Ultimate Guide to Medicaid Benefits in the USA

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Medicaid Coverage

What is Medicaid?

Medicaid is a federal health insurance program available to low-income families and other mandatory coverage groups. It offers millions of Americans health care. The federal government and the states each provide funding to the program.

How many types of Medicaid are there in the USA?

Medicaid coverage comes in two different general categories. People with limited or no health insurance are helped by “Community Medicaid.

Those who qualify for Medicaid nursing home coverage receive assistance with the cost of living in a nursing home; the recipient also contributes most of their income toward nursing home costs, typically keeping only $66 per month for expenses other than the nursing home.

What are the Medicaid plans in the USA?

A Medicaid plan is an agreement between a state and the Federal government describing how that state administers its Medicaid programs.

It ensures that a state will follow federal regulations and be eligible to receive federal matching money for its program operations. 

The state plan outlines the categories of people covered, the services offered, the procedures for paying providers, and the state’s administrative endeavors.

For more information regarding Medicaid plans, visit here.

Medicaid vs. Medicare – Can I have both?

You can have both if you are eligible for both Medicare and Medicaid (dually eligible).

Does Medicaid Pay for Assisted Living?

Medicaid pays a portion of assisted living expenses. Medicaid may cover the following services: Nursing homes, residential care facilities, and assisted living communities offer long-term care.

Medicaid Waivers

A Medicaid waiver is a legal clause that enables the federal government to disregard regulations that ordinarily apply to the Medicaid program. 

The idea is to provide local states the freedom to achieve objectives like cutting costs, boosting coverage, or enhancing treatment for specific target populations like the elderly or pregnant women.

Medicaid Eligibility

Who is eligible for Medicaid?

Persons of age 65 or above are eligible for Medicaid. Anyone aged 58-60 with a disability is also eligible.

Medicaid provides health coverage for some low-income people, families, children, pregnant women, the elderly, and people with disabilities. The program in various states covers all low-income adults below a particular income threshold.

Medicaid Application

How can you apply for Medicaid?

To apply for Medicaid, you must fill out an application through the official government site: Health Insurance Marketplace.

How long does it take to get approved for Medicaid?

Usually, it takes the Medicaid agency 45 days to process your application. The agency may demand 90 days if the application requires a disability determination.

How do I appeal if my Medicaid application is denied?

You can write a simple appeal request, submit your application in person at your local state Medicaid agency office, and have it stamped to show that it was received by the deadline.

Medicaid Usage

How to Find Out If My Medicaid Is Active?

Contact the office where you applied. If you don’t have the contact information for your state readily available, you can find that information here.

