What Disqualifies You From Medicaid

Medicaid eligibility depends on income and certain eligibility categories like age, disability status, or family composition. Generally, having income or assets above specific limits can disqualify you from Medicaid. Additionally, income from work, investments, or other sources may affect your eligibility. Moreover, owning certain assets, such as a second home or a valuable vehicle, can also lead to disqualification. Also, if you are not a U.S. citizen or a qualified immigrant, you may not be eligible for Medicaid.

Financial Eligibility Thresholds

To qualify for Medicaid coverage, individuals and families must meet specific financial eligibility criteria. These thresholds vary from state to state, but there are general guidelines that apply across the country.

Income Limits

  • Individuals: The income limit for individuals is typically set at or below 138% of the Federal Poverty Level (FPL).
  • Families: The income limit for families is typically set at or below 200% of the FPL.

The FPL is a measure of poverty that is set by the federal government each year. The exact income limits for Medicaid eligibility vary from state to state, so it’s important to check with your state’s Medicaid agency to find out the specific requirements.

Asset Limits

  • Individuals: The asset limit for individuals is typically set at $2,000.
  • Couples: The asset limit for couples is typically set at $3,000.
  • Families: The asset limit for families is typically set at $4,000.

Assets are considered to be anything that you own that has value, such as cash, bank accounts, stocks, bonds, and real estate. The value of your home and one vehicle are typically excluded from the asset limit.

Other Financial Factors

  • Income from work: Income from work is typically counted towards the Medicaid income limit.
  • Social Security benefits: Social Security benefits are typically not counted towards the Medicaid income limit.
  • Supplemental Security Income (SSI): SSI benefits are typically counted towards the Medicaid income limit.
  • Child support: Child support is typically not counted towards the Medicaid income limit.
Medicaid Income Eligibility Thresholds by State
State Income Limit for Individuals Income Limit for Families Asset Limit for Individuals Asset Limit for Couples Asset Limit for Families
Alabama $1,661 $3,323 $2,000 $3,000 $4,000
Alaska $1,868 $3,737 $2,000 $3,000 $4,000
Arizona $1,611 $3,222 $2,000 $3,000 $4,000
Arkansas $1,710 $3,421 $2,000 $3,000 $4,000
California $1,765 $3,531 $2,000 $3,000 $4,000

Note: The income and asset limits listed in the table are for individuals and families without any dependent children. The limits are higher for individuals and families with dependent children.

Inmate Status

Inmates in federal or state correctional institutions are generally ineligible for Medicaid. This is because the government provides medical care to inmates through the prison system. However, there are some exceptions to this rule.

  • Inmates who are pregnant may be eligible for Medicaid if they meet certain income and residency requirements.
  • Inmates who are receiving hospice care may also be eligible for Medicaid.
  • Inmates who are released from prison may be eligible for Medicaid if they meet certain income and residency requirements.

In addition, some states have programs that provide medical care to inmates who are not eligible for Medicaid. These programs are typically funded by state and local governments.

State Program Eligibility
California Inmate Medical Care Program Inmates who are not eligible for Medicaid
New York Correctional Health Services Program Inmates who are not eligible for Medicaid
Texas Prison Inmate Medical Care Program Inmates who are not eligible for Medicaid

Asset Limits

Medicaid has asset limits that determine if you’re eligible for coverage. Assets include checking and savings accounts, CDs, stocks, bonds, real estate (other than your primary residence), and personal property (such as jewelry and vehicles). If your assets exceed the limits, you may not be eligible for Medicaid.

  • In 2023, the asset limit for individuals is $2,500, and the asset limit for couples is $5,000. However, these limits can vary depending on the state you live in and your circumstances.
  • For example, some states allow you to have more assets if you have a disability or if you are receiving long-term care services.
  • If you have assets that exceed the limit, you may be able to transfer them to a spouse or child to make yourself eligible for Medicaid.
Medicaid Asset Limits for Individuals and Couples
Individual Couple
2023 $2,500 $5,000
2024 $2,750 $5,500

It’s important to note that Medicaid asset limits are subject to change. Therefore, it’s a good idea to check with your state’s Medicaid office to learn about the most up-to-date limits.

Immigration Status

To qualify for Medicaid, individuals must be U.S. citizens or certain qualified non-citizens with a valid Social Security number, including:

  • Permanent residents
  • Refugees
  • Asylees
  • Legal permanent residents (LPRs)
  • Cuban and Haitian entrants
  • Amerasian immigrants
  • Victims of human trafficking or certain other crimes

Non-qualified immigrants, undocumented immigrants, and visitors with temporary visas are generally ineligible for Medicaid.

States can choose to offer Medicaid coverage to additional groups of qualified non-citizens, including:

  • Pregnant women
  • Children under the age of 19
  • Certain individuals with disabilities

However, states cannot use federal Medicaid funds to provide coverage to these groups.

Individuals who are unsure about their immigration status or eligibility for Medicaid can contact their local Medicaid office or visit the Medicaid website for more information.

Table of Non-Qualified Immigrants

| Category | Subcategory |
|:—|:—|
| Non-qualified immigrants | Temporary workers |
| | Students |
| | Tourists |
| | Visitors |
| | Crew members on ships or aircraft |
| | Diplomatic personnel |
| | Illegal immigrants |
| | Individuals who have been deported or removed from the United States |
Well, there you have it, folks! Those are the main things that can disqualify you from Medicaid. Hopefully, you’re not one of the people who has to deal with these issues, but if you do find yourself in that boat, my heart goes out to you. Just remember, you’re not alone, and there are folks out there like me who are here to help you through this. If you liked this article, be sure to swing by again! I’ll be posting more helpful and informative articles just like this one in the future. And don’t forget, sharing is caring! If you know someone who could benefit from this info, please send it their way. That’s all for now from me, folks. Thanks again for reading, and I’ll catch ya later!