Medicaid is a social-welfare program that provides comprehensive government-based health insurance to low-income people. Medicaid is free health insurance for those who qualify. In most cases, there are no monthly premiums, and there is no or minimal cost-sharing in the form of deductibles or copayments.
Medicaid works slightly differently in each state, but to be eligible, you must meet low-income guidelines, which vary depending on factors such as age, pregnancy, and whether you’re disabled. In many states, adults under the age of 65 will qualify for Medicaid if their household income is no more than 138% of the federal poverty level. Pregnant women and children can generally qualify for Medicaid with household incomes well above that level, but people age 65 and older generally need to have lower incomes as well as low asset levels in order to qualify for Medicaid.
However, some states have stricter eligibility criteria for adults under the age of 65. In those states, you must meet low-income guidelines and also be a member of a medically vulnerable group (people who are pregnant, parents/caretakers of a minor child, elderly, disabled, and children). In other words, there are some states (14 as of early 2021, although it will only be 12 as of mid-2021 ) where being low-income by itself will not make you eligible for Medicaid.
Medicaid may be available to immigrants who have been legally residing in the United States for five years or more if they meet eligibility requirements.
Medicaid isn’t usually available to undocumented immigrants, although there may be exceptions such as short-term limited Medicaid coverage in emergency situations, and emergency coverage for people who are pregnant. And again, Medicaid eligibility varies from state to state. California, for example, has chosen to extend Medicaid eligibility to undocumented children and young adults who otherwise meet the income criteria for eligibility.
Medicaid is paid for by federal and state taxes, and administered at the state level (which is why coverage and eligibility rules vary from one state to another). If you receive Medicaid, your friends, neighbors, and fellow citizens are paying for your health care with their tax dollars.
Although Medicaid is government health insurance, the vast majority of care provided to Medicaid recipients is provided by private businesses and healthcare providers. If you get Medicaid, you’ll likely be cared for at the same hospitals and by the same physicians as your neighbors with private health insurance.
And most states contract with private insurance companies to administer the coverage, which means your coverage ID card may display the name of a well-known private health insurer.
You can apply for Medicaid through your Affordable Care Act health insurance exchange or by contacting your state’s Medicaid program directly.