Can I Apply for Medicaid If We Already Have Private Health Insurance?

Written by James Hirby and Fact Checked by The Law Dictionary Staff  

Administered by the federal government, Medicaid is designed to make healthcare affordable for millions of Americans with low to moderate incomes. The program has been around since the "Great Society" reforms of the mid-1960s and grows in popularity with each passing year. It's important not to confuse Medicaid with Medicare: Whereas eligibility for the former program is income-dependent, cutoff requirements for the latter program are more complicated. Most Medicare recipients are senior citizens who regularly take dozens of prescription drugs and can't afford regular private health insurance.

If you're interested in applying for Medicaid to help defray some of the costs of your medical care, you'll need to keep several things in mind. First, Medicaid isn't a one-size-fits-all program. It's actually comprised of several different individual health insurance programs designed to help certain classes of individuals obtain health coverage. For instance, one of the most popular Medicaid programs is the Children's Health Insurance Program. Known as "CHIP," this program accepts applications from the families of individuals under the age of 18. If you're 18 years of age or older and lack children under that age, you won't qualify for this particular program.

All Medicaid programs are income-sensitive. In most jurisdictions, the program's eligibility cutoff is set at 200 percent of the federal poverty level. To determine whether your family is eligible for Medicaid, you'll need to add together the annual earnings from each member of your household to determine your total annual household income figure. Even earnings from teenage children who work part-time jobs should be included in this calculation.

Finally, it's important to remember that Medicaid is administered at the state level. Although all state Medicaid administrators receive federal funding and must adhere to certain guidelines set by the federal government, the exact terms of each Medicaid program will vary by jurisdiction. To ensure that you meet all of your state's eligibility guidelines, check with your local Medicaid administrator.

You'll be happy to learn that you don't have to cancel your private insurance coverage in order to qualify for Medicaid. However, you must demonstrate a need for additional medical coverage or an inability to afford your monthly insurance premiums. If you already qualify for health insurance coverage under the terms of an employer-sponsored plan, you can apply for Medicaid and receive monthly premium support. In many cases, the coverage that you'll receive through your employer's plan will be quite robust. If you're laid off, Medicaid may even pay your COBRA premiums.

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