Medicaid frequently asked questions (FAQs)

Medicaid is a federal and state program that provides health care coverage to people who qualify. Each state runs its own Medicaid program, but the federal government has rules that all states must follow. The federal government also provides at least half of the funding for their Medicaid requirements. Learn more about Medicaid and what it covers.

In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states, Medicaid covers all low-income adults below a certain income level.

The exact requirements to qualify for Medicaid depend on where you live. To find out if you're eligible for Medicaid in your state, visit the website for Medicaid in your state. Then check the eligibility requirements.

You'll find a link to the website for your state Medicaid agency on the "Plan Details" page for each health plan UnitedHealthcare Community Plan offers. To see plans available in your area, please use the search box at the bottom of this page.

Yes, as long as you meet the qualifications for Medicaid in your state. Whether or not you get Social Security Disability Insurance (SSDI) doesn't change your Medicaid eligibility. Getting SSDI automatically qualifies you for Medicare, but there's a waiting period. You’ll likely need to wait 2 years after you qualify for the Social Security disability benefit before you can get Medicare.

Learn more about Social Security disability and Medicaid and Medicare.

When you apply for Medicaid, you'll need to fill out an application form. Different states have different requirements for Medicaid. You'll likely need to have various documents, such as:

Personal information

• Information about household members (name, date of birth and Social Security number)
• Proof of citizenship

Financial information

• Rent or mortgage information
• Expenses (utilities, daycare, etc.)
• Vehicle information
• Bank statements
• Income (pay stubs)

Medical information

• Proof of disability or medical records showing a lasting medical condition
• Recent medical bills

You'll need to apply through the state agency that manages the Medicaid program in your state. To see plans available in your area, please use the search box at the bottom of this page.

You can apply for Medicaid or CHIP (the Children's Health Insurance Program) at any time throughout the year.

The Medicaid program in each state is run by the state government for that state. While certain states may offer different types of Medicaid plans, each plan is typically for a certain type of person (such as children, families or low-income adults). It’s not likely you can change your Medicaid plan or switch to a different Medicaid plan unless your life situation changes. (If you get married or become pregnant, for example). You can apply for Medicaid at any time throughout the year.

You'll find a link to the website for your state Medicaid agency on the "Plan Details" page for each health plan UnitedHealthcare Community Plan offers. To see plans available in your area, please use the search box at the bottom of this page.

UnitedHealthcare Community Plan serves members who qualify for Medicaid or for both Medicaid and Medicare in 42 states and the District of Columbia.*

UnitedHealthcare offers Medicaid plans in these states:
Arizona, Colorado, Florida, Hawaii, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Mississippi, North Carolina, Nebraska, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, Washington, Wisconsin

*As of September 2023

Each state manages its own Medicaid program so what’s covered by Medicaid can change from state to state. But there are some services that every state must cover in their Medicaid program by federal law. These are called mandatory benefits. States can also choose to offer other benefits under Medicaid. These are called optional benefits.

Mandatory Medicaid benefits include:

• Inpatient hospital care
• Inpatient short-term skilled nursing or rehabilitation facility care
• Doctor services
• Outpatient hospital or clinic care
• Laboratory and X-ray services
• Short-term home health care (provided by a home health care agency)
• Ambulance service
• Prescription drugs for people not covered by Medicare

Optional benefits offered by some states may include:

• Eye exams and glasses
• Hearing tests and hearing aids
• Dental care
• Preventive screenings
• Physical therapy (beyond what is offered under Medicare)
• Non-emergency transportation to and from medical treatment
• Some prescription drugs not covered by Medicare
• Some nonprescription drugs, including certain vitamins
• Chiropractic care
  

Medicaid is a health care program that's managed at the state level by each state government. However, state governments do not actually provide health insurance. State governments contract with private insurance companies like UnitedHealthcare to provide health coverage for beneficiaries of Medicaid and other government health care programs. Our government-sponsored health plans operate under the name UnitedHealthcare Community Plan.

In most cases, Medicaid is the payer of last resort. That means that Medicaid will pay after any other payer has paid its share of the services provided. For example, if you have Medicare or any type of private health care coverage, Medicaid will always be the secondary payer. Health care providers will bill the primary payer first, and Medicaid will pay what's left over. That's why Medicaid enrollees must say if they have other sources of coverage.

In most cases, Medicaid pays the full cost for covered services, so people with Medicaid do not have to pay a monthly premium or any deductibles. But there are some exceptions and rules vary by state. In certain cases, if someone has Social Security benefits, a small amount may be taken from those benefits to help cover the cost of Medicaid coverage.

Medicare is a national health insurance program run by the federal government. It’s for people age 65 and older, and also some people under age 65 with certain disabilities. Learn more about Medicare.

The Affordable Care Act (ACA) expands access to quality and affordable health coverage for millions of Americans. Signed into federal law by President Barak Obama in 2010, the ACA guarantees health coverage regardless of income level, work situation, or previous health conditions.

DDD stands for Division of Developmental Disabilities – a division of the Department of Economic Security (DES). DES works with families, community organizations, advocates and state and federal partners to realize our collective vision that every child, adult, and family will be safe and economically secure.

A state-specific health plan for certain Medicaid recipients. It's for physically disabled adults and children.

Supplemental Security Income (SSI) is a monthly cash benefit paid by the federal Social Security Administration (SSA) and state Department of Health and Services (DHS) to low-income elderly, blind, and disabled residents. SSI benefits are not the same as Social Security benefits.

CHIP, which stands for Children’s Health Insurance Program, provides low-cost insurance for children whose families do not meet the income eligibility requirements for Medicaid. CHIP may also provide coverage for pregnant women in some states, but does not cover adults caring for children who qualify for CHIP.