

One dilemma that anybody will face is a health problem. The problem is worse when an individual does not have the financial capacity it takes to treat himself. 

Medicaid Income Limits 2020: 

Medicaid arrived in the United States of America as a way out for low-income people and families.

Medicaid health care program has several qualifying requirements. The Medicaid Income Cap is the most significant criterion for determining whether you are in your state qualifying for Medicaid.

Within this article we will state-by-state have the Medicaid Benefit Cap.

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What is Medicaid?

Medicaid is the health insurance program for low-income, needy Americans and their families funded by the federal and state governments. States jointly fund and run their programs so eligibility for Medicaid varies depending on where you live.

This offers millions of Americans with free or low-cost health care, including families and teenagers, pregnant women, the disabled, and people with disabilities.

The requirements for Medicaid eligibility are broadly based on income, age , disability, pregnancy, the size of the household and the role of the applicant in the home.

The Medicaid Income Limit is the most important criteria for deciding if you are in your state qualifying for Medicaid.

If you earn too much income, you will not qualify for this federal program and will need to seek other forms of assistance for healthcare.

How Medicaid works

Medicaid was created in 1965 to cover healthcare for non-workable Americans. The scheme is voluntary. States should not be interested, but they all are.

To order to receive federal funds, participating states must follow requirements set by the Center for Medicare and Medicaid Services, but they do have a lot of discretion over eligibility and covered health care services.

President Barack Obama’s health care law aimed to standardize Medicaid standards, explicitly in order to qualify any American who made up 133 per cent of the poverty line.

Yet the Supreme Court challenged the cause and reversed it. States have been able to expand Medicaid but they no longer have to. Thirty-five states (plus Washington, D.C.) did; 15 didn’t.

Yet eligibility through states has become even more diversified after the Trump administration revealed it will encourage states to implement job requirements for low-income yet disabled Americans receiving Medicaid.

In other words, it is even more difficult to figure out whether you qualify for Medicaid than before

How to Qualify for Medicaid

Almost all state has several systems for Medicaid. But, as a general rule of thumb, if you make up less than 100 percent to 200 percent of the level of federal poverty (FPL) and are pregnant, elderly, disabled a parent/caretaker, or a child, you are likely to have a program.

So if you earn less than 133% of the FPL, you can have a plan depending on whether your state has extended Medicaid under Obamacare.

In 2019, the federal poverty levels (in all states except Alaska and Hawaii, which have higher guidelines) are:

Federal poverty levels in 2019
People in household Poverty guideline
1 $12,490
2 $16,910
3 $21,330
4 $25,750
5 $30,170
6 $34,590
7 $39,010
8 $43,430
Over 8 people Add $4,420 per extra person

In 2019, the federal poverty level in Alaska ranges from $15,600 (for one person) to $54,310 (for eight people). The federal poverty level in Hawaii ranges from $14,380 (for one person) to $49,940 (for eight people).

Poverty Guidelines for 2020

The 2020 poverty guidelines are in effect as of January 15, 2020. The Federal Register notice for the 2020 Poverty Guidelines was published January 17, 2020.

2020 Poverty Guidelines for The 48 Contiguous States and The District of Columbia
PERSONS IN FAMILY/HOUSEHOLD POVERTY GUIDELINE
For families/households with more than 8 persons, add $4,480 for each additional person.
1 $12,760
2 $17,240
3 $21,720
4 $26,200
5 $30,680
6 $35,160
7 $39,640
8 $44,120

 

 2020 POVERTY GUIDELINES FOR ALASKA

PERSONS IN FAMILY/HOUSEHOLD POVERTY GUIDELINE
For families/households with more than 8 persons, add $5,600 for each additional person.
1 $15,950
2 $21,550
3 $27,150
4 $32,750
5 $38,350
6 $43,950
7 $49,550
8 $55,150

 

2020 Poverty Guidelines for Hawaii

PERSONS IN FAMILY/HOUSEHOLD POVERTY GUIDELINE
For families/households with more than 8 persons, add $5,150 for each additional person.
1 $14,680
2 $19,830
3 $24,980
4 $30,130
5 $35,280
6 $40,430
7 $45,580
8 $50,730

HHS Poverty Guidelines for 2022

The 2022 poverty guidelines are in effect as of January 12, 2022.
Federal Register Notice, January 12, 2022 – Full text.

Join our listserv to stay up-to-date on the latest news regarding the poverty guidelines.

2022 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIA
Persons in family/household Poverty guideline
1 $13,590
2 $18,310
3 $23,030
4 $27,750
5 $32,470
6 $37,190
7 $41,910
8 $46,630
For families/households with more than 8 persons, add $4,720 for each additional person.
2022 POVERTY GUIDELINES FOR ALASKA
Persons in family/household Poverty guideline
1 $16,990
2 $22,890
3 $28,790
4 $34,690
5 $40,590
6 $46,490
7 $52,390
8 $58,290
For families/households with more than 8 persons, add $5,900 for each additional person.
2022 POVERTY GUIDELINES FOR HAWAII
Persons in family/household Poverty guideline
1 $15,630
2 $21,060
3 $26,490
4 $31,920
5 $37,350
6 $42,780
7 $48,210
8 $53,640
For families/households with more than 8 persons, add $5,430 for each additional person.

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Who is eligible for Medicaid?

Who is eligible for Medicaid?

You should apply for Medicaid if your income is low and you match one of the descriptions below if you :

  • Think you are pregnant
  • Are a child or teenager
  • Are legally blind
  • Have a disability
  • Are age 65 or older
  • Need nursing home care.

