The Edg Number for Medicaid is a unique identification number assigned to each Medicaid recipient. It is used to track Medicaid claims and payments and to ensure that recipients receive the benefits they are entitled to. The Edg Number is typically printed on the Medicaid recipient’s Medicaid card. It is also available on the Medicaid recipient’s Medicaid account online. The Edg Number is confidential and should not be shared with anyone other than authorized Medicaid staff.
Medicaid Eligibility Determination Group (EDG) Codes
Medicaid Eligibility Determination Group (EDG) codes are used to determine an individual’s eligibility for Medicaid, the health insurance program for low-income individuals and families. The EDG number is a two-digit code that is assigned to each individual based on their age, income, and family size. The code is used to determine the individual’s eligibility for Medicaid and the amount of their co-pay.
- EDG 01: Children under 19, born after September 30, 1983, with family income at or below 133% of the Federal Poverty Level (FPL).
- EDG 02: Children under 19, born after September 30, 1983, with family income above 133% of the FPL, but at or below 185% of the FPL.
- EDG 03: Children under 19, born on or before September 30, 1983, with family income at or below 100% of the FPL.
- EDG 04: Children under 19, born on or before September 30, 1983, with family income above 100% of the FPL, but at or below 150% of the FPL.
- EDG 05: Pregnant women with family income at or below 133% of the FPL.
- EDG 06: Pregnant women with family income above 133% of the FPL, but at or below 185% of the FPL.
- EDG 07: Parents and caretaker relatives of children who are eligible for EDG 01, 02, 03, or 04, with family income at or below 133% of the FPL.
- EDG 08: Parents and caretaker relatives of children who are eligible for EDG 01, 02, 03, or 04, with family income above 133% of the FPL, but at or below 185% of the FPL.
- EDG 09: Adults aged 19 to 64 with family income at or below 133% of the FPL.
- EDG 10: Adults aged 19 to 64 with family income above 133% of the FPL, but at or below 185% of the FPL.
- EDG 11: Adults aged 65 and older with family income at or below 133% of the FPL.
- EDG 12: Adults aged 65 and older with family income above 133% of the FPL, but at or below 185% of the FPL.
- EDG 13: Individuals with disabilities with family income at or below 133% of the FPL.
- EDG 14: Individuals with disabilities with family income above 133% of the FPL, but at or below 185% of the FPL.
The EDG number is used to determine an individual’s eligibility for Medicaid and the amount of their co-pay. The co-pay is the amount of money that an individual is required to pay for their Medicaid coverage. The co-pay amount varies depending on the individual’s EDG number and their income.
| EDG Number | Age | Income | Co-pay |
|---|---|---|---|
| 01 | Under 19 | At or below 133% of FPL | $0 |
| 02 | Under 19 | Above 133% of FPL, but at or below 185% of FPL | $5 |
| 03 | Under 19 | At or below 100% of FPL | $0 |
| 04 | Under 19 | Above 100% of FPL, but at or below 150% of FPL | $5 |
| 05 | Pregnant women | At or below 133% of FPL | $0 |
| 06 | Pregnant women | Above 133% of FPL, but at or below 185% of FPL | $5 |
| 07 | Parents and caretaker relatives | At or below 133% of FPL | $0 |
| 08 | Parents and caretaker relatives | Above 133% of FPL, but at or below 185% of FPL | $5 |
| 09 | Adults aged 19 to 64 | At or below 133% of FPL | $0 |
| 10 | Adults aged 19 to 64 | Above 133% of FPL, but at or below 185% of FPL | $5 |
| 11 | Adults aged 65 and older | At or below 133% of FPL | $0 |
| 12 | Adults aged 65 and older | Above 133% of FPL, but at or below 185% of FPL | $5 |
| 13 | Individuals with disabilities | At or below 133% of FPL | $0 |
| 14 | Individuals with disabilities | Above 133% of FPL, but at or below 185% of FPL | $5 |
Medicaid Eligibility Categories
Medicaid is a federal and state health insurance program that offers coverage to low-income individuals and families. Medicaid eligibility is determined by a number of factors, including income, age, disability, and family size. Medicaid eligibility categories vary from state to state, but there are some general eligibility requirements that apply across the country.
