Medicaid is a state-administered program for low-income and disabled U.S. citizens and legal aliens. Although many of the coverage details are determined by individual states, each state must provide certain services, such as specific hospital and doctor services.
It's possible to be eligible for both Medicare and Medicaid. If you think you might qualify, you need to fill out a Medicaid application. If you do qualify, Medicaid can help pay for your Medicare premiums, deductibles and/or coinsurance.
You Can Apply For Medicaid Even If You're Not Sure You Qualify
The Centers for Medicare & Medicaid Services (CMS) advises you to complete a Medicaid application even if you're not sure you qualify. Remember that it's better for you to apply for Medicaid and be turned down than not to apply at all. A caseworker will review your case to determine whether or not you qualify for Medicaid benefits. Your Medicaid eligibility can change from year to year, so you may want to complete a new Medicaid application each year, even if your application was previously turned down.
The Medicaid Application Process
Step 1: See if you're eligible for Medicaid in your state.
Here are two ways you can learn more:
- Visit the www.healthcare.gov website.
- Call your state Medicaid office.
Medicaid programs and application processes differ from state to state. Visit the www.CMS.gov webpage to learn about Medicaid program details and the specific Medicaid application process in your state.
Step 2: Gather all necessary information to fill out the Medicaid application.
Medicaid applications are often denied because of incomplete information on the application form. Before you submit your Medicaid application, be sure to have all of the following documentation ready.
- Proof of age (birth certificate or driver's license).
- Proof of citizenship or alien status.
- Proof of all sources of income (pay-stubs or tax return, Social Security, Supplemental Security Income, Veteran's benefits, retirement accounts, and any other income).
- Proof of assets and other resources: include copies of bank statements or other financial resources if directed on your Medicaid application.
- Proof of residence (rent receipts or landlord statements, a copy of your mortgage, recent mail addressed to you at your current address): make copies to include with your application.
- Proof of other insurance: include a copy of your red, white, and blue Medicare card (or other insurance ID card) with your Medicaid application. Remember that state applications and instructions may vary. Check your state's Medicaid application website to see if they ask for additional documentation.
Step 3: Submit your Medical application.
Follow your state's instructions for submitting your application. Medicaid application options may include paper applications, online application submissions, and even in-person applications at your local Medicaid office.
States must respond to regular Medicaid applications in 45 days (up to 90 days for disability applications).
If your Medicaid application isn't approved, you have the right to appeal. If your Medicaid application was turned down for missing information or documentation, get whatever is needed and follow the instructions on the denial letter to resubmit the application. If you feel the denial of your application is incorrect, provide documentation to prove otherwise. Your rights for appeal will be outlined on your Medicaid application denial letter.
Renewing Your Medicaid Application
You must fill out a new Medicaid application every year to stay in the Medicaid program. The Medicaid application process may be easier each year. For example, if they already have your birth certificate on file, they may not ask for it again with your next application. However, information such as your income or alien status may change from year to year, so you'll be asked to provide an update every time you renew your Medicaid application.