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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.


Medicaid is a free public health insurance program. It is not welfare. Because of the nature of our site, while we describe the groups that qualify for Medicaid, out focus is on people who qualify because of a disabling health condition.

Medicaid is a program of both the Federal government and the states. Working under Federal guidelines, each state sets and administers its own program. For instance, each state decides who qualifies, what benefits are provided, and the rate of payments to health care providers for services. Because of the variety among the states, our discussion is general. However, we point you in the direction to learn the information you need in your state.

It is best to prepare for applying for Medicaid before actually applying. (For instance, there are some days and times better than others to apply for Medicaid.) If you are also applying for Supplemental Security Income (SSI), it is advisable to apply for SSI before applying for Medicaid.

  • Most states offer quick approval of Medicaid through a process known as Presumptive Medicaid. It allows virtually immediate access to Medicaid on the basis that your medical condition is so severe that you need the coverage now without having to complete all the paperwork - although the paperwork will still need to be completed.  If you believe your medical condition makes you disabled, and intend to apply for Presumptive Medicaid, tell the Worker at the interview. Bring with you a statement about your medical condition from your doctor. 

After the interview, a different Analyst will review your medical records to determine if you are "disabled" for purposes of Medicaid. There may be additional forms for you to fill out. If the Analyst requests a Consultative Exam, you have the right to request that your own doctor do it.

If your claim for Medicaid is denied, you have the right to appeal that decision.  

Following are a few notes to consider before we list the links to our practical Medicaid content:

  • If you have assets, you can give them away and qualify for Medicaid except for long term care which requires advance planning.
  • Medicaid coverage will last as long as you meet the criteria for eligibility. If, for example, you have income in a month that exceeds the maximum allowable for eligibility, then you are not eligible for Medicaid for that month. If you don't report the income immediately, Medicaid will make you ineligible when the income is discovered. Medicaid will also seek reimbursement for expenses paid during the month you were ineligible.  Medicaid conducts annual financial reviews to assure that you still meet the eligibility requirements. 
  • You can receive both Medicaid and Medicare
  • All Medicaid programs have Presumptive Medicaid which permits coverage to start at the time of applying for some, but not all, classes of applicants.
  • If you weren't working when you qualify for Medicaid, you can return to work and still keep Medicaid.
  • If you use Medicaid and have assets when you die (we're all going to die someday), Medicaid has a mandate to try to recover what it spent from your estate.  States vary about how aggressive each one is in seeking recovery.

To learn about Medicaid in your state (including contact information for the Medicaid office; eligiblity requirements; how to apply and description of benefits), see: See offsite link 

Before taking an action about Medicaid, check the facts in your state.

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When Is Medicaid Effective?

Medicaid is generally effective on the first day of the month in which you apply for it. However, if there are prior unpaid medical bills and you request it at the time of application, Medicaid is permitted to provide up to three months retrospective coverage provided you met the financial eligibility requirements during each of those three months.

If Medicaid accompanies Supplemental Security Income (SSI) benefits, then Medicaid is effective when the SSI is effective.

There is Presumptive Medicaid similar to Presumptive SSI in most states which will make Medicaid benefits available at the time you apply.

How Do I Maximize Use Of Medicaid?


Getting Medicaid is one thing. Keeping it, and maximizing use of it, is another. 

To maximize chances of keeping Medicaid, it is advisable to:

  • Know your worker, or case manager, or representative, or whatever the person's title is in your state.
    • You should have received, through the application process, the name and phone number of a contact at Medicaid to call with questions and changes. It is important that you know who this is. It doesn't hurt to periodically stay in touch with the person as well. See Make a Friend At The Insurance Company. The same advise applies to Medicaid.
  • Read your mail.
    • It is important to open and read all of the correspondence that Medicaid sends. The primary reason people lose their Medicaid coverage is that they ignore requests for information or fail to respond to correspondence sent to them.
    • Medicaid sends a lot of correspondence, including:
      • Questionnaires to be completed.
      • Advice about changes.
      • Once a year, Medicaid re-screens people for financial eligibility.
    • If you don't understand a particular letter or document, ask someone who does. Call your Medicaid Worker, or ask someone knowledgeable at your local disease specific nonprofit organization.
  • If you think Medicaid has stopped covering you, call immediately to find out why.  For some reason, in many states Medicaid has an ugly habit of just stopping. While it may seem like it stops for no reason, there usually is something that triggered your loss of eligibility. Whatever the reason, odds are that if this happens, Medicaid will notify you in a letter.
  • If you receive Medicaid because you qualify for Supplemental Security Income (SSI), even if you lose SSI you don't necessarily have to lose Medicaid particularly if the loss would be because of an increase in income from Social Security Disability Insurance (SSDI) due to inflation.