Overview of Medicaid in 50 States

StateIn-depth ArticleMedicaid PlansWaiversIndividual Income Limit (Yearly)
Kentucky MedicaidHow to Get Kentucky Medicaid Benefits-Coventry Cares of Kentucky
-Anthem Health Plan
-Wellcare of Kentucky
-ABI Acute and ABI Long-Term Care Waivers
-Home and Community Based (HCB) Waiver
-Model II Waiver (MIIW)
-Michelle P. Waiver (MPW)
-Supports for Community Living (SCL) Waiver
-Kentucky Transitions
$17,131
Alabama MedicaidHow to Get Alabama Medicaid Benefits-Medicaid for Children
-Medicaid for Parents and Caretaker Relatives
-Medicaid for Pregnant Women
-Medicaid for the Elderly and Disabled
-Medicaid in the Nursing Home
-Breast and Cervical Cancer Program
-Plan First Family Planning Program
-Elderly and Disabled (E&D) Waiver Program
-State of Alabama Independent -Living Waiver (SAIL) Program
-Home and Community-Based Waiver for Persons with Intellectual Disabilities (ID) program
-Technology Assisted (TA) Waiver for Adults Program
-Living at Home (LAH) Waiver for Persons with Intellectual Disabilities
-Alabama Community Transition (ACT) Waiver
$17,131
Alaska MedicaidHow to Get Alaska Medicaid Benefits-Alaska Medicaid State Plan
-MAGI (Modified Adjusted Gross Income) Medicaid
-TEFRA for children with disabilities at home
-ALI Waiver
-APDD Waiver
-The Child with Complex Medical -Conditions (CCMC) waiver
-Individualized Supports Waiver (ISW)
-Intellectual and Developmental Disabilities,(IDD)
$22,597
Arizona MedicaidHow to Get Arizona Medicaid Benefits-Bridgeway Health Solutions Centene Corporation
-Care 1st Health Plan
-Health Choice
-Health Net of Arizona
-Evercare/United Health Care Community Plan
-Maricopa Health Plan
-Mercy Care Plan
-Phoenix Health Plan
-University Family Care
-1115 Demonstration Project waiver$18,075
Arkansas MedicaidHow to Get Arkansas Medicaid Benefits-ARHOME
-ARKids First
-TEFRA
-ACS Waiver$17,131
California MedicaidHow to Get California Medicaid Benefits-County Organized Health Systems (COHS)
-Two-Plan Model
-Geographic Managed Care Model
-Regional
-Imperial
-San Benito
-Medi-Cal waivers
-Certain waivers
-Freedom of Choice Waivers
$17,609
Colorado MedicaidHow to Get Colorado Medicaid Benefits-Denver Health Medicaid Choice
-Rocky Mountain HMO
-Home and Community Based Services (HCBS) Waivers$18,075
Connecticut MedicaidHow to Get Connecticut Medicaid Benefits-Health Care for Uninsured Kids and Youth (HUSKY)
-HUSKY A
-HUSKY B
-HUSKY C
-HUSKY D
-Connecticut Home Care Program for Elders
-Katie Beckett Waiver
-Personal Care Attendant (PCA) Waiver
-Acquired Brain Injury (ABI) Waivers
-Individual and Family Supports Waiver
$18,075
Delaware MedicaidHow to Get Delaware Medicaid Benefits-United HealthCare Community Plan
-Delaware Physicians Care
-Diamond State Health Plan – Delaware’s Medicaid Managed Care Program
-Delaware Diamond State Health Plan (DSHP) 1115 Demonstration Waiver
-Delaware Diamond State Health Plan (DSHP) 1115 Demonstration Waiver Amendment
$18,075
Florida MedicaidHow to Get Florida Medicaid Benefits-American Elder Care
-Amerigroup
-Coventry
-Humana
-Molina
-Sunshine
-United
-Home and Community-Based Services (HCBS) Waivers$18,075
Georgia MedicaidHow to Get Georgia Medicaid Benefits-WellCare
-Peach State Health Plan
-Amerigroup Community Care
-NOW Waiver Program
-COMP Waiver Program
$33,568
Hawaii MedicaidHow to Get Hawaii Medicaid Benefits-Kaiser Permanente Hawaii
-Evercare
-Ohana Health Plan
-AlohaCare
-Hawaii Medical Services Association
-Medicaid I/DD Waiver$20,787
Idaho MedicaidHow to Get Idaho Medicaid Benefits-Blue Cross of Idaho
-Access2Care
-OptumHealth
-A&D Waiver$18,075
Illinois MedicaidHow to Get Illinois Medicaid Benefits-Family Health Network
-Harmony Health Plan
-Cook County IlliniCare Health Plan
-Blue Cross Blue Shield of Illinois
-Cigna HealthSpring of Illinois
-Community Care Alliance of Illinois(CCAI)
-Humana Health Plan
-Meridian
-Aetna Better Health
-MLTSS waiver$18,755
