What Is Medicaid?
Medicaid is a joint federal and state health program that helps cover medical costs for people with limited income and resources. Eligibility and benefits can vary by state, and it may help with long-term care in certain situations.
Understanding Medicaid
Clear information for important coverage decisions.
Understanding Medicaid starts with knowing which rules apply to your situation. Your state, household, income, age, and care needs can all play a role. Here’s a practical starting point for exploring eligibility, comparing coverage, and preparing your next steps.
What determines eligibility?
Medicaid includes different eligibility pathways. The same financial rules do not apply to everyone.
Your household and circumstances
Eligibility may depend on household size, age, pregnancy, disability, residency, and citizenship or qualifying immigration status.
Your income
Income limits and counting methods depend on your state and eligibility category. A change in income or household circumstances may affect your eligibility.
Whether assets are considered
MAGI-based Medicaid eligibility does not use an asset test. Other pathways, including some for older adults, people with disabilities, and long-term care, may apply resource rules.
Medicaid and Medicare: the differences
These programs have different eligibility rules and benefits. Some people qualify for both.
| Topic | Medicaid | Medicare |
|---|---|---|
| Eligibility | Based on state program rules, including income and other qualifying circumstances. | Generally for people age 65 or older and certain younger people with qualifying disabilities or conditions. |
| Administration | Administered by states under federal requirements, with joint federal and state funding. | A federal health insurance program. |
| Coverage | Includes medical benefits and may cover qualifying long-term services and supports. | Includes hospital and medical coverage, with prescription drug coverage available through Part D or many Medicare Advantage plans. |
| Personal costs | Premiums and cost sharing depend on the state, eligibility group, and services. | Premiums, deductibles, copayments, and coinsurance depend on coverage and plan choices. |
Take the next step with a clearer picture.
A little preparation can make conversations about coverage more productive.
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Review your state’s information
Explore the programs available where you live and how to submit an application.
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Gather your current coverage details
Have your insurance cards and information about Medicare, employer coverage, or other benefits available.
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Identify your care needs
Note your doctors, prescriptions, and any need for ongoing help at home or in a care facility.
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Ask before making financial changes
For long-term care planning, review potential transfers or gifts with a qualified elder law attorney before acting.
This information is educational and is not a determination of eligibility or legal advice. Your state Medicaid agency makes eligibility decisions. Certified Financial Group, LLC is not affiliated with or endorsed by Medicare, Medicaid, or any government agency.