The Social Security Administration (SSA) oversees and manages several federal programs that pay allotments to beneficiaries and qualifying dependents. Whether your income from the SSA will be included or excluded for Medicaid eligibility will depend upon which federal program you are enrolled in.
TYPES OF SOCIAL SECURITY INCOME INCLUDED IN MEDICAID ELIGIBILITY
Retirement Social Security: This is the annual income you receive based on the work credits accumulated over the number of years you worked, the amount of income you earned, and the age at which you retire.
Survivor and Dependent Social Security: This is the annual income that your spouse and eligible children receive in the event of your death or disability. This income is based on your social security contributions and is issued for a defined period of time established by the federal government.
Social Security Disability Insurance: This is the annual income you receive if you become disabled and have accumulated the qualifying number of social security earned work credits. If you are retired, it is possible to receive retirement social security and social security disability insurance. The total of both types of social security income will be counted for Medicaid eligibility.
TYPE OF SOCIAL SECURITY INCOME EXCLUDED IN MEDICAID ELIGIBILITY
Supplemental Security Income: This is the amount provided to low-income households that have disabled children or disabled adults who have not accumulated the number of social security work credits to receive social security disability insurance.
MEDICAID INCOME QUALIFICATIONS BY STATE
Medicaid is a program that is jointly shared between the federal and state governments. The purpose of Medicaid is to help qualifying households with limited income and assets get assistance to pay for health care costs. Depending on your state’s Medicaid guidelines, it is possible to be on Medicare and also be eligible for Medicaid assistance. As of 2019, the Medicaid program is the largest single health coverage source in the United States of America.
While the federal government defines which social security income is included or excluded for Medicaid eligibility, each state and the District of Columbia determines the income limits for individuals and families enrolling in Medicaid. The passage of the Affordable Care Act of 2010 provided the states with the opportunity to establish state-level income qualifying limits. This meant that states could expand their Medicaid services to include low-income Americans under the age of 65.
To date, 29 states and the District of Columbia have taken advantage of this expansion. The remaining 21 states have not expanded their Medicaid programs. To find out if you live in an expanded Medicaid state, please check the list of current states with enacted expansions.
State income requirements for Medicaid enrollment are calculated using a format based on a measurement of earnings to determine the federal poverty level (FPL). States with expanded Medicaid programs have set individual and family income maximums at 138 percent of the current FPL.
States without expanded Medicaid programs have maintained income maximums for individuals and families at 106 percent of the FPL established before the Affordable Care Act of 2010 was enacted. This means that the initial FPL for an individual remains at $11,670 and for a family of four at $23,850.
The Medicaid services guidelines in each state are continuously improving to make eligibility enrollment systems more user-friendly. To see how Medicaid operates in coordination with the Health Insurance Marketplace policies in your state, visit the Directory of Medicaid State Overview Profiles and click on your state.