What is Medicaid Expansion?
Some states have expanded Medicaid to help more people with low incomes get health coverage. This means that if your income is below a certain level, you might qualify for Medicaid.
Who Can Get Medicaid?
In every state, you might qualify for Medicaid based on:
- How much money you make
- Your family size
- If you have a disability
- Other factors
Each state has different rules, so you need to check what’s available where you live.
If Your State Expanded Medicaid:
If you live in a state that expanded Medicaid, you can get coverage if your income is below 138% of the federal poverty level (FPL). This is a specific number that changes every year.
What to Do Next:
- Check if You Qualify: Find out if your state has expanded Medicaid and if your income qualifies you.
- Understand Your Options: If your state hasn’t expanded Medicaid and your income is low, you might not qualify for Medicaid or savings on a private health plan.
Important Points:
- If your income is at or below 150% of the FPL, you might be able to enroll in or change your Marketplace coverage during a special period. Check if you can get health coverage.
- Apply for Medicaid even if your state hasn’t expanded it. You might still have coverage options, especially if you have children, are pregnant, or have a disability. Giving more detailed income info might show that you qualify for savings.
If You Don’t Qualify for Medicaid or Marketplace Savings:
- Community Health Centers: These centers provide low-cost care based on your income. They can help you get the care you need.
- Catastrophic Health Plans: If you’re under 30, you can get a “Catastrophic” health plan. If you’re 30 or older, you need to claim an exemption to qualify.
- Marketplace Plans: If your income goes up to between 100% and 400% FPL, you can get a Marketplace plan with tax credits to help pay for it. You might still get savings even if your income is higher.
If your income changes and you need to enroll in a Marketplace plan, contact the Marketplace Call Center within 60 days. You’ll need to confirm that:
- You weren’t eligible for Medicaid because your state didn’t expand it.
- You weren’t eligible for a Marketplace plan with tax credits because your income was too low.
- Your income has gone up, making you eligible for a Marketplace plan with tax credits.
Know your benefits and contact your healthcare provider to learn more about your coverage options. This ensures you’re getting the care you need.
