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Medicaid provides health coverage to 66.7 million Americans. Recipients are low-income adults, children, pregnant women, the elderly, and people with disabilities. Each state administers Medicaid according to federal requirements, so the rules differ somewhat state-to-state. For the most part, Medicaid eligibility is based on modified adjusted gross income.

According to the Centers for Medicare & Medicaid Services (CMS), every state’s Medicaid program is getting a facelift in eligibility requirements. They’re also improving aspects of the program like the enrollment and renewal systems. Most are expanding coverage for low-income adults. States are also integrating their application and enrollment process with the Health Insurance Marketplace to streamline the process of getting coverage.

If you believe you may qualify for Medicaid, you’re likely wondering about your specific state’s requirements. CMS has your questions covered. Its State Overviews page offers an interactive map with important information about each state’s unique Medicaid program.

Your State’s Requirements for Medicaid Eligibility

The CMS map shows users more than just the eligibility requirements for Medicaid in a specific state. Each state page offers information such as:

  • How the state determines whether a person is eligible for Medicaid
  • Information about efforts to enroll eligible individuals in Medicaid in the state
  • State performance on frequently-reported health care quality measures
  • Important state documents including up-to-date amendments, waivers and more

The chart below is an example of the data CMS provides about Medicaid in each state. In New York State, for example, users can see eligibility based on modified adjusted gross income, enrollment statistics, and much more.

do i qualify for medicaid

Every state offers this type of information, so prospective and current recipients can understand eligibility, enrollment, and state-specific performance.

If you’re looking into eligibility requirements because you or your child has been catastrophically injured, there’s more you need to know. Even if you are eligible for Medicaid now, a personal injury settlement can impact whether you continue to receive benefits. However, by working with a skilled settlement planner, you can keep your Medicaid benefits and your settlement.

One way we work with Medicaid recipients is by establishing a special needs trust. This type of trust is intended to supplement (but not replace) needs-based government benefits like Medicaid and Supplemental Security Income (SSI). A special needs trust can pay for things Medicaid does not cover, which allows recipients to comply with an protect the program’s interests while still paying for necessities.

If you’re Medicaid eligible and about to receive a settlement, by working with a comprehensive settlement planner, you can get your questions answered and ensure your Medicaid benefits remain there for you now and in the future.

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