- Personal Finance. What is the 2025 federal poverty level for Medicaid benefits? Breakdown and guidelines
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When people hear about Medicaid, they often assume it's a healthcare program just for the elderly.
While it's true that many older Americans rely on Medicaid, especially for services like nursing home care, it actually serves a much broader population.
Medicaid eligibility policies
Medicaid is a state-run, federally ed program that helps cover medical expenses for people of all ages who meet certain income and eligibility requirements.
The program was designed to provide low- or no-cost healthcare to individuals and families with limited income and resources.
Though all states must follow general federal rules, each one operates its own Medicaid system.
That means eligibility rules and available benefits can vary significantly depending on where you live.
Some states have even expanded their programs to offer coverage to more low-income adults, regardless of age or family status.
So, is Medicaid for old people or young? The answer is: both.
Medicaid serves a wide range of people, including infants, children, pregnant women, parents, disabled individuals, and seniors.
Eligibility depends on several factors-primarily income, household size, disability status, and whether your state has expanded Medicaid under the Affordable Care Act.
In states that did expand, anyone earning below 138% of the federal poverty level may qualify based on income alone.
Children make up a significant portion of Medicaid enrollees.
States are required to provide coverage for low-income children under 19, including those in foster care or adoption assistance programs.
Pregnant women and new mothers with limited income are also often eligible.
For adults, Medicaid helps those who are disabled, blind, or meet specific financial criteria.
Seniors may qualify if they have limited assets or need long-term care services not typically covered by Medicare.
If you live in a state that hasn't expanded Medicaid and your income is below the federal poverty level, you might fall into a gap where you're ineligible for both Medicaid and Marketplace subsidies.
Still, applying is encouraged, as certain circumstances. such as pregnancy, disability, or having children, could open up options.
Additionally, low-cost community health centers and "Catastrophic" plans may offer alternative care options for those who don't meet standard Medicaid guidelines.