Medicaid has income requirements to decide an applicant’s eligibility. Counting all income types is crucial to determine if an applicant meets the limit. Employment income, self-employment income, Social Security benefits, pensions, unemployment benefits, and alimony are considered. Any other income like gifts, inheritances, or child support payments are also counted. Income from investments, such as dividends or capital gains, and income from assets, such as rental properties, are also included. When considering household income, the income of the applicant and their spouse, if married, is combined. However, the income of children or other family members is generally not included.
Types of Income Considered for Medicaid
Medicaid is a government-sponsored health insurance program that provides coverage to low-income individuals and families. To qualify for Medicaid, applicants must meet certain income and resource requirements. Income is defined as any money or other resources that a person receives on a regular basis. The following types of income are considered when determining Medicaid eligibility:
- Wages and salary
- Self-employment income
- Unemployment compensation
- Social Security benefits
- Supplemental Security Income (SSI)
- Workers’ compensation
- Pensions and annuities
- Interest and dividends
- Rental income
- Gifts and inheritances
In addition to the types of income listed above, states may also consider other sources of income when determining Medicaid eligibility. These sources may include:
- Alimony and child support
- Prizes and winnings
- Lump sum payments
- Vacation pay
- Sick pay
The amount of income that a person can earn and still qualify for Medicaid varies from state to state. In most states, the income limit for Medicaid is set at 138% of the federal poverty level (FPL). The FPL is a measure of poverty that is used by the government to determine eligibility for various programs. The FPL is updated each year based on the Consumer Price Index (CPI). As of 2023, the FPL for a family of four is $32,180.
In some states, Medicaid eligibility is also based on a person’s resources. Resources include things like cash, bank accounts, stocks, bonds, and real estate. The resource limit for Medicaid varies from state to state. In most states, the resource limit is set at twice the FPL. For a family of four, this would be $64,360.
| Family Size | Income Limit |
|---|---|
| 1 | $18,310 |
| 2 | $24,600 |
| 3 | $30,890 |
| 4 | $37,180 |
| 5 | $43,470 |
| 6 | $49,760 |
| 7 | $56,050 |
| 8 | $62,340 |
What Income is Counted for Medicaid?
Medicaid is a government program that provides health insurance to low-income individuals and families. To qualify for Medicaid, your income must be below a certain level. When determining your income for Medicaid, the state will count most types of income, including:
- Wages, salaries, and tips
- Self-employment income
- Social Security benefits
- Supplemental Security Income (SSI)
- Unemployment benefits
- Workers’ compensation benefits
- Veterans benefits
- Child support payments
- Alimony payments
- Investment income
- Rental income
- Royalty payments
- Pensions and annuities
- Income from trusts and estates
- Gifts and prizes
Excluded Income for Medicaid
There are some types of income that are not counted when determining your income for Medicaid. These include:
- Income that is specifically excluded by law, such as Supplemental Security Income (SSI).
- Income that is used to pay certain expenses, such as child care costs or medical expenses.
- Income that is received on an irregular basis, such as gifts or prize winnings.
| Type of Income | Excluded Amount |
|---|---|
| Child support | The first \$50 received each month |
| Social Security benefits | The first \$20 received each month |
| SSI | All SSI benefits |
| Wages | The first \$30 and 1/2 of the next \$30 earned each month |
The amount of income that you are allowed to have and still qualify for Medicaid varies from state to state. In most states, the income limit is 138% of the federal poverty level (FPL). However, some states have higher or lower income limits.
To find out the income limit for Medicaid in your state, you can contact your state Medicaid office or visit the Medicaid website.
Applying for Medicaid with Income
To be eligible for Medicaid, applicants must meet certain income and asset requirements. The amount of income that is counted towards Medicaid eligibility varies by state and depends on the applicant’s specific circumstances.
Income Determination Criteria
- Gross Income: This includes all sources of income before taxes or other deductions. It includes wages, salaries, tips, commissions, self-employment income, interest, dividends, capital gains, pensions, annuities, Social Security payments, Supplemental Security Income (SSI), unemployment benefits, and any other income from any source.
- Exclusions: Certain types of income are not counted towards Medicaid eligibility. These exclusions may vary by state, but commonly excluded income includes:
• Child support payments received on behalf of a child
• Foster care payments
• Adoption assistance payments
• Disaster relief payments
• Energy assistance payments
• Income earned by a child under the age of 18
• Earned income tax credits
• State and local income tax refunds
Income Limits
Each state has different income limits for Medicaid eligibility. The limits are typically expressed as a percentage of the Federal Poverty Level (FPL). For example, a state may set the income limit for a single adult at 138% of the FPL. This means that an individual with an income below 138% of the FPL would be eligible for Medicaid.
Income Verification
When applying for Medicaid, applicants must provide documentation to verify their income. This documentation may include pay stubs, tax returns, bank statements, investment statements, and Social Security award letters.
Applying for Medicaid with Unearned Income
For individuals with unearned income, such as Social Security benefits or disability payments, the income limit for Medicaid eligibility is typically higher than for individuals with earned income. This is because unearned income is considered to be less stable and less reliable than earned income.
Impact of Income on Medicaid Eligibility
Exceeding the income limit for Medicaid eligibility can result in denial of coverage. However, there are some exceptions to this rule. For example, individuals who are pregnant or who have children under the age of 19 may be eligible for Medicaid even if their income exceeds the limit.
Conclusion
The amount of income that is counted towards Medicaid eligibility varies by state and depends on the applicant’s specific circumstances. Individuals who are applying for Medicaid should contact their state Medicaid office to learn more about the income requirements and to obtain an application.
Resources
- Medicaid Eligibility
- Getting Medicaid & CHIP
- Medicaid Income Eligibility Levels by State for Adults in 2023
Well pals, that about wraps up our little chat about what income counts for Medicaid! I hope you found this article helpful and informative. If you have any more questions, feel free to check out the Medicaid website or give them a call. Otherwise, thanks for stopping by and be sure to visit again soon for more interesting and informative articles!