Indiana MedicaidHow to Get Indiana Medicaid Benefits-Anthem
-Managed Health Services
-MDwise
-Aged and Disabled Waiver$16,971
Iowa MedicaidHow to Get Iowa Medicaid Benefits-Blind allowance
-Dependent person allowance
-Family life home assistance
-In-home health-related care assistance
-Residential care facility assistance
-Supplement for Medicare and Medicaid eligibles
-Health and Disability (HD) Waiver
-AIDS/HIV (AH) Waiver
-Elderly (E) Waiver
-Intellectual Disability (ID) Waiver
-Brain Injury (BI) Waiver
-Physical Disability (PD) Waiver
-Children’s Mental Health (CMH) Waiver
$18,075
Kansas MedicaidHow to Get Kansas Medicaid Benefits-Aetna Better Health
-Sunflower State Health Plan
-UnitedHealthcare Community Plan
-KS Autism Waiver (0476.R02.00)
-KS HCBS Brain Injury (4164.R06.00)
-KS HCBS Intellectual Disabilities and Developmental Disabilities (I/DD) Waiver (0224.R06.00)
-KS Home and Community Based -Services for the Frail Elderly (0303.R05.00)
-KS Physical Disability Waiver (0304.R05.00)
-KS Serious Emotional Disturbance (SED) Waiver (0320.R04.00)
-KS Technology Assisted Waiver (4165.R06.00)
$32,752
Louisiana MedicaidHow to Get Louisiana Medicaid Benefits-Aetna Better Health
-Amerihealth Caritas Louisiana
-Healthy Blue
-Louisiana Healthcare Connections
-UnitedHealthcare Community
-Children’s Choice
-New Opportunities Waiver
$18,075
Maine MedicaidHow to Get Maine Medicaid Benefits-Patient Centered Medical Home (PCMH)
-State Medicaid Home Program
-MaineCare Elderly & Adults with Disabilities Medicaid Waiver$18,075
Maryland MedicaidHow to Get Maryland Medicaid Benefits-MCO Program
-HealthChoice MCOs
-United Healthcare Community Plan
-AmeriGroup Community Care
-Diamond Plan
-Medicaid Home and Community-Based Waiver Programs$18,075
Massachusetts MedicaidHow to Get Massachusetts Medicaid Benefits-Patient-Centered Medical Home for MassHealth MCO & PCCM choices
-Medicaid Share Saving Pilots
-Pioneer ACO models
-MA Acquired Brain Injury Non-Residential Habilitation (ABI-N)
-MA Acquired Brain Injury w/Residential Habilitation (ABI-RH)
-MA Adult Supports
-MA Children’s Autism Spectrum Disorder
-MA Community Living Waiver
$18,075
Michigan MedicaidHow to Get Michigan Medicaid Benefits-Psychological disorders
-Healthy Kids’ Dentistry Waiver
-Omega Dental of Michigan
-MI Children’s Waiver Program
-MI Choice
-MI Habilitation Supports Waiver
-MI Health Link HCBS
-MI Waiver for Children with Serious Emotional Disturbances
$18,075
Minnesota MedicaidHow to Get Minnesota Medicaid Benefits-Itasca Medical Care
-Metropolitan Health Plan
-South Country Health Alliance
-Home and Community Based Service Waivers$18,075
Mississippi MedicaidHow to Get Mississippi Medicaid Benefits-Magnolia Health
-United HealthCare
-Molina Healthcare
-MS Assisted Living (0355.R04.00)
-MS Elderly and Disabled (E&D) (0272.R06.00)
-MS Independent Living Waiver (MS.0255.R06.00)
-MS Intellectual Disabilities/Developmental Disabilities (ID/DD) (0282.R05.00)
-MS PRTF Application (01.R02.00)
-MS Traumatic Brain Injury/Spinal -Cord Injury (0366.R04.00)
$18,075
Missouri MedicaidHow to Get Missouri Medicaid Benefits-Home State Health
-Healthy Blue
-UnitedHealthcare
-Show Me Healthy Kids
-Adult Day Care Waiver
-Aged and Disabled Waiver
-AIDS Waiver
-Brain Injury Waiver
-Independent Living Waiver
-Medically Fragile Adult Waiver
-Structured Family Caregiving Waiver
-MO Children with Developmental -Disabilities (MOCDD) Waiver
-Comprehensive Waiver
-Community Support Waiver
-Partnership for Hope Waiver
$18,075
Montana MedicaidHow to Get Montana Medicaid Benefits-Montana Living Life Well Program
-HMK (Healthy Montana Kids)
-Montana HELP Plan
-Montana Medicaid Passport to Health
-Children’s Autism Waiver
-HCBW for Individuals with DD
-Community Supports
-Big Sky Bonanza
-HCB Waiver for Adults with Severe Disabling Mental Illness
-Elderly and Physically Disabled Waiver
$13,590
