Do Homeless People Qualify for Medicaid?

homeless medicaid patient in hospital

Medicaid is a program in the United States intended to help low-income people cover their medical costs, but many homeless people still are not covered by it. Now I don’t know about you, but when I think of “low-income”, I can’t think of any better example than the homeless population.

I was homeless myself not that long ago. So I know all too personally the struggles that people deal with on an everyday basis when living on the streets. Being a hypochondriac, I’m also somebody who constantly worries about my health and how I’ll be able to cover medical costs if something happens to me while I’m struggling.

With that said, I was in my late 20’s and early 30’s during my longest homeless stint on the streets and during some of that time I was covered by Medi-Cal, which is California’s version of Medicaid.

So while there are still many people who are homeless and not eligible for Medicaid, there’s still many who are and I’d even venture to say that the vast majority of homeless people do qualify.

But you need to know why some people are eligible and some are not, as a lot of it has to do with where you live and a few other bits of criteria that might be important in your situation.

So let’s go over all the details you need to know if you’re trying to get on Medicaid so that you can at least be informed and know what your chances are of being approved.

 

Eligibility is Always Changing
The qualifications and eligibility for Medicaid are constantly changing and the main reason for that is because of the constant power struggle between Democrats and Republicans in the United States.

Many of the people that were eligible for Medicaid while Democrats were in office are often not eligible when Republicans took control. Under President Obama, the Affordable Care Act (ACT) was passed which almost immediately expanded Medicaid coverage in the majority of states.

Before this program, most people needed to be part of a special category which meant senior citizens, pregnant women, families, single parents with kids, those with SSI-qualifying disabilities, or those who are blind. In addition to this, there were also income requirements for many of these people where they couldn’t make so much money or still might not qualify.

When the program expanded, at least 31 states could now cover single homeless people and the only criteria they needed to meet was that their income was less than 138% of the Federal Poverty Line. I’ll explain more about the FPL and eligibility below, but just know that most homeless people are still covered under this criteria in the majority of states, but not all.

Because Medicaid is a program where both the Federal Government and states have a say in things (similar to how minimum wage works), not all states have expanded coverage and many conservative states have became stricter in regards to eligibility under President Trump.

Under Trump’s presidency, he made changes that allowed many states to introduce new requirements, with the most prominent and controversial requirement being that many people will not qualify for Medicaid unless they are working a job for a certain number of hours per month.

Many typically conservative states have recently required things such as this in recent years and many homeless people therefore don’t qualify in these states if they’re unable to work.

States have always been able to specify their own criteria in regards to who qualifies and who doesn’t, but that criteria previously had to still fit in with federal guidelines in regards to certain categories or groups of people. Much of that has been thrown by the wayside now, so in addition to your personal situation and income, the state you reside in can also play a major role in whether you’ll qualify for Medicaid or not.


Who Qualifies for Medicaid?

As previously stated, there are those who are in the special category of people who have a high likelihood of being approved. Those who do not meet the criteria to fit within that special category have a better chance of qualifying if they live in any of the states (and Washington D.C.) where ACA coverage is still expanded and if they have low-income.

If you live in one of those areas, there’s an almost certain chance that you’ll qualify for Medicaid as long as your income is below 138% of the Federal Poverty Line (FPL). Just keep in mind that you still have to be a U.S. citizen or permanent legal resident in the United Stats as well.

 

How Does the Federal Poverty Line Work?
The Federal Poverty Line changes almost every year due to economy changes and inflation, but it doesn’t vary too significantly from the previous year. The numbers I’m quoting here are based on the 48 continental states and the capitol. Hawaii and Alaska have their own separate Federal Poverty Line.

In 2019, the Federal Poverty Line has been set at $12,140 annually for single adults with no children in their household (or within their family on the streets). 138% of that would be around $16,753 annually. So as long as you were expected to make less than this in 2019 and you were in a state with expanded coverage under the ACA, then it’s very probable you’d qualify.

For years 2020, 2021, and onward, this amount is different and will almost surely continue to rise with inflation changes. You should always research online the FPL for the current year we’re in as it will almost always be different each year.


Waivers for Those Who Don’t Qualify

This is a long shot but worth looking into if you don’t qualify for Medicaid. There’s a program called Medicaid waivers where waiver forms can be filled out and submitted by each state to the Federal Government specifying why the state feels you should be considered for an exemption to the eligibility requirements.

Normally, these waivers are submitted by social service agencies based on studies they are currently running or programs they are testing. For example, before the Affordable Care Act was approved which made many homeless people eligible for Medicaid for the first time, the city of Los Angeles was able to still get coverage for many homeless people by using waivers.

They were running studies to determine how effective Medicaid was in helping those who were living on the streets and how it improved their homeless recovery rates. Because they were running studies and pilot programs such as this, the Federal Government would often approve their waiver submissions and literally thousands of homeless people were able to receive coverage when they otherwise wouldn’t have without the waivers.

The best way to determine if you might be eligible to have your application submitted as a waiver is to speak to your local social services department and ask your social worker if you have one. But I want to stress that since the ACA improved coverage for those living on the streets in many areas, waiver programs for the homeless have become somewhat obsolete in many of them.

 

Social Workers Can Help
Federal law states that third-party representatives can apply for Medicaid on your behalf. So if you’re currently homeless or struggling and don’t know where to begin, you may want to seek out assistance in applying for Medicaid if you feel overwhelmed by the process.

Social workers and other types of case workers may be your best bet, so you may want to visit your local social services department and ask for assistance with Medicaid.

If, for any reason, they can’t assist you with this, you can also seek out help from various charities and other organizations online by searching online for the keywords “Medicaid application assistance” and input your city or state next to that line of text in a search engine.

You should be able to find information on what groups in your area can help you with this process. If you have a friend or family member that’s willing to help you and think they’re up for the task, you can always have them fill out the applications for you as well.

 

How to Apply for Medicaid
In addition to receiving assistance through third-parties, you can also apply for Medicaid on your own if you prefer. This is the best option if you actually know where to start and are motivated to fill out all the forms and have enough information about yourself to do so.

You can apply for Medicaid at the official Healthcare.gov website. Simply use the search bar at the top of the site and search for the word “Medicaid”. Just note that if you’re applying for Medicaid online, this means you are applying through the Health Insurance Marketplace that was set up under Obama’s presidency.

This way, if you don’t qualify for Medicaid, the system can advise you of other health insurance options that you may qualify for within the marketplace. Now if you don’t want to apply online, you have one other option and that’s to visit a local Medicaid office in your area and fill out an application there or ask if they can do this for you after providing the information they might need.

This would normally be your local social services department but may vary depending on your city or town. On the healthcare.gov website, you can search for Medicaid offices by state to find the one closest to you.