- Income: Medicaid is available to individuals and families with incomes below certain thresholds. These thresholds vary from state to state, but they are generally based on the federal poverty level (FPL). The FPL is a measure of poverty that is used to determine eligibility for a number of federal programs, including Medicaid.
- Age: Medicaid is available to children under the age of 19, pregnant women, and people who are 65 or older.
- Disability: Medicaid is also available to people who are disabled. A disability is defined as a physical or mental condition that substantially limits a person’s ability to work.
- Family Size: Medicaid is also available to families with children. The size of the family is taken into account when determining Medicaid eligibility.
In addition to these general eligibility requirements, there are also a number of other factors that can affect Medicaid eligibility. These factors include:
- Residency: Medicaid is only available to people who are citizens or legal residents of the United States.
- Social Security Number: Medicaid applicants must have a Social Security number or a valid immigration status.
- Work History: In some states, people who are unemployed or underemployed may be eligible for Medicaid.
Medicaid Income Limits
Medicaid income limits are based on the federal poverty level (FPL). The FPL is a measure of poverty that is used to determine eligibility for a number of federal programs, including Medicaid.
The FPL is updated each year by the U.S. Department of Health and Human Services (HHS). The current FPL for a family of four is $26,500.
Medicaid income limits vary from state to state, but they are generally based on the FPL. In most states, the Medicaid income limit for a family of four is between 138% and 400% of the FPL. This means that a family of four with an income below 138% of the FPL is likely to be eligible for Medicaid. A family of four with an income between 138% and 400% of the FPL may be eligible for Medicaid, depending on the state’s Medicaid program.
The following table shows the Medicaid income limits for a family of four in each state.
| State | Medicaid Income Limit |
|---|---|
| Alabama | $26,500 |
| Alaska | $32,500 |
| Arizona | $26,500 |
| Arkansas | $26,500 |
| California | $400% of the FPL |
| Colorado | $400% of the FPL |
| Connecticut | $400% of the FPL |
| Delaware | $26,500 |
| Florida | $26,500 |
| Georgia | $26,500 |
| Hawaii | $26,500 |
| Idaho | $26,500 |
| Illinois | $400% of the FPL |
| Indiana | $26,500 |
| Iowa | $26,500 |
| Kansas | $26,500 |
| Kentucky | $26,500 |
| Louisiana | $26,500 |
| Maine | $26,500 |
| Maryland | 400% of the FPL |
| Massachusetts | 400% of the FPL |
| Michigan | $26,500 |
| Minnesota | $400% of the FPL |
| Mississippi | $26,500 |
| Missouri | $26,500 |
| Montana | $26,500 |
| Nebraska | $26,500 |
| Nevada | $26,500 |
| New Hampshire | $26,500 |
| New Jersey | $26,500 |
| New Mexico | $26,500 |
| New York | $400% of the FPL |
| North Carolina | $26,500 |
| North Dakota | $26,500 |
| Ohio | $26,500 |
| Oklahoma | $26,500 |
| Oregon | $400% of the FPL |
| Pennsylvania | $26,500 |
| Rhode Island | $400% of the FPL |
| South Carolina | $26,500 |
| South Dakota | $26,500 |
| Tennessee | $26,500 |
| Texas | $26,500 |
| Utah | $26,500 |
| Vermont | $26,500 |
| Virginia | $26,500 |
| Washington | $400% of the FPL |
| West Virginia | $26,500 |
| Wisconsin | $26,500 |
| Wyoming | $26,500 |
Medicaid Eligibility: Understanding Income and Asset Limits
Medicaid is a government-sponsored healthcare program designed to provide various medical services to low-income individuals and families. To qualify for Medicaid, applicants must meet specific eligibility criteria, including income and asset limits. Understanding these limits is crucial for determining eligibility and accessing the program’s benefits.
Income Limits for Medicaid
- Income limits vary depending on the state and household size.
