Understanding Medicaid and If You Qualify

Medicaid is the United States’ top public health insurance program for low-income individuals and families. Nearly 1 in 5 Americans utilize the Medicaid system to receive various forms of healthcare, including doctor & hospital visits, prescriptions, mental health services, and more.

It is no mystery that private healthcare in the United States is costly when not provided or supplemented by employment. It is essential to the general well-being of many Americans with low incomes and, therefore, the entire USA. Medicaid runs like many other government programs operated at the state level but is overseen at the federal level.

Eligibility Requirements for Medicaid

The Affordable Care Act changed Medicaid’s method to determine eligibility and now uses a Modified Adjusted Gross Income (MAGI). MAGI looks at Adjusted Gross Income (AGI) plus non-taxable Social Security benefits, tax-exempt interest payments, and untaxed foreign income (if applicable). For most Americans, the most critical piece is the AGI, as most people seeking Medicaid do not have foreign Income or tax-exempt interest payments they receive.

Gross Income includes:

  • Received Alimony
  • Capital gains or realized gains that are taxable
  • Dividend & interest payments
  • Business income
  • Farm, rental, and royalty income
  • Retirement income
  • Wages & Tips

MAGI is also used when filing taxes. This means that Americans who file taxes will have this information readily available, and it is a line item on their prior year’s tax return.

Who is Eligible for Medicaid

Medicaid is available to nearly all Americans with incomes that fall within the program’s income guidelines. If you have children, but your income is too high to qualify for Medicaid, and you cannot afford private coverage, you may be eligible for CHIP (Children’s Health Insurance Program). Who is eligible for Medicaid:

  • Adults with low incomes
  • Children
  • People 60 or older
  • Pregnant women
  • Individuals with disabilities

How to Apply for Medicaid

The best way to apply for Medicaid is to go to the government-run HealthCare.gov website and create an account. Follow the application process and enter all pertinent information, including Complete Name, Social Security Number, Current Address, Income Details, etc.

Important Dates for Medicaid and HealthCare.gov

  • November 1, 2022: Open Enrollment began — this is the first day you can enroll, re-enroll, or change a 2023 health plan through the Marketplace. Your coverage can start as soon as January 1, 2023, so apply now if you do not have any health insurance.
  • December 15, 2022: This is the final day of the year to enroll or change your coverage plan to begin on January 1, 2023.
  • January 1, 2023: The first day of 2023 coverage begins for those who enroll or change plans by December 15.
  • January 15, 2023: Final day to enroll or change a 2023 health plan through the Marketplace.

Medicaid is a Powerful Program for Low-Income Americans

There is nothing wrong with being unable to afford private healthcare. Costs in the USA are some of the highest for developed nations, and you owe it to yourself to apply to Medicaid if you qualify. Use the resources available above, and you’ll find applying for and receiving medical insurance far simpler than you could have thought.

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