How To Apply for Medicaid: Learn About Eligibility for Medicaid

Get Help Filling out a Medicaid Application Form

Doctor visiting her patient

While Medicare is a federally operated program, Medicaid is a state-operated program that obtains assistance from the federal government based on the socioeconomic status of the state's residents. It is important to realize that each state has its own criteria for Medicaid eligibility. Essentially, Medicaid is a program that is available to specific low-income families which fit into specific eligibility restrictions that have been designed by the state and the federal government.  Before applying it may be a good idea to educate yourself on federal and state policy - fortunately, this is easily done through online coursework. 

But, there are some other issues that you will want to know:

  1. Medicaid does not pay money directly to you; rather, in most cases, it sends the funds to those  providers with whom you have had contact.
  2. There are a number of qualifications for receiving Medicaid, including your age, whether you are pregnant, disabled or blind.
  3. When choosing to apply, honestly evaluate your financial situation as it will appear to the people reviewing your application. If you own a new or relatively new car, your chances of getting Medicaid assistance are decreased. If you own a home, keep in mind that such property is worth money and could affect your case for receiving it also.
  4. Over the past few decades, Medicaid has been but one of the many federal and state programs that have undergone overhauls. Essentially, until Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act (commonly called the "Welfare Reform" program) in 1996, all immigrants regardless of citizenship were eligible for it. A year later, Congress passed the State Children's Health Insurance Program, or the SCHIP. With respect to these two legislative actions, there are some general rules that govern eligibility. Listed below are some basic rules and requirements:
    • For those immigrants who entered the United States before 1996, both Medicaid and Medicaid SCHIP programs are available (with the exception of Wyoming).
    • For those immigrants who entered the United States after 1996, there are specific restrictions that apply during the first five years.
    • While it is true that Medicaid is a state-funded program, it is regulated and also funded by the federal government. An excellent website to visit regarding Medicaid and immigrants is The Guttmacher Report.

How do you apply for Medicaid? Can you apply online?

In order to know how to apply, you need to contact your local Social Security Office, the Welfare Department in your city, or Department of Health and Human Resources to get an application form. Application methods vary from state to state. Even if you can apply online, for example, sometimes you still must visit an office in person to present your needs.

Here are some other important points to understand:

  1. Your child may be eligible to receive Medicaid assistance even if you don't fit the requirements. This is one reason it is very important to check with you individual state "Child Medical Services" department.
  2. If you are one with a low income and have children to support, you should check with your local  office for guidance.
  3. Many states also provide you with a card or some other means of buying food. At no time should you share this card with anyone else. Like Medicare, there is always a certain risk of fraud, and it is your responsibility to report such fraud if you know of any.
  4. If you ever need an ally, ask your health care provider. I have written many letters in behalf of my patients and almost every time, I received a positive response.

Don't forget that education is your best weapon if you ever have to challenge a ruling on your eligibility.  If you've been denied for Medicaid coverage or if you think you're not getting the full benefit you deserve, you may want to enroll in online health care policy classes to ensure that you are arguing from a knowledgeable position.


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