Understanding the Eligibility Requirements of Medicaid

Medicaid is an insurance program that is offered bya resident, the status of their parent or caretaker does
every state to people with lower incomes. Thenot matter. As long as the child is a legal resident, they
program is, in part, federally funded, but each state ismay receive Medicaid benefits.
given freedom in how they implement their MedicaidMedicaid is available for a number of disabilities,
Program.including HIV. In fact, Medicaid is the single largest
Medicaid, while federally funded and regulated, variessource of funding for HIV care from the federal
from state to state, because each state is givengovernment. However, in order for HIV to be classified
freedom to choose how to meet the federalas a Disability, the disease must have progressed to
regulations. The same federal agency that administersAids, which is defined as having a T Cell count of less
Medicare, the Center for Medicare and Medicaidthan 200.
Services (CMS,) is responsible for ensuring that theIn order to become enrolled in Medicaid, it is necessary
states are meeting the federal regulations.to submit an application to your state. In order to
Medicaid is intended to help those with lower incomesadhere to federal regulations, the state must review
afford medical care, but over 50% of those in povertyand act on the application within 45 days of receipt,
do not qualify for Medicaid.although they are given 90 days in the case of
Eligibility for Medicaid is divided into several categories,disabilities.
with each category having several requirements thatBeginning in 2005, as part of the Deficit Reduction Act,
must be met. The basic categories are children,there were several changes to Medicaid, which serve
pregnant women, the parents of eligible children, singleto provide tighter control over who can receive these
parents, and single individuals. The actual requirementsbenefits. It is now necessary to provide proof of
can change a great deal between states, specificallyresidency or citizenship before being approved for
because each state administers their own MedicaidMedicaid Benefits.
Program, but the states are required by the FederalThe government has also put in place much stricter
Government to cover individuals who fall into thefinancial requirements on an individuals assets. Most
above categories.states cap an individuals assets at $2000, although this
While poverty is an overall requirement to be eligiblefigure does vary. The government now analyzes all
for Medicaid, being poor by itself does not qualifymoney transfers and gifts over the past five years.
someone for Medicaid. Instead, an individual or familyThe total of these assets is then used to penalize the
must both have a low income and fall into one of theindividuals receipt of nursing home benefits. In the case
specific categories.of many seniors that have made gifts of their assets,
Typically, Medicaid is only available to Americanthis penalty prohibits them from qualifying for Medicaid,
Citizens or those who are otherwise legal residents.even though they do not have the money to pay for it.
However, in the case of children, as long as the child is