- In most cases, eligibility is based on the Federal Poverty Level (FPL).
- For example, in 2023, a single individual with an income below 138% of the FPL (approximately $18,400) may qualify for Medicaid.
- This limit is adjusted annually based on inflation.
Asset Limits for Medicaid
- In addition to income limits, Medicaid also imposes asset limits.
- These limits vary depending on the state and the type of Medicaid program.
- Generally, assets such as cash, bank accounts, investments, and certain personal property are counted towards the asset limit.
- In 2023, the asset limit for individuals is typically around $2,000, while the limit for couples is approximately $3,000.
Exceptions to Income and Asset Limits
- There are certain exceptions to income and asset limits for Medicaid eligibility.
- Individuals who meet specific criteria, such as those with disabilities, pregnant women, or children, may be eligible for Medicaid regardless of their income or assets.
- Additionally, certain assets, such as a primary residence and personal belongings, are often excluded from asset calculations.
Applying for Medicaid
To apply for Medicaid, individuals must contact their state’s Medicaid office. The application process typically involves providing information about income, assets, and household composition.
Medicaid eligibility is subject to change, and specific guidelines may vary among states. For the most accurate and up-to-date information, it is recommended to contact the local Medicaid office or visit the official Medicaid website for your state.
| State | Income Limit | Asset Limit |
|---|---|---|
| California | 138% of FPL | $2,000 |
| Texas | 150% of FPL | $2,500 |
| New York | 100% of FPL | $3,000 |
Eligibility Determination Group (EDG) Number for Medicaid
The Eligibility Determination Group (EDG) Number is a unique identifier assigned to each person or family applying for Medicaid. It is used to track the application process and determine eligibility. The EDG number is also used to manage Medicaid benefits and services.
How to Apply for Medicaid
To apply for Medicaid, you can:
- Apply online at the state’s Medicaid website.
- Contact your state’s Medicaid office to apply by phone or in-person.
- Apply through an in-person interview at your local Department of Human Services (DHS) office.
You will need to provide the following information when you apply:
- Your Social Security number or proof of U.S. citizenship or legal residency.
- Your financial information, including your income and assets.
- Proof of your identity, such as a driver’s license or birth certificate.
- Proof of your residency in the state where you are applying.
Once you have applied for Medicaid, your application will be reviewed to determine if you are eligible. This process can take several weeks. If you are approved for Medicaid, you will receive a Medicaid ID card in the mail.
EDG Number Format
The EDG number format varies by state. However, it typically consists of a combination of letters and numbers. For example, in California, the EDG number is a 12-digit number that begins with the letter “M”.
Where to Find Your EDG Number
You can find your EDG number on your Medicaid ID card. It is also printed on any Medicaid correspondence you receive from your state’s Medicaid office.
What if I Don’t Have an EDG Number?
If you do not have an EDG number, you can contact your state’s Medicaid office to obtain one. You will need to provide your name, address, and Social Security number.
EDG Number: A Quick Reference
| Term | Description |
|---|---|
| EDG Number | Unique identifier assigned to each Medicaid applicant or family |
| Purpose | Tracks application process, determines eligibility, manages benefits |
| Application Methods | Online, by phone, in-person interview |
| Required Information | Social Security number, financial info, proof of identity, residency |
| Approval Process | Takes several weeks, Medicaid ID card issued if approved |
| EDG Number Format | Varies by state, typically a combination of letters and numbers |
| Finding Your EDG Number | On Medicaid ID card or Medicaid correspondence |
| No EDG Number | Contact state’s Medicaid office with name, address, Social Security number |
Thanks for sticking with me until the end of this deep dive into the world of Medicaid and the mysterious Edg Number. I know it can be a lot to take in, but hopefully I was able to shed some light on this important topic. If you have any more questions, feel free to reach out and I’ll do my best to answer them. In the meantime, keep an eye out for more articles like this coming soon. I’ll be exploring other aspects of Medicaid and other healthcare-related topics, so be sure to check back again later. Thanks again for reading!