To maximize use of Medicaid:

To avoid penalties for fraud:

NOTE: It is worth checking to see if Medicaid in your state covers the cost of transportation to and from treatment.

More information about this subject is contained in the Main Article in "To Learn More."

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Medicaid As A Supplement to Medicare

Medicaid is an excellent supplement to Medicare coverage. It is considered good enough that insurance companies are prohibited from selling you a Medigap policy for your Medicare coverage if you have Medicaid.

Medicaid covers the deductibles and coinsurance payments of Medicare, plus it covers prescription drugs.

There are also several programs that will cover Medicare premiums and other charges that Medicare does not cover. 

Long Term Custodial Care (also known as "Institutional Care")

Medicaid is the nation's largest payer of costs for taking long term care of a person when constant medical attention like the kind you get in a hospital is not required. This kind of care is known in Medicaid-speak as "custodial care" (also known as "institutionalized care").  

Custodial care is the care needed to accomplish the basic activities of daily life. Care becomes Custodial Care when a person is likely to need such care for at least 30 days.

Custodial care can be given in different settings.

The key is the type of care, and length of time -- not the setting in which the care is given. Custodial care can be provided in a skilled nursing home, hospice, or an intermedicate care facility (ICF). Except in a very few states, an Assisted Living Facility, Board and Care home, a Retirement Home, Respite Care or an Adult Day Care Facility are not covered by Medicaid. 

  • To learn about care in an assisted living facility or at home, including eligibility rules and what is covered, see: Medicaid Aged & Disabled Medicaid Waiver Program
  • To find out if your state includes Medicaid Aged & Disabled Medicaid Waiver Program, or find the contact information for your state Medicaid office click here offsite link 

The requirements for qualification for Medicaid-funded custodial care are similar to those for basic Medicaid. Higher incomes are allowed because there are special rules for institutional coverage that make it more accessible to people with higher incomes.

There are also special rules for people who have a spouse who does not need custodial care and continues to live in the community. The spouse who does not need custodial care is referred to as the "community" spouse. If you have a spouse:

If you have assets that you want to protect, and you want to plan in case you need institutionalized long term care, there are steps that can be taken. Planning needs to be done with care. A mistake can be very costly.

Techniques which have been used to qualify for Medicaid and Long Term care are:

  • Transfer assets for a reason other than to be eligible for Medicaid. (You must be able to prove the existence of the reason).
  • Transfer assets. Medicaid has special transfer rules for long term custodial care. There may be penalties for transfers to qualify for custodial care.
  • Invest in your home up to the legal limit.
  • Transfer your home and keep a life estate.
  • Make a loan.
  • Make a payment to a Continuing Care Retirement Community.
  • Purchase items that Medicaid doesn't count.
  • Make an exempt transfer.
  • Set Up A Supplemental Needs Trust or another Trust.
  • Purchase an annuity.
  • Reduce equity in your home.
  • Get a divorce.

No one can predict what will happen if you take advantage of a planning alternative, spend the money you have left on care, and have no money left to pay bills during a penalty period during which you can't obtain Medicaid. States can set their own criteria that can help in this situation ("waiver"), but there is no certainty.

Before you take any steps to qualify for Medicaid long term care, it is advisable to consult with a professional familiar with the rules in your state, generally an attorney who specializes in "elder care." For help finding a lawyer who specializes in elder care, see: offsite link.

NOTE: If you have assets or income greater than qualify for Medicaid long term care, one way to get long term care without having to worry about a "look back" period is to call the service something else. For example, Medicaid may pay for the services of a home care aide if you pay for the custodial care.

Reimbursement From Your Estate

Medicaid has a federally imposed obligation to try to get reimbursed from your estate after you die for the amount Medicaid spends on you.

To make sure this right isn't meaningless, Medicaid is entitled to place a lien on your home while you are alive.  Medicaid doesn't take or sell your home while you, a spouse or a minor or adult disabled child, actually live in it.

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Additional Information About Applying For Or Living With Medicaid (Medi-cal in Califiornia)

For additional information, contact:

  • A health insurance assistance program can help provide information about eligiblity and applying for Medicaid. It can also help identify organizations that can provide assistance once you have Medicaid. To locate a health insurance assistance program, see: offsite link.
  • Legal experts, including lawyers who do not charge. If the person charges for his or her services, the more homework you do before meeting, the less expensive your legal feels are likely to be. 
  • Your state's Medicaid office.