Medicaid

What Makes Your Client Eligible

Your clients may be eligible to receive Medicaid benefits as members of "mandatory" or "optional" eligibility groups. All states must cover the mandatory groups, but states can choose whether or not to cover optional groups. Examples of both, include:

Mandatory

• Low-income families with children
• Low-income (“poverty-level") pregnant women and children
• Certain low-income Medicare beneficiaries

Optional

• Individuals who would be eligible for Supplemental Security Income (SSI) if they were not in medical institutions
• Individuals receiving only state supplemental payments

Medicaid varies from state to state. For information about the Medicaid plan in your state, visit www.cms.hhs.gov/medicaid/statemap.asp.

For more information about eligible Medicaid groups, visit http://cms.hhs.gov/medicaid/eligibility.

Medicare and Medicaid Dual-Eligibility Information