Medicaid eligibility standards are expanding under the Affordable Care Act starting January 1, 2014:

Children

Current El​​igibility Eligibility in January 2014

Eligibility today is based on household size, income and Federal Poverty Limits (FPL). Children ages 0 up to 19 are eligible for the following Medicaid programs:

  • Apple Health for Kids no premium - households with income under 200% FPL
  • Apple Health for Kids premium coverage - households with income 200% - 300% FPL

Eligibility in 2014 will be determined with Modified Adjusted Gross Income (MAGI) rules using system data matches and client self attestation. Children ages 0 up to 19 are eligible for the following programs:

  • Medicaid with no premium - households with income under 200% FPL
  • Medicaid with premiums ($60 max per household) - households with income 200% - 300% FPL
  • Premium Tax Subsidy Credit - households with income 300% - 400% FPL

Pregnant Women

​Current Eligibility Eligibility in January 2014

Today pregnant women are eligible for Medicaid with no cost sharing if family income is under 185% FPL

In 2014 pregnant women will be eligible for:

  • Medicaid with no cost sharing - households with income under 185% FPL
  • Premium Tax Subsidy Credit - households with income 186% - 400% FPL

Adults

​Current Eligibility Eligibility in January 2014

Today the following adults are eligible for Medicaid with no cost sharing:

  • Adults with dependent children receiving family medical with income under 73% FPL
  • Adults with 90 day incapacity with income under 75% FPL (based on single household)
  • Basic Health waiver adults with income under 73% FPL

In 2014 adults will be eligible for:

  • Medicaid with no cost sharing - households with income under 138% FPL
  • Premium Tax Subsidy Credit - households with income 139% - 400% FPL

Classic Medicaid

In 2014 the following will remain eligible for classic Medicaid and will qualify based on current income and resource standards used today:

  • Foster Care Children
  • SSI cash recipients
  • Aged, blind and disabled individuals