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Understanding Medicaid Eligibility: A Comprehensive Guide for Individuals and Families

Understanding Medicaid Eligibility: A Comprehensive Guide for Individuals and Families

If you are serious about applying for Medicaid, one of your first steps should be to determine your eligibility. Only certain people are eligible for Medicaid, and these requirements can be quite complex. Fortunately, you may be able to make a few adjustments to become eligible. A Medicaid lawyer can guide you through these steps, helping you achieve financial stability and reliable healthcare throughout the rest of your life. A lawyer can also help you determine whether you qualify for Medicaid based on your unique circumstances. The best way to discuss these circumstances is during a consultation.

Medicaid Eligibility Differs by State

The first thing you need to know about Medicaid is that eligibility requirements may vary by state. Although some of the requirements are universal, others vary depending on where you live. You may need to discuss your State’s unique requirements alongside your Medicaid lawyer for best results.

One of the most important factors to consider is whether your state has expanded Medicaid coverage. It may be easier to qualify if your State has expanded Medicaid. If you live in one of these States, you can qualify based on your income alone. As long as your income is below 138% of the “federal poverty level,” you automatically qualify with no other requirements to consider. In 2024, the federal poverty level for a single individual was about $15,000. This poverty level increases by about $5,000 for each additional person in the family. For example, a family of four is associated with a poverty level of $30,000.

Speak with your lawyer to learn more about the federal poverty income level. It changes from year to year, and calculations can be deceptively complex. Remember, you do not necessarily need to be below the federal poverty level – you only need to be within 138% of the number.

Basic Medicaid Eligibility Requirements

There are a few other basic, universal requirements to consider when it comes to Medicaid in the United States. Generally speaking, only US citizens are eligible to receive Medicaid. You must also be a legal resident of the State in which you file your application. This second requirement is much easier to meet than citizenship, as you only need to live in the State for six months to become a resident. Some “qualified non-citizens” may also qualify for Medicaid, such as lawful permanent residents.

Eligibility Requirements That Most States Enforce

Although requirements vary depending on your state, you probably will not qualify if you are under 65 with more than $2,000 in cash. If you are over the age of 65, you may qualify based on more complex requirements. All States have strict rules against some of the most popular qualification strategies. Medicaid officials pay especially close attention to strategies involving asset transfers and gifts.

California Medicaid Eligibility Requirements

California’s version of Medicaid is called “Medi-Cal.” California is one of the many States that have expanded Medicaid, allowing you to qualify based on your income alone. California also offers Medicaid to various other individuals, including those who are over the age of 65. In addition, people who are blind or disabled may qualify regardless of their age. Pregnant individuals may also qualify, and some youths under the age of 21 could be eligible. If you are a refugee, you might also receive Medicaid in California. Certain cancer patients could qualify as well.

Texas Medicaid Eligibility Requirements

In Texas, you must have a low income or “very low income” to qualify for Medicaid. You must also fall into one of the following categories:

  • You’re pregnant
  • You’re caring for a child
  • You’re blind
  • You’re disabled or caring for someone who is disabled
  • You’re over the age of 65

In other words, Texas is one of the states that has not expanded Medicaid eligibility. That being said, Texas defines “low-income” in relatively generous terms – as anyone with an income under about $30,000 per year generally qualifies.

Florida Medicaid Eligibility Requirements

Florida’s Medicaid eligibility requirements are very similar to those of Texas. The Sunshine State has not expanded eligibility, which means you cannot qualify on the basis of income alone. You must be characterized as “low-income” while also falling into one of the following categories:

  • Pregnant
  • Blind
  • Caring for a child
  • Caring for a disabled person
  • Disabled
  • 65 or older

With that said, the income requirements for Florida are considerably more strict compared to Texas. A single individual can only qualify for Medicaid if their annual income is less than about $20,000 per year.

New York Medicaid Eligibility Requirements

Like California, New York expanded Medicaid eligibility requirements. This means you can qualify based on your income alone – as long as it falls below the 138% threshold of the federal income poverty level. Aside from this requirement, you can also qualify based on pregnancy, disability, blindness, parenthood, or age (65 and older).

New York also offers Medicaid based on immigration status. This makes New York one of the few states in which non-citizens and permanent residents can get access to Medicaid. If you are an undocumented migrant living in New York, you might want to speak with a Medicaid lawyer to learn more about this opportunity.

Strategies for Becoming Eligible for Medicaid

There are various strategies that can help you become eligible for Medicaid. These strategies may depend on the unique requirements of your home state. They could include gifting, transfers, trusts, and homestead exemptions. Speak with your lawyer to learn more about your options if you do not yet qualify for Medicaid.

Find an Experienced Medicaid Lawyer

Contact The Elderly Care Law Firm if you would like to learn more about Medicaid eligibility. With our help, you can review these requirements in more detail and determine whether you qualify. From there, you can explore various steps and strategies to help you qualify. Even if you are not currently eligible to pursue Medicaid, it may be easier than you think to meet the necessary requirements. To discuss your next steps in more detail, feel free to book a consultation today with our experienced Medicaid lawyers.

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Sherrie Lim

Client Services Coordinator

Sherrie Ann Lim brings over twelve years of customer service experience and a strong background in team leadership and client support. Although she holds a Bachelor of Science degree in Physical Therapy, her career path led her to the dynamic world of the contact center industry, where she discovered a deep passion for service, communication, and operational excellence. 

Sherrie is known for her perseverance, enthusiasm, and confident sense of responsibility. She consistently delivers high-quality results, efficiently managing tasks while remaining flexible to the evolving needs of her clients. Her commitment to continuous improvement and excellence positions her as a trusted ally for businesses seeking proactive and reliable virtual support. 

Drawing from her college background, Sherrie has a deeper understanding of the physical and emotional needs associated with aging, making her especially attuned to the importance of compassionate and informed care for the elderly. She recognizes that elder care isn’t just about physical support, it also involves emotional presence, patience, and clear communication. Her strong appreciation for family ties fuels her commitment to helping clients manage the intricacies of elder care with empathy and attentiveness, ensuring that elderly loved ones feel respected, safe, and truly cared for. 

 

She loves taking care of her family during her rest days and free time, finding joy in the simple yet meaningful routines of home life. Whether it’s preparing home-cooked meals, baking sweet treats for her kids, or tackling household projects, Sherrie finds fulfillment in creating a nurturing and organized environment for her family. Whenever time and opportunity allow, she also enjoys traveling with her family, exploring new places, creating lasting memories, and embracing experiences that strengthen their bond and bring joy into their lives. 

Fun Fact: Sherrie’s two kids were born on the exact same date—two years apart! 

May Cruz

Client Services Coordinator

May began her community service career with the Philippine Department of Health as a Computer Operator, providing vital technical support to healthcare workers across island provinces and helping to bridge technology gaps in remote medical settings. Her commitment to service extended beyond her official duties—she also volunteered in medical missions, assisting indigenous communities and contributing to the delivery of essential healthcare with empathy and cultural sensitivity. 

Continuing her dedication to public service, May later worked at a law firm as a Disability Service Coordinator, assisting military veterans in navigating disability services. She brought empathy, compassion, and heart to the role, ensuring that each veteran felt heard, respected, and supported throughout the process. 

With a unique blend of technical expertise and human-centered care, May remains deeply committed to using her skills to uplift underserved and vulnerable communities. 

Fun Fact: Despite not knowing how to swim, May is a certified open water diver. Her adventurous spirit and determination push her beyond her comfort zone—both in life and under the sea.