Can the Unemployed Get Medicaid?

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  • Can the unemployed get Medicaid? What are your health coverage options for those periods when you are out of work? Find out about coverage for the unemployed.
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Can the Unemployed Get Medicaid?

People who have lost their jobs, for whatever reason, may be eligible for health coverage through Medicaid. Medicaid provides basic health insurance for tens of millions of Americans with a limited ability to pay. Unemployed workers who have lost their income may be able to sign up for the healthcare services Medicaid provides, even if they were not eligible for coverage while employed.

Losing a job can be difficult, regardless of the reason. Apart from the loss of your former stable income, you might find yourself without the health insurance you counted on to protect yourself and your family. Many people who find themselves out of work wonder how they can keep their families covered until a new job comes along. Fortunately, Medicaid offers basic health services to people with medical needs and financial limits that make it difficult to pay. Not everyone is eligible for coverage, however, and your former income could complicate your income verification during the application process.

Medicaid Provides Health Coverage for Low-Income Americans

Medicaid developed during the 1960s as a low-cost health insurance program for Americans with a limited ability to pay for care. Organized as a joint federal-state program, Medicaid operates somewhat differently in each of the 53 regions where it is available (50 states, plus the District of Columbia, Puerto Rico and Guam).

Most people who sign up for Medicaid do so through their state or territory’s government, usually online or in person at a human services office. Applications are subject to verification of income and assets, and in some states, medical need, age or pregnancy. Once an application is approved, which takes anywhere from a few days to several weeks, new enrollees are issued a benefits card they can present to healthcare providers and pharmacies at the point of payment.

Some Medicaid plans are directly administered by the state offering benefits, while others are managed by private sector insurance providers. There is very little difference to beneficiaries between these two options, apart from the generally larger provider network that a Medicaid-funded HMO or PPO offers. Medicaid participants may be expected to pay some of their medical costs out of pocket. This usually depends on their state, income or other factors.

Some states, such as California, reserve the right to recover care costs from deceased enrollees’ estates and impose a significant share of cost obligations. Other Medicaid programs, such as Guam, charge no co-payment or other fees for service. Be sure to ask your intake worker about Medicaid in your state and about what costs, if any, you are expected to manage on your own.

Who Is Eligible for Medicaid?

Medicaid has somewhat different eligibility criteria in every territory and state, but all state-level programs use federal guidelines as a starting point for approval of applicants. As a rule, Medicaid enrollees must be:

  • U.S. citizens or permanent legal residents who meet length-of-residency requirements
  • Residents of the state where the application is submitted
  • Earning less than the state maximum income and have less than the maximum countable assets, which does not include a single home or car
  • Free from past convictions for benefits fraud, not have voluntarily surrendered access to benefits in lieu of prosecution or have any other disqualifying civil or criminal history

Income verification is usually part of the Medicaid application process. To establish an applicant’s income, program workers often look back over a period of 60 months to see how much money you earned. In California, the look back period is 30 months. This assessment helps to determine whether you earn too much money to qualify for Medicaid benefits. It also helps to establish how much of a share-of-cost you should have before your Medicaid benefits kick in, if any.

Income Verification and the Look-Back Period

Recently unemployed people could have trouble with the Medicaid look-back period. It is entirely common for workers to earn well above the maximum allowable income for several years, only to lose their paycheck when the job ends. In this case, you could be in the unfortunate position of having a 5-year income history that puts you well outside of the eligible range of Medicaid applicants, while having no actual income at the moment. A situation like this may complicate your application to Medicaid, but it does not disqualify you.

Signing Up for Medicaid When You’re Unemployed

If you have recently found yourself unemployed, you could be eligible for Medicaid. Most states’ applications include a box you can check if you have lost your former income from work, which alerts the program workers that your past income figures might not be an accurate guide to your present eligibility. To be on the safe side, you should let your intake worker know about your employment status at the time you submit the application, or you can tell a worker about your situation during the initial telephone interview.

The intake worker you speak with may require some kind of verification that you are unemployed before approving the application. This may be done over the phone or by submitting a written statement from your former employer that indicates you no longer work for them.

Unlike an unemployment insurance claim, the specific reason your employment ended is not relevant to your application for Medicaid, and so you could potentially be approved for health coverage even if you have been denied unemployment compensation.

Other Help for the Unemployed

Medicaid is not the only resource you might be eligible for if you have lost a job. Apart from your state’s unemployment compensation program, you could benefit from a range of support services intended to help financially struggling people get by until another job opens up. Programs you might consider looking into include:

  • SNAP, also called food stamps
  • TANF, also called cash aid or welfare
  • WIC nutritional support for young children
  • County or state job placement assistance or retraining services
  • Emergency food or housing vouchers
  • Low-Income Housing Assistance, formerly called Section 8

Fortunately, many of these programs are administered by the same health and human services office that takes your Medicaid application. If you are recently out of work, speak with a worker in this office about the various programs you may qualify for. Often, approval for Medicaid or another low-income support program makes you automatically eligible for other programs with similar enrollment criteria.