You may be automatically eligible for Medicaid if you receive any of the following:

  • Supplemental Security Income (SSI)
  • Cash Assistance
  • State/County Special Assistance for the Aged or Disabled

When you apply for Medicaid, your application will be carefully reviewed by a caseworker.

In general, you should apply for Medicaid if you match the descriptions below:

Medicaid for Aged, Blind, and Disabled

To receive Medicaid for the blind or disabled, a doctor must evaluate you. If you receive Supplemental Security Income, you are eligible for NC Medicaid and do not need to apply.

Monthly Income Limits for Medicaid for Aged, Blind and Disabled
Family size 1 2
Monthly Income Limit $1,064 $1,437

Your resources may not be more than $2,000 for an individual or $3,000 for a couple. The value of your home, a car, home furnishing, clothing and jewelry are not counted.

Resources include:

  • Cash
  • Bank accounts
  • Retirement accounts
  • Stocks and bonds
  • Cash value of life insurance policies
  • Other investments

If your family income and resources are over the limit and you have high medical bills, you may still qualify for Medicaid and have a Medicaid deductible.

Medicaid also may help pay for nursing homes and intermediate care facilities and long-term care in the home.

Medicaid for Infants and Children

Monthly Income Limits: Medicaid for Infants and Children
Family Size Age 0 – 5 Age 6 – 18
1 $2,233 $1,415
2 $3,017 $1,911
3 $3,801 $2,408
4 $4,585 $2,904
5 $5,369 $3,401

If your family income is greater than the amounts listed above, your children ages 6-18 may be eligible for NC Health Choice for Children or Medicaid with a Medicaid deductible.

Medicaid for Families with Dependent Children

Medicaid for Families with Dependent Children provides medical coverage for parents or other caretakers/relative with children ages 18 and under in the household and for children under the age of 21. A pregnant woman also may qualify.

Monthly Income Limits: Medicaid For Families with Dependent Children
Family Size Caretakers and children age 19 and 20
1 $434
2 $569
3 $667
4 $744

If the family income is over the limit, you may still qualify for Medicaid and have a Medicaid deductible.

Medicaid for Pregnant Women

A pregnant woman may apply for this program before or after she delivers. A woman who has experienced a recent pregnancy loss also may be eligible. Medicaid for Pregnant Women covers only services related to pregnancy:

  • Prenatal care, delivery and 60 days of postpartum care
  • Services to treat medical conditions that may complicate pregnancy
  • Childbirth classes
  • Family planning services
Monthly Family Income Limits: Medicaid for Pregnant Women
Family Size Monthly Income Limit
1 $2,085
2 $2,816
3 $3,548
4 $4,280
(An unborn child is counted in the family size)

Other Groups Eligible for Medicaid

Medical

You should consider applying for Medicaid whether you are qualifying for or leaving Temporary Assistance for Needy Families ( TANF) and need health care coverage.

In addition, if you are a family with children under 18 and have very low to no income and little assets. (You’re not required to receive TANF.), you should consider applying for Medicaid. Also, submit if you are a woman with breast or cervical cancer.

Ultimately, consider applying if your salary is higher than the guidelines (see income cap below) and you have the medical bills that you owe (whether you are pregnant, under 18 or over 65, blind or disabled).

Medicaid Eligibility Criteria

Whether you qualify for Medicaid depends on a variety of factors, including whether your state has expanded their Medicaid programs to cover all people with household incomes below a certain level.

In addition, you must meet the following eligibility rules:

  • Be a resident of the state you are applying in
  • Be a U.S. citizen or a qualifying noncitizen
  • Provide a Social Security number for each person requesting coverage, unless an exception is met
  • Meet income and asset limit
  • Meet any other program rules that are specific to your state.

How Many People are on Medicaid?

According to the Centers for Medicare & Medicaid Services, as of July 2019

  • 72,139,715 individuals were enrolled in Medicaid and CHIP
  • 65,527,476 individuals were enrolled in Medicaid.
  • 6,612,239 individuals were enrolled in CHIP.

How to apply for Medicaid

When you are eligible for Medicaid, you can register to the state’s Medicaid website or the federal health care exchange, HealthCare.gov, all year round.

When you apply for Medicaid through Healthcare.gov and it looks like you’re eligible, the state agency will be contacted by the federal government and will notify you about enrollment.

States also usually require you to print paper applications that you can send to your local government office, via fax or directly return.

To complete your Medicaid application, you’ll probably need to provide documentation that satisfies the requirements of your state. Could include this documentation:

  • Your birth certificate or driver’s license to serve as proof of age and citizenship
  • Recent pay stubs or tax returns to serve as proof of income
  • Copies of bank statements
  • Proof of address, which could include a lease, utility bill statements or a copy of your mortgage
  • Medical records to serve as proof of disability

States have 45 days to get your Medicaid application processed. They have 90 days if eligibility is tied to a disability (Disability can lead to a permanent drop in income.

If you are not eligible for Medicaid, you might be able to receive subsidized health insurance via Healthcare.gov.

Only certain life events, however, allow you to apply for a marketplace health care plan outside open enrollment, which takes place every year from Nov. 1 to Dec. 15.

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Medicaid Income Limits by State

You must be in need of health care/insurance assistance to qualify for this Medicaid and your financial situation must fall under low income or very low income.

A percentage of Federal Poverty Levels is based on the Medicaid income limit. States typically classify beneficiaries of Medicaid into four Groups.

Each of these categories has its Federal Poverty Level based income limit. The four categories are those of:

  • Infants and Children
  • Families with Dependent Children
  • Pregnant Women
  • Aged, Blind, and Disabled
  • Adults – If your State Expanded Medicaid

Summary

We hope you found this guide on Medicaid Income Limits helpful. If you have more questions about the Medicaid program, leave those in the comments section below.

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