What Is Medicaid Eligibility?

Medicaid eligibility refers to the requirements individuals must meet to qualify for Medicaid, a state and federally funded program that provides low-cost or free healthcare to eligible individuals, including low-income adults, seniors, pregnant women, and people with disabilities.

Who qualifies for Medicaid?

Eligibility varies by state, but factors typically include:

• Income level: Based on the Federal Poverty Level (FPL) and state-specific guidelines.
• Age and disability: Seniors and individuals with qualifying disabilities may be eligible.
• Family status: Pregnant individuals and low-income families with children often qualify.
• Medicaid expansion: Some states have expanded eligibility to cover more low-income adults.

What does Medicaid cover?

• Doctor visits, hospital stays, and preventive care
• Nursing home and long-term care services (for those who qualify)
• Home health services and durable medical equipment
• Prescription medications (coverage varies by state)

How Solace can help

A Solace advocate can help you check Medicaid eligibility, apply for benefits, and navigate coverage options—including how Medicaid works with Medicare for those who qualify for both.