Your Source for Health Reform

Topic: Medicaid Eligibility



In general, Medicaid eligibility is based on income and family size, but there are different categories of eligibility, and it can be complicated. Some Medicaid programs are designed for people in specific age groups or with specific medical needs.


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Eligibility Mistakes for Tax Dependents

Healthcare.gov has been incorrectly counting Social Security income received by children and other tax dependents when calculating household income. The mistake can push a person’s income over the Medicaid or CHIP eligibility threshold. This February 2015 alert for assistors and advocates explains the error and outlines steps to appeal incorrect eligibility decisions.

Presumptive Eligibility in Your Hospital

The Affordable Care Act allows some hospitals to enroll uninsured patients meeting basic eligibility criteria into Medicaid. Hospitals learn the steps to implement presumptive eligibility in this 2013 tool kit from Enroll America.

Income Rules for Medicaid and the Marketplace

This October 2014 question and answer sheet from the Center on Policy and Budget Priorities discusses the new income measure called MAGI. The measure determines eligibility for marketplace tax credits and Medicaid.

Responding to Medicaid Redeterminations

Illinois residents who receive Medicaid or All-Kids must complete a redetermination to continue their coverage. This June 2014 FAQ from the Illinois Department of Healthcare and Family Services outlines the redetermination process. The FAQ lists the hotline number to call with questions or problems.

Explaining New CHIP and Medicaid Eligibility

This January 2015 primer from the Georgetown University Center for Children and Families describes the new household size and income standards for Medicaid and CHIP enrollment.

Medicaid Applications and SSI Recipients

If you were approved for Supplemental Security Income and are applying to Medicaid, this fact sheet from The Arc of Illinois helps to break down the application process. It covers the ways you can apply for Medicaid after you have been approved for SSI, and includes links to other resources to make the process easier.

Medicaid FAQ: Eligibility and Accessing Medical Services

These frequently asked questions from the Illinois Department of Human Services detail how to sign up for Medicaid and All Kids, how to access medical providers like a primary care physician or dentist under Medicaid, what to do if you have lost or did not receive a medical card, and what services are provided under Medicaid. The FAQ provides contact info to address issues and access needed care.

Application Process for Families that Include Immigrants

This resource from the Center on Budget and Policy Priorities offers an in-depth guide including general rules of immigrant eligibility for healthcare, eligibility factors for federal non-emergency Medicaid and CHIP, as well as showing which immigrant statuses qualify for marketplace coverage.

ACA’s Impact on Medicaid for People with Disabilities

Medicaid is an important source of health insurance coverage for people with disabilities. This April 2014 issue brief from the Kaiser Family Foundation discusses how Medicaid eligibility, enrollment, and benefits are affected by the ACA.

How to Check the Status of Your Medicaid Application

This fact sheet from Get Covered Illinois explains the process of checking the status of a Medicaid Application submitted through the call center or the ABE website within Illinois.

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