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.

What to do next

Not sure if you qualify for Medicaid? A Solace advocate can guide you through the process. Find an advocate today.