Medicaid Gross Income & Deductions Limits

Medicaid is a state-run program that helps people to afford their medical bills. There is more to determining eligibility for Medicaid than simply a person's income. Only people with certain circumstances and who meet particular limits for their modified adjusted gross income will qualify for the program. The Affordable Care Act proposes to make amendments to these requirements in 2014.


Gross Income

The limits for an applicant's gross income and assets are dependent upon the state in which he resides. Each state sets a level for the modified adjusted gross income of a person who wishes to qualify for Medicaid. Your modified adjusted gross income is your adjusted gross income, found on line 38 of Form 1040, plus additions for several tax deductions you previously subtracted to determine adjusted gross income. These deductions include: individual retirement account contributions, tuition and fees deduction, student loan interest deduction, foreign earned income that was excluded, adoption benefits deduction for the amount received from your employer and foreign housing deduction. Once you add these back to your adjusted gross income, you can determine whether you meet the modified adjusted gross income for your state. For many states, the modified adjusted gross income level begins at the federal poverty line.


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In some states the amount of assets you own may affect your eligibility for Medicaid coverage. Assets include any retirement or saving accounts, savings bonds, your home, inheritances and any other type of security or property that could be exchanged for cash. The guidelines for how your assets will affect your eligibility depend on the state in which you reside.


Individual Limits

Individual circumstances aid in determining whether or not you are eligible to receive Medicaid, as it is not solely based on income and assets. Other determinants include whether you are pregnant or have children under the age of 18 who reside at home with you. The children do not necessarily have to be your own. If you are their legal guardian, you may still qualify. If you are over the age of 65, blind, disabled or terminally ill, you may also qualify. If any of the above situations apply and you are either leaving welfare or have existing medical bills you cannot pay, you may be approved as well.


Proposed Changes by the Affordable Care Act

The Affordable Care Act proposes to make changes that affect the eligibility of certain individuals for receiving Medicaid coverage. If put into effect, all individuals from ages 19 to 65 whose income is at or below 133 percent of the federal poverty level for the pertinent year will be eligible to receive Medicaid. The Act will also create a more simplified income test and streamline the enrollment process for applicants while allowing an individual to remain enrolled for up to 12 months if no changes in circumstances occur during that time period. The states will still largely govern and run their Medicaid programs, with the baseline eligilibility requirements set by the federal government. These changes are currently set to take place in 2014.




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