MEDICAID

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 Medicaid is a program that provides health coverage to some low-income Delaware residents. Medicaid covers low-income infants and children, families with children, pregnant women, elderly, and people with disabilities. Legal residents who are not U.S. citizens may be eligible for Medicaid after they have resided in the US for five years.  Non-citizens who do not have immigration documents may receive Emergency Services and Labor and Delivery services only.

  • Eligibility for Medicaid is based on the amount of your household income.

In Delaware you may be eligible for Medicaid if you are an individual, a child, a parent of a child, or pregnant, and your family income meets the Medicaid income standards. 

Income eligibility levels for these categories are described below. You should contact the Division of Social Services for more information.

Low income persons eligible for Medicaid in Delaware*

Category                  Income eligibility (as percent of federal poverty level)
Child up to 19             200% (monthly income of about $2,767 for a family of 3)
Children (1-5)             133%
Children (6-19)           100%
Working Parent           107%
Non-working Parent     100%
Pregnant woman         200%
* Eligibility information was compiled from State Health Facts Online, the Kaiser Family Foundation, and may have changed since this guide was published.  Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

To get an idea of how your income compares to the federal poverty level, use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2006:

Size of Family Unit                       Poverty Guideline (annual income)
               1                                             $  9,800
               2                                             $13,200
               3                                             $16,600

-For larger families add $3,400 for each additional person
-So, for example, using this guideline, 200% of the federal poverty level for a family of 3 would be an annual income of $34,200, or a monthly income of $2,767.
-Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

  • Families and children under age 18 participating in Delaware’s cash assistance program are automatically covered.
  • Parents who receive benefits under Temporary Assistance for Needy Families (TANF) should know that when you get a job and your TANF benefits would normally end, you generally could stay on Medicaid for a 24-month transitional period.

In addition, your children may continue to qualify for Medicaid if your family’s income meets certain income standards.  (See above).

  • Poor elderly or disabled people who get Supplemental Security Income (SSI) benefits are automatically eligible for Medicaid.

Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your Medicaid coverage if you are elderly or you are still considered disabled and you continue to have medical need.

  • Elderly or disabled people who have low incomes and are enrolled in Medicare may also qualify for help from Medicaid. Even though your income may be too high to qualify for Medicaid coverage, there may be other ways Medicaid can help you.

If your household income is below the poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance.

If your household income is above 100% but below 135% of the poverty level, Medicaid will pay for your monthly Medicare premiums only.

Contact the DHSS office for more information about other eligibility requirements.

  • There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for Medicaid, contact Delaware Health and Human Services at (800) 464-4357 in-state or (800) 273-9500 out-of-state or http://www.dhss.delaware.gov/dhss/dss/medast.html.


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