Friday, September 9, 2011

Kentucky Medicaid Eligibility Requirements

Kentucky Medicaid is a state and federally funded health-care plan.


Kentucky Medicaid provides free or low-cost health care to eligible low-income residents. Eligibility depends on your household size, income, assets, health and age. Medically needy or underinsured residents are encouraged to apply for Medicaid benefits at the Kentucky Department for Community Based Services or by calling 1-800-635-2570 for more information.


General Eligibility


Medicaid recipients must be U.S. citizens or qualified aliens residing in Kentucky. Benefits are offered to adults with children under age 19, pregnant women, children, adults age 65 or older and disabled individuals. You must have a Social Security number or apply for one. Unqualified or illegal aliens may be eligible for emergency Medicaid services if they meet income requirements


Adults


As of 2010, parents or caregivers of qualified children may qualify for benefits if their gross monthly income does not exceed $308 for a family of three. Adults enrolled in the Aid to Families with Dependent Children (AFDC) or Kentucky Transitional Assistance Program (KTAP) may qualify if their income does not exceed $974 monthly for a family of three. Pregnant women qualify for assistance if their gross monthly income is at or below 185 percent of the Federal Poverty Level (FPL). While most adult applicants may have assets or resources valued at $4,000 for a family of two, pregnant women are exempt from resource limits.


Children


A child up to age one is covered for the first year under the mother's Medicaid if they qualified during the pregnancy. The Medicaid income limits for children under age 19 are 150 to 200 percent of the FPL, depending on the coverage. As of 2010, the maximum gross monthly income for a qualifying child in a family of three is $3,052.


Elderly and Disabled


Medicaid may be used in conjunction with Medicare, and Supplemental Security Income (SSI) recipients are categorically eligible for Medicaid. Medicare recipients may receive assistance with Medicare co-pays, deductibles and premiums if their income is 100 to 135 percent of the FPL. Working disabled individuals may be eligible for benefits under the Medicaid Works program if their income does not exceed 250 percent of the FPL, with assets valued at $5,000 or less.


Considerations


Family income calculations vary depending on the household. If you are pregnant or a parent under age 21 living at home, your parent's income is included in the calculation. Unborn children are considered a family member, adding to the household size. Not all income is used to determine eligibility as deductions and exemptions to earnings are subtracted from your gross income before income limit tests apply. Additionally, qualifying Medicaid recipients may "spend down" to meet income requirements if their medical costs are high.







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