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How Do You Lose Medicaid Eligiblity?

Medicaid eligibility is based on many different requirements. If someone’s status changes while on the program he or she could possibly lose eligibility.

Medicaid is a joint state as well as federal program and contains 56 different programs. It is the third largest source of health care coverage in the United States. Each state has its own eligibility standards, packages, rates and guidelines for the program. In general, there are 3 types of critical health care protection: 1) long-term care for elderly or disabled people; 2) health insurance for people with a disability and families with children with a low-income; 3) supplemental coverage for services that are not covered by Medicare for low-income beneficiaries.

Medicaid eligibility

Medicaid in only available to people who live on a limited income. Certain requirements must be met to be eligible for Medicaid. This program does not provide money to the individual covered, but send payments to health care providers. Depending on the rules of the state the recipient lives in, he or she may be responsible for paying part of the medical services costs.

Groups covered under Medicaid/ Lose of coverage if outside of these groups

The following are the groups covered by Medicaid. If anyone covered by Medicaid falls out of these guidelines, Medicaid eligibility coverage is affected and coverage could possibly be lost.

~Pregnant women
~Children under the age of 6 with a family income at or below 133% of the poverty level.
~Children between the ages of 6 and 19 with a family income below or at poverty level.
~Adults who are taking care of children under the age of 18.
~People who are receiving SSI (Supplement Security Income).
~Teenagers up to the age of 21 who are living independently.
~People who are disabled, blind or over the age of 65.



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