MEDICAID

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Medicaid is a program that provides health coverage to eligible low-income Nevada residents. Medicaid covers families with children and pregnant women, the elderly, and people with disabilities, if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for Medicaid. Questions concerning immigration status and eligibility should be directed to the Nevada Department of Health and Human Services.

  • For certain categories of people, eligibility for Medicaid is based on the amount of your household income.

In Nevada you may be eligible for Medicaid if you are an infant, a child, pregnant, or a parent of a child and your family income meets the Medicaid income standards. Income eligibility levels for these categories are described below. Your assets and some expenses also may be taken into account, so contact the Nevada Department of Health and Human Services for more information.

Low income persons eligible for Medicaid in Nevada*

Category — Income eligibility (as percent of federal poverty level)
Infant 0-1 — 133% (monthly income of about $1,903 for family of 3)
Child 1-5 – 133%
Child 6-19 — 100%
Parents
-Non-working — 25%
-Working - 86%
Pregnant woman — 185%
*Eligibility information was compiled from State Health Facts Online, the Henry J. 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 (FPL),* use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2007:

Size of Family Unit              Poverty Guideline (annual income)
      1                                              $10,210
      2                                              $13,690
      3                                              $17,170

–For larger families add $3,480 for each additional person.
–So, for example, using this guideline, 133% of the federal poverty level for a family of 3 would be an annual income of $22,836, or a monthly income of $1,903.

  • Parents who receive benefits under TANF should know that when you get a job and your TANF benefits end, you generally can stay on Medicaid for a 12-month transitional period.

In addition, your children may qualify for Medicaid if your family’s income meets certain income standards.

  • Very poor elderly or disabled people who get Supplemental Security Income (SSI) benefits also qualify 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 at least for a limited time.

  • Retired 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 insurance coverage, there may be other ways Medicaid can help you.

If your household income is at or below 100% of the federal poverty level, Medicaid will pay your Medicare monthly premium and your Medicare deductibles and coinsurance.  This is called the Qualified Medicare Beneficiary (QMB) program.

If your household income is below 120% of the federal poverty level, Medicaid will pay for your monthly Medicare premiums only.  This is called the Specified Low-Income Medicare Beneficiary (SLMB) program.

  • If you are uninsured and screened and diagnosed with breast or cervical cancer by the Women’s Health Connection program, you may be eligible for full Medicaid Benefits (see below).
  • There may be other ways that Medicaid can help. To find out if you or other members of your family qualify for Medicaid, contact the Nevada Division of Welfare. You can apply for Medicaid at the Nevada Division of Welfare District Office, or at many other designated outreach sites throughout Nevada.

To obtain the locations and telephone number of sites near you, call the Nevada Division of Welfare or visit http://welfare.state.nv.us/main/find_us.htm.


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