Just because you meet all of the eligibility requirements for Medicaid doesn’t mean you will automatically start receiving benefits. You must still take action to manually apply for and enroll in the program, and there is some paperwork needed to do so.
In this Medicaid application guide, we outline the paperwork needed to apply for Medicaid, where you can get the required Medicaid application forms and how you can get started signing up for Medicaid.
Medicaid and Medicare both operate under the same governing body, the Centers for Medicare and Medicaid Services (CMS). Because the two programs are related, the application process is similar.
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There are two ways to apply for Medicaid:
While Medicare and Medicaid are different programs, it’s possible to be enrolled in both programs at the same time. If you do not qualify for automatic Medicare enrollment, you may be able to apply if you’re eligible by visiting your local Social Security office or filling out an online application.
Each state Medicaid application may look slightly different, but some of the paperwork and information you may need to supply can include:
Some states may require you to complete a Medicaid application in person, while other states may allow you to apply by mail, online or even over the phone. Contact your state Medicaid office and ask how to obtain and submit a Medicaid application.
Medicaid qualification rules vary by state, and some states have more strict requirements than others. Generally speaking, you must be a U.S. citizen or qualified non-citizen and a resident of the state in which you are applying for benefits. You must also meet certain financial requirements that will vary by state.
In addition, you’ll likely have to fall into one of the following categories:
Most states make Medicaid available to low-income adults regardless of age. Others require you to be at least 65 years old to qualify based on income alone.
The financial limits are based on income and assets or resources and will differ by state. Income is measured in relation to the federal poverty level. You can find the percentage of the federal poverty level you are allowed to make and still qualify for Medicaid in each state.
Your assets will also need to be under a certain value, which again will vary by state and program. Things like your home, primary vehicle and other things do not count against you as assets.
Most states will make a determination about a Medicaid application in 45 to 90 days. Individuals applying because of a disability may be on the longer end of that estimate as the disability must be thoroughly reviewed and approved.
Once you are approved for Medicaid coverage, benefits are available retroactive to the date of application or the first day of the month that you applied for up to three months.
If you qualify for both Medicaid and Medicare, you may be eligible for a special type of Medicare Advantage plan called a Dual-eligible Special Needs Plan (D-SNP). These Medicare-Medicaid plans can cover everything that Medicare covers, and some plans may cover additional benefits such as hearing, vision and dental care. All D-SNP plans cover your prescription drug costs.
To learn more about D-SNP plans and to find out if there are any plans available where you live, you can compare plans online for free. You can also call to speak with a licensed insurance agent.
Speak with a licensed insurance agent
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.
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