Anyone can apply for Medicaid any time. You do not need to be on disability. Just contact your state Medicaid office or apply online through the Health Insurance Marketplace.
The Medicaid rules vary a lot by state. In some states it is quite easy to get on Medicaid, and in other states it is quite difficult.
If you got turned down for Medicaid, or thought you would be turned down so didn’t bother applying, don’t give up hope! There a whole bunch of things you can still try:
If you got turned down for Medicaid, even though you think you meet the requirements, appeal the medicaid decision. They do make mistakes sometimes.
Don’t list weird people on your application. List yourself and your minor children. List your spouse if you are not legally separated. Don’t put down other people just because you live with them!! In most cases, you do not want to list your housemate, friend, landlord, mother, aunt or other random people who live with you. Here’s a list of who to include and who not to include. If you did list these people and got turned down…. apply again!
If you need help with bathing, eating, dressing, or personal care, you can look into applying for Medicaid Long Term Care which will provide a caregiver in your home. In some states, this program also comes with medical care, doctor’s visits, hospitals, and medications. Some medicaid home care programs also provide delivered meals and other services such as shopping, cooking, errands, and cleaning. These programs are designed for people with “nursing-home level need”
If you are married…. If you are not eligible for Medicaid because your spouse has too much income or savings, you are still eligible to apply for the Medicaid Long Term Care program listed above. In most states, they will not count your spouse’s income. In many states, they will also allow your spouse to keep savings, sometimes as much as $120,000.
If you have too much income for Medicaid, you may still be eligible for to apply for the Medicaid Long Term Care program listed above. It will depend on your state. In some states you can have higher income and still qualify. If they tell you that you can’t qualify, try consulting with a medicaid estate planning lawyer, or someone who specializes in medicaid long term care planning. There are many ways that your social services department won’t tell you about.
If you are applying for disability, you can make a dire need request to Social Security. This won’t get you a doctor immediately, but it could speed up your application. After you are approved, then you will have insurance! If you need critical or life-saving medical care that you cannot afford, include this in your dire need request.
Some estate planning lawyers recommend that couples considering getting a “Medicaid divorce” so one person can qualify for medicaid. It looks complicated to me, but apparently works for some people. Note: This may work for Medicaid, but will not work for SSI. Social Security rules are different than medicaid rules. If you continue to live together or function as a married couple, Social Security will still consider you married.
If you are in serious need of medical care, some people move to a different state so they can get the help they need. In some states it’s super easy to get on Medicaid, in other states it’s nearly impossible. Start by finding a state that has expanded medicaid and of course make sure you will meet the requirements before making any big moves. The rules are very different in different states. As far as I know, you can be considered a resident and apply for Medicaid the first day you arrive and set up residence somewhere. There may still be a wait time while your application is processed.
If you have high medical costs, you may be able to get on medicaid through a Medicaid Spend Down program in some states. If you are already on Medicare, you still may be eligible for this program.
If you applied for Medicaid years ago and got turned down, try again now. The laws have changed a lot in the last few years, and are continuing to change constantly.
If you have been diagnosed with Serious Mental Illness, you may be eligible for medicaid through a mental health medicaid waiver program. You will get other cool services too! These programs are now available in Connecticut, California, and Colorado. Virginia has a similar program called GAP. Ohio is just starting one called Specialized Recovery Services. Other states may have them as well. Call your medicaid office and ask to speak to someone who handles medicaid waivers. You can also look up the names of different waiver programs in your state. Make sure to ask about or research exactly what kind of mental health symptoms and treatment you need to qualify. Most waiver programs have very specific guidelines and if you don’t know them, you may find it difficult or impossible to get into the program.
If you are on Medicare and low-income, please sign up for a Medicare Savings Program. This won’t actually give you Medicaid, but it will get Medicaid to pay for all your premiums deductibles and co-pays. Don’t get scared off by the Medicare website, which, oddly, does not include the correct information about the financial criteria. Instead, check out this actually accurate guide to Medicare Savings.
Most states have medicaid programs for parents. If you were turned down for Medicaid in the past, but now you have kids…. go try again!
If your state did NOT expand Medicaid:
If you are poor but still got turned down for Medicaid, you are probably living in a state that did NOT expand Medicaid. Rat bastards!
Luckily, there is a loophole!! Some states have special Medicaid programs for people who are aged, blind or disabled.
You can get in these programs even if you are not yet on SSI or SSDI. These programs exist in North Carolina, Florida, Wisconsin, Utah and probably a few other places. I found these programs by googling “state name medicaid aged blind disabled”. Try it! Or contact your local medicaid office and ask for the medicaid, blind, aged and disabled program.
If your state DID expand Medicaid:
If you are not on disability and you live in a state that did expand Medicaid and your income is low, you should be able to qualify.
Make sure you do not apply for the disability Medicaid program. The disability medicaid program is harder to qualify for. When asked if you have disabilities, check the box “no”. (legally this is true, if you haven’t been approved for disability).
If you got turned down, apply again and check “no” for disabilities.
Never take no for an answer over the phone or in person. People are told weird, discouraging things all the time. Research the guidelines, and if you think you qualify, apply in writing. Let them turn you down IN WRITING. I have met many people who were told they would not be eligible, then applied anyway, and got approved. Here’s a little story to give you hope: How Sage Got Approved by Ignoring Everything He Was Told
Social Security automatically comes with insurance. If you think you are not eligible to apply for disability, you may be right, or you may be wrong. Every now and then I meet someone who is wrong about this, and that is a happy day. Please double check: Fifteen Ways to Qualify for Disability After You Were Told You Don’t Qualify for Disability
If you are already on disability and your disability check is under $735 per month, you may be eligible for SSI (which automatically gives you Medicaid). If you are not getting SSI, there is a reason. Maybe it is a good reason (you are rich!) or maybe it is a bad reason (you didn’t know you could apply for SSI, or your bank account has $1 too much). Check out How to Make SSI Stop or Start and Ten Common Reasons SSI Might be Denied. If you have an inheritance or too much money in the bank, you are allowed to spend it in certain ways and then qualify (for example, pay a mortgage, buy a house, or open a trust).
If you are applying for disability, you will automatically get health insurance after you are approved. But that will be three years from now! Or will it? How to Greatly Improve Your Chances of Getting Approved Quicker
You can always give up on Medicaid and instead try some other ways to find medical care: How to Get to the Doctor When You Can’t Get to the Doctor
🍁 Updated: May, 2017.