Medicare

My mom is an 83-year-old widow with an income of about $12,000 and almost no savings. She is covered by Medicare. Does she qualify for the Medicaid expansion under the ACA?

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No.  The Medicaid expansion provided under the Affordable Care Act is for adults who are under the age of 65 with incomes up to 138% of poverty (about $17,236 for an individual in 2020).  The law explicitly excludes people ages 65 and older from this Medicaid eligibility category.  So even if your mom’s income is low enough to qualify for Medicaid under these rules, she is not eligible for it because she is over age 65.

However, your mom might qualify for Medicaid under the current eligibility rules if her income and assets are low enough.  Under the current rules, Medicaid helps many low income people on Medicare with their Medicare premiums and cost-sharing requirements, and may also cover some benefits that are not covered by Medicare, such as dental services and long-term services and supports.  Also, your mom might qualify for extra financial assistance to help with the cost of Medicare Part D prescription drug coverage.  To find out if she qualifies for these programs, you can contact the State Health Insurance Assistance Program in your state, the State Medical Assistance Office (for Medicaid), or the Social Security Administration (for Part D extra help).  Medicare provides links and phone numbers for these and other organizations at the following website: http://www.medicare.gov/contacts/.

 

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While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.