Understanding Medicaid Eligibility for Spouses under the ACA

The Affordable Care Act (ACA) has made significant changes to the way health insurance works in the United States. One of the most important changes is that Medicaid is now available to more people than ever before. However, there are still some income limits that you need to be aware of if you want to qualify for Medicaid.

Medicaid and the ACA
Before the ACA, Medicaid was only available to very low-income individuals and families. However, the ACA expanded Medicaid eligibility to include people with incomes up to 138% of the federal poverty level (FPL). This means that a single person with an income of up to $17,774 per year can now qualify for Medicaid.

In some states, Medicaid is available to people with incomes up to 150% of the FPL. However, these states are required to pay for a portion of the cost of Medicaid coverage for people with incomes between 138% and 150% of the FPL.

Income Limits for Medicaid
The income limits for Medicaid vary from state to state. However, the general rule is that you must have an income below a certain level to qualify for Medicaid. The income limit for Medicaid is based on the federal poverty level (FPL). The FPL is a measure of income that is used to determine eligibility for many government programs.

The FPL is updated every year. For 2023, the FPL is $13,590 for a single person and $27,750 for a family of four.

Income Considerations for Spouses
When determining Medicaid eligibility for spouses, the income of both spouses is considered. This means that if your spouse has a high income, you may not be eligible for Medicaid, even if your own income is low.

Special Rules for SSDI and VA Disability
There are some special rules that apply to SSDI and VA disability benefits when determining Medicaid eligibility. SSDI benefits are considered to be countable income for Medicaid purposes. However, VA disability benefits are not considered to be countable income. This means that if you receive VA disability benefits, your income will be lower for Medicaid purposes, and you may be more likely to qualify for Medicaid.

Conclusion
If you are considering applying for Medicaid, it is important to understand the income limits and how your spouse’s income will affect your eligibility. If you have any questions about Medicaid eligibility, you can contact your local Medicaid office or a licensed health insurance agent.

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