Applying for Medicaid

Although many of the Medicaid coverage details are determined by individual states, each state must provide certain services, such as specific hospital and doctor services.

Remember that it's better for you to apply for Medicaid and be turned down than not to apply at all. The Centers for Medicare & Medicaid Services (CMS) advises you to complete a Medicaid application even if you're not sure you qualify. A caseworker will review your case to determine whether or not you qualify for Medicaid benefits. Your Medicaid eligibility can change from year to year, so you may want to complete a new Medicaid application each year, even if your application was previously turned down.

There are two ways you can get a Medicaid application form:

  • Visit the healthcare.gov website and select your state, or
  • Call your state Medicaid office.

Because Medicaid programs and application processes differ from state to state, review the Medicaid application process in your state. Visit the CMS.gov page to learn more about Medicaid program details and the specific Medicaid application process in your state.

Medicaid applications are often denied because of incomplete information on the application form. Before you submit your Medicaid application, be sure to have all of the following documentation ready.

  • Proof of age (birth certificate or driver's license).
  • Proof of citizenship or alien status.
  • Proof of all sources of income (paystubs or tax return, Social Security, Supplemental Security Income, Veteran's benefits, retirement accounts, and any other income).
  • Proof of assets and other resources
  • Proof of residence (rent receipts or landlord statements, a copy of your mortgage, recent mail addressed to you at your current address)
  • Proof of your disability: if you think you qualify because you're disabled, you'll need to include documentation as specified in your Medicaid application.
  • Proof of other insurance: include a copy of your red, white, and blue Medicare card (or other insurance ID card) with your Medicaid application.

Remember that state applications and instructions may vary. Check your state's Medicaid application website to see if they ask for additional documentation.

Submitting your Medicaid application

Medicaid application options may include paper applications, online application submissions, and even in-person applications at your local Medicaid office. Remember to follow your state's instructions for submitting applications.

States must respond to regular Medicaid applications in 45 days. For disability applications, it may take up to 90 days.

There may be times that your Medicaid application will be turned down for missing information or documentation. Get whatever is needed and follow the instructions on the denial letter to resubmit the application. If you feel the denial of your application is incorrect, provide documentation to prove otherwise. Your rights for appeal will be outlined on your Medicaid application denial letter.

How to Renew your Medicaid application

To stay in the Medicaid program, you must fill out a new Medicaid application every year. The Medicaid application process may get easier each year. For example, if they already have your birth certificate on file, they may not ask for it again for your next application. But, information like your income or alien status may change every year, so you will be asked to provide an update every time you renew your Medicaid application.