What is the Edg Number for Medicaid

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 NumberAgeIncomeCo-pay
01Under 19At or below 133% of FPL$0
02Under 19Above 133% of FPL, but at or below 185% of FPL$5
03Under 19At or below 100% of FPL$0
04Under 19Above 100% of FPL, but at or below 150% of FPL$5
05Pregnant womenAt or below 133% of FPL$0
06Pregnant womenAbove 133% of FPL, but at or below 185% of FPL$5
07Parents and caretaker relativesAt or below 133% of FPL$0
08Parents and caretaker relativesAbove 133% of FPL, but at or below 185% of FPL$5
09Adults aged 19 to 64At or below 133% of FPL$0
10Adults aged 19 to 64Above 133% of FPL, but at or below 185% of FPL$5
11Adults aged 65 and olderAt or below 133% of FPL$0
12Adults aged 65 and olderAbove 133% of FPL, but at or below 185% of FPL$5
13Individuals with disabilitiesAt or below 133% of FPL$0
14Individuals with disabilitiesAbove 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.

StateMedicaid 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
Maryland400% of the FPL
Massachusetts400% 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.

Medicaid Income and Asset Limits
StateIncome LimitAsset Limit
California138% of FPL$2,000
Texas150% of FPL$2,500
New York100% 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

TermDescription
EDG NumberUnique identifier assigned to each Medicaid applicant or family
PurposeTracks application process, determines eligibility, manages benefits
Application MethodsOnline, by phone, in-person interview
Required InformationSocial Security number, financial info, proof of identity, residency
Approval ProcessTakes several weeks, Medicaid ID card issued if approved
EDG Number FormatVaries by state, typically a combination of letters and numbers
Finding Your EDG NumberOn Medicaid ID card or Medicaid correspondence
No EDG NumberContact 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!