Nebraska MedicaidHow to Get Nebraska Medicaid Benefits-Specialty Physician Case Management
-Prepaid Inpatient Health Plan
-Nebraska Health Connection
-Arbor Health
-UnitedHealthcare Community Plan
-CoventryCares
-NE Comprehensive Developmental Disabilities Services Waiver
-NE Developmental Disabilities Day Services Waiver for Adults
-NE HCBS Waiver for Aged & Adults & Children with Disabilities
-NE Traumatic Brain Injury Waiver
-WAIVER TERMINATED – NE Autism Waiver
$18,075
Nevada MedicaidHow to Get Nevada Medicaid Benefits-Nevada Mandatory Health Maintenance Program
-Non-emergency transportation program
-The Nevada Comprehensive Care Waiver (NCCW)
-HCBW for people with physical disabilities
-Assisted living
Frail elderly
$18,075
New Hampshire MedicaidHow to Get New Hampshire Medicaid Benefits-Medicaid Care Management program
-Alternative Benefit Plan (ABP)
-Recent Programs
-DLTSS Acquired Brain Disorder (ABD) Waiver
-DLTSS Developmental Disabilities (DD) Waiver
-DLTSS In Home Support (IHS) Waiver for Children with Developmental Disabilities
$18,075
New Jersey MedicaidHow to Get New Jersey Medicaid Benefits-PACE program
-Delivery System and Reform Incentive Payment (DSRIP)
-The NJ Family Care program
-Home and community-based services waiver for the developmentally disabled
-Traumatic brain injury (TBI) waiver
$18,075
New Mexico MedicaidHow to Get New Mexico Medicaid Benefits-Coordinated Long Term Supports and Services (CoLTS)
-Salud! Behavioral Health
-State Coverage Initiative (SCI)
-Coordinated Long Term Services
-Mi Via-ICF/M.R
-Mi Via NF
-Developmental Disabilities Waiver
-Medically Fragile
-Centennial Care Waiver
$18,075
New York MedicaidHow to Get New York Medicaid Benefits-Medicaid Managed Care
-Managed Long Term Care (MLTC) Programs
-Medicaid Advantage and Medicaid Advantage
-NY CAH III
-NY CAH VI
-NY Children’s Waiver
-NY Long Term Home Health Care Program
-NY OPWDD Comprehensive Waiver
$18,075
North Carolina MedicaidHow to Get North Carolina Medicaid Benefits-Carolina ACCESS (CA)
-Community Care of North Carolina (CCNC)
-Waiver for Mental Health (MH), Developmental Disability (DD), and Substance Abuse (SA) Services
-Program for All-Inclusive Care for the Elderly (PACE)
-Comprehensive Waiver
-Supports Waiver
-CAP Choice – IP
-CAP / DA
-Community Alternatives Program -(CAP) for Children
-Innovations Waiver
$18,075
North Dakota MedicaidHow to Get North Dakota Medicaid Benefits-Primary Care Case Management (PCCM) Program
-ExperienceHealthND program
-Medicaid Expansion MCO
-Medicaid Waiver HCBS;
-Children’s Hospice;
-Autism Spectrum Disorder Birth through Four;
-Self-Directed Supports (ended 03/31/2011);
-Traditional MR DD HCBS;
-Technology Dependent Medicaid Waiver;
-Medicaid Waiver for Fragile Children
$18,075
Ohio MedicaidHow to Get Ohio Medicaid Benefits-Medicaid Managed Care Program
-Program for the AllInclusive Care for the Elderly (PACE)
-OH Assisted Living
-OH Home Care Waiver
-OH Individual Options
-OH Integrated Care Delivery System (ICDS) Waiver
-OH Level One Waiver
-OH Ohio RISE Waiver
-OH Self Empowered Life Funding (SELF)
$18,075
Oklahoma MedicaidHow to Get Oklahoma Medicaid Benefits-Sooner Care
-Program of All-inclusive Care for the Elderly (PACE)
-SoonerRide
-Advantage Waiver
-Community
-Homebound
-In-Home Supports Waiver for Children
-In-Home Supports Waiver for Adults
-Medically Fragile
-Sooner Services
-Seniors and People with Disabilities
$18,075
Oregon MedicaidHow to Get Oregon Medicaid Benefits-Physician Care Organization Program
-Oregon Health Program Plus
-Coordinated Care Organizations
-Medically Involved Children’s Waiver
-ICF / MR Comprehensive Residential
-Medically Fragile (Hospital) Model
-Behavioral (ICF/MR) Model
-ICF/MR Support Services
$18,075
Pennsylvania MedicaidHow to Get Pennsylvania Medicaid Benefits-Voluntary Managed Care Program
-Pennsylvania HealthChoices
-ACCESS Plus Program
-Adult Autism Waiver (AAW)
-Aging Waiver
