How to Apply for Medicaid as a Senior
Medicaid can help cover health care costs for people who meet their state's eligibility requirements. For older adults, applying can feel confusing because Medicaid is a joint federal and state program, and the application process is handled through your state.
The basic process is straightforward: find your state's Medicaid agency, complete an application, provide the requested information, and wait for the state to determine whether you qualify.
Here's how to get started.
Step 1: Find Your State Medicaid Agency
Medicaid is administered by each state, so the application process depends on where you live.
The federal Medicaid.gov State Contacts page provides contact information for every state's Medicaid agency. Your state agency is the place to apply, ask questions about eligibility, check an application, and find out what documents or information you need.
You may be able to apply online, by telephone, by mail, or in person. The exact options vary by state.
If you search for your state's Medicaid application online, make sure you are using an official government website. Medicaid applications require personal and financial information, so an official state website is the safest place to begin.
Step 2: Gather Your Information
Having your information together before you begin can make the application much easier.
Your state may ask for information about your household, income, assets or resources, health insurance, and other circumstances that affect Medicaid eligibility. The exact requirements depend on your state and the type of Medicaid coverage for which you are applying.
You may need information such as your Social Security number, date of birth, address, income information, bank or financial information, and information about other health insurance.
If you receive Social Security, have a pension, work part-time, or receive another source of income, have those records available.
You may also need documentation to verify the information you provide. Your state will tell you what it needs and how to submit it.
Most of this information will be required up front in the application, however actual documentation can usually be sent at a later time if they are requested from you. Having them when you apply is the fastest, but sometimes not always possible.
Step 3: Complete the Application
Complete the application through your state's approved Medicaid application system.
Read each question carefully and answer it as accurately as you can. Medicaid agencies verify the information provided during the application process, so guessing or leaving important information out can create problems later.
If someone helps you complete the application, make sure you review the information before it is submitted.
You may also be able to apply by phone or in person if completing an online application is difficult. Medicaid.gov specifically directs applicants to their state Medicaid agency for application assistance.
Step 4: Submit Any Documents the State Requests
After you submit your application, the state may ask for additional information or documentation.
For example, you might receive a notice asking you to verify income, residency, financial information, or another part of your application.
Pay attention to deadlines listed in these notices. If the state asks for documentation and you are unsure what it wants, contact the Medicaid agency rather than ignoring the request.
Keep copies of the application, documents you submit, notices you receive, and confirmation that your application was submitted. Having your own records can make it much easier to resolve a question later.
Step 5: Wait for the Eligibility Decision
Your state Medicaid agency reviews the application and determines whether you qualify under the rules that apply to your circumstances.
Medicaid eligibility varies by state, and different eligibility categories can have different requirements. The state makes the actual eligibility determination.
Most applications take about 30 days to process, though some can take longer dependent on the case load. Once it is reviewed, you should receive a notice explaining the decision.
If you are approved, the notice should explain your coverage and what you need to do next.
If you are denied, the notice should explain the decision and provide information about your rights to challenge it if you believe the decision is incorrect.
If the application is still being processed and you have not heard anything, contact your state Medicaid agency to check its status. Medicaid.gov specifically directs applicants to their state agency for application status information.
What If You Already Have Medicare?
Having Medicare does not automatically prevent someone from applying for Medicaid.
Medicaid has its own eligibility rules, and someone who qualifies for both programs can have coverage through both. The programs then work together in ways that can affect health care costs and coverage.
That situation is called dual eligibility, and it deserves its own explanation because having both programs can be more complicated than simply having two insurance cards.
You can apply for Medicaid even if you are already receiving Medicare. Your state Medicaid agency will determine whether you qualify.
Where to Get Help
If the application feels overwhelming, start with your state Medicaid agency. It is the primary source for questions about eligibility, applications, required documentation, and application status. You can also use Medicaid.gov to find your state's contact information.
If you are helping a parent, spouse, or another older adult apply, it can be useful to sit with them while they complete the application, organize their paperwork, and keep track of notices and deadlines.
Final Thoughts
Applying for Medicaid starts with your state Medicaid agency. Find the official application, gather your information, complete the application, provide any requested documentation, and keep track of your notices and application status.
Medicaid does not have one nationwide application process. Your state determines the specific application procedures and eligibility requirements, so the official state agency should always be your primary source.
For someone who already has Medicare, the next question is often what happens when both programs are involved.
Up Next: Some older adults qualify for both Medicare and Medicaid. When that happens, the two programs can work together to cover different parts of their health care costs.
The next article explains what dual eligibility means, how Medicare and Medicaid work together, and what having both programs can mean for your coverage and out-of-pocket costs.
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