Everything to Know About Medicaid & How to Qualify for Lifeline/ACP
Medicaid is a public health insurance program that provides health coverage to low-income individuals and households, including eligible children, pregnant women, elderly persons, and people with disabilities. It is paid for conjunctly by the state and federal government. Since its inception in 1965, disadvantaged communities have depended on the benefits of Medicaid, which has increased in recent years as health care costs skyrocket. More individuals and households struggle to cover their medical expenses, and Medicare plays a significant role in getting individuals the care they need.
People who are more reliant on medical care are usually children, pregnant women, the disabled, and the elderly who lack access to affordable health insurance. According to Kaiser Family Foundation (KFF), Medicaid covered 1 in 5 Americans in 2019. The program continues to support enrollees with comprehensive health coverage and financial support. It grants access to long-term care among vulnerable communities that is comparable to individuals with private health insurance, such as employment-based insurance. Medicaid remains one of the most popular sources of health coverage for low income individuals.
What Does Medicaid Offer?
According to the Medicaid official website, there are mandatory benefits that every state must offer, which is a requirement under Federal law. These benefits cover a broad range of health services. These services include:
- Inpatient and outpatient hospital services
- Physician services
- Laboratory and x-ray services
- Home health services
- Rural health clinic services
- Nursing facility services
There are other health services mandatory under Medicaid, which you can find on the Medicaid benefits page. After states provide the mandatory health assistance required by federal law, they have the freedom to structure the program as they see fit. For example, states can establish which populations are covered and can provide additional services within the program, such as prescription drugs and physical therapy that are not a requirement by law. As a result, Medicaid coverage will vary by state.
Do You Qualify?
Medicaid is jointly funded by states and the federal government, so eligibility requirements vary by state. You can become eligible based on two broad factors: financial and nonfinancial requirements.
You will qualify financially if your income is at or below the Federal Poverty Level (FPL). The size of the family determines this threshold. For example, in 2022, a single adult who earns $13,590 or less is considered eligible. Again, this financial threshold increases by the size of the household. For example, a family of eight that generates an income of $46,630 is eligible. Their income may be higher, but since more individuals live in the household, the family is still eligible to apply for Medicaid.
Families with more than eight individuals are considered “larger households” and must add $4,720 for every additional person. This financial eligibility requirement for Medicaid applies to 48 states and the District of Colombia (excluding Alaska and Hawaii).
The Department of Health and Human Services determines the Federal Poverty Level in Alaska and Hawaii. The FPL in these states is higher than in other states. It’s important to note that the earnings reported above are not the same in every state. Medicaid is administered at the state level, so income levels differ in each state.
In addition to financial eligibility requirements, individuals must meet nonfinancial criteria. If you want to apply for Medicaid, you must be a:
- Resident of the state in which you are applying
- U.S. citizen or qualified non-citizen
- Medically needy individual (there are various groups of low-income individuals):
- Pregnant women
- The elderly (persons age 65 and older)
- People with disabilities
If your income is too high to meet the medically needy income level (MNIL), you can “spend down.” Subtract your medical expenses to determine if your income will reach a level that qualifies you for Medicaid. You can also reduce your estate by gifting your assets to family members who can use them on your behalf. However, not every state has medically needy pathways, as they don’t offer a “medically needy program.”
How Can You Receive Medicaid?
The application process is known to be lengthy and complicated. It is one of the most complex federal and state programs that exist. But don’t get discouraged. You don’t have to do it alone. Many experts recommend that individuals work with a Certified Medicaid Planner (CMP) to help guarantee their application is approved the first time. A CMP is a professional candidate who can help you navigate the Medicaid rules (current and upcoming).
Regardless of how difficult Medicaid may be, the first thing you need to do is apply. If you make at or less than 100% to 200% of the Federal Poverty Level, you will likely receive Medicaid. Children, the elderly, persons with disabilities, and pregnant women are also more likely to be eligible.
You can apply for Medicaid in one of two ways:
- Contact your state’s Medicaid agency
- Apply through the Health Insurance Marketplace (online or in-person)
However you apply, make sure you have the necessary documents to meet your state’s requirements, such as proof of identification and bank statements.
Sign Up with Q Link Wireless
When you participate in qualifying government benefit programs, such as Medicaid, you may be able to apply to the Lifeline Program or Affordable Connectivity Program (ACP). Both are government benefit programs by the Federal Communications Commission (FCC) to provide low-income individuals access to cell phone services at discounted costs.
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If you have additional questions, feel free to contact us at 1-855-754-6543 . A Q Link Wireless representative will be happy to assist you!