-Alternatives To Nursing Homes
-Attendant Care Waiver
-Community Living Waiver
-Consolidated Waiver
-Independence Waiver
-Infant, Toddlers, and Families Waiver
-OBRA Waiver
-Person/Family Directed Support Waiver
$18,075
Rhode Island MedicaidHow to Get Rhode Island Medicaid Benefits-RIte Care program
-Connect Care Choice
-Rhody Health Partners and RIte Smiles
-One state plan
-One 1115 Waiver, Rlte Care
-Nine 1915(c) Waivers
-One 1915(b) waiver, Rite Smiles
$18,075
South Carolina MedicaidHow to Get South Carolina Medicaid Benefits-Managed care organizations (MCOs)
-Medical Homes Network (MHN)
-Medically Complex Children;
-Community Supports;
-Mechanical Ventilator Dependent;
-Head and Spinal Cord Injury;
-Pervasive Developmental Disorder;
-MR and Related Disabilities;
-HIV/AIDS;
-Community Choices
$13,590
South Dakota MedicaidHow to Get South Dakota Medicaid Benefits-Health Maintenance Organization (HMO)
-Point of Service (HMO-POS)
-Preferred Provider Organization (PPO)
-CHOICES Waiver
-Family Support 360
-Assistive Daily Living Services (ADLS)
-HOPE Waiver
$18,075
Tennessee MedicaidHow to Get Tennessee Medicaid Benefits-TennCare Program
-TennCare CHOICES program
-Program of AllInclusive Care for the Elderly
-The Statewide Waiver
-The Arlington Waiver
-The Self-Determination Waiver
-TennCare CHOICES
$18,075
Texas MedicaidHow to Get Texas Medicaid Benefits-STAR
-STAR+PLUS
-Star Health
-Non-Emergency Medical Transportation (NEMT)
-CLASS Waiver
-DBMD Waiver
-HCS Waiver
-MDCP Waiver
-HCBS Waiver
-TxHmL Waiver
-YES Waiver
$26,909
Utah MedicaidHow to Get Utah Medicaid Benefits-Choice of Health Care Delivery
-Non-Emergency Transportation
-Healthy Outcomes for Medical Excellence
-Medicaid Autism Waiver
-Acquired Brain Injury
-New Choices Waiver
-Medically Complex Children’s Waiver
-Physical Disabilities Waiver
-Aging Waiver
$18,075
Vermont MedicaidHow to Get Vermont Medicaid Benefits-Global Commitment to Health (GCH) Demonstration program
-Choices for Care program
-Global Commitment to Health
-Choices For Care
$18,075
Virginia MedicaidHow to Get Virginia Medicaid Benefits-MEDALLION primary care case management (PCCM)
-Options program
MEDALLION II
-VA Building Independence Waiver
-VA Children’s Mental Health Waiver PRTF
-VA Commonwealth Coordinated Care Plus
-VA Family and Individual Support Waiver
-VA HIV/AIDS
$18,075
Washington MedicaidHow to Get Washington Medicaid Benefits-Apple Health
-Regional Support Networks
-Program of All-Inclusive Care for the Elderly
-Washington Mental Health Services
-Community Protection Waiver
-Core Waiver
-Basic Waiver
-Basic Plus Waiver
-MNRW
-New Freedom
-COPES
-Medically Needy In-Home
-Washington Take Charge
$27,180
West Virginia MedicaidHow to Get West Virginia Medicaid Benefits-Mountain Health Trust (MHT)
-Physician Assured Access System
-Mountain Health Choices
-Aged and Disabled Waiver
-Intellectual/Developmental Disabilities Waiver
-Children with Serious Emotional Disturbance Waiver
-Substance Use Disorder (SUD) Waiver
-Traumatic Brain Injury Waiver
$17,667
Wisconsin MedicaidHow to Get Wisconsin Medicaid Benefits-BadgerCare Plus
-Medicaid SSI Managed Care Program
-Family Care
-Children’s Physical Disability Waiver
-Children’s Developmental Disability Waiver
-Children’s Mental Health Waiver
-Community Integration Program – DD
-Family Care – Aged / Physical Disability
-Community Options Program
-Brain Injury
-Family Care MR / DD
$40,770
Wyoming MedicaidHow to Get Wyoming Medicaid Benefits-Medicaid State Plan -Amendments (SPAS)
-CHIP State Plan Amendments
-Demonstrations & Waivers
-LTC / HCBS Waiver
-Assisted Living Facility HCBS
-Adult Developmental Disabilities
-Acquired Brain Injury
-Children’s Mental Health
-Children with DD
-Community Choices Waiver
$18,075


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Editor
Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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