It is possible to qualify for Medicare, Medicaid or both. Here is a ventilation of eligibility conditions.
Eligibility for health insurance
Age -based cover If you are 65 years old or more and that if you (or your spouse) pay drug taxes for at least 10 years (or 40 quarters), you are automatically eligible for the Medicare part without a bonus A. If you or a loved one do not pay enough medicre tax, you can always register, but you pay a premium for an A.
Disabled coverage If you are under 65, you can qualify for health insurance thanks to social security disability services.
If you have amyotrophic lateral sclerosis (SLA), also called Lou Gehrig’s disease, you can automatically receive Medicare as soon as your social security disability insurance (SSDI) start; If you have a terminal kidney disease (ESRD), your advantages are partly starting when you start to receive treatment. If you have another handicap, your coverage starts 24 months after starting to obtain disability services.
Medicaid eligibility
Medicaid is mainly intended for people with limited income and resources. Currently, Medicaid is the greatest source of health coverage in the United States.
Income -based coverage You can be eligible for Medicaid if your household income is less than a certain amount. This amount varies depending on the state (and is based on other factors, such as household size and disability status), but if your state has widened Medicaid, you are eligible if your household income is less than 133% of the level of federal poverty.
For example, a family of four who has an income of $ 42,760 – who, in 2025, represents 133% of the level of federal poverty – would be eligible for Medicaid in the states that extended the program.
Age and disability coverage If you are on Medicare, you can also be eligible for Medicaid if your income and assets are weak (which means you have double eligibility). Indeed, Medicare does not cover all your health insurance costs, so you can be eligible for Medicaid on the basis of factors that include the income and age of your household.
In most states, you are also eligible for Medicaid if you receive additional security income (SSI), which provides monthly income for disabled people.
It can be more difficult to qualify for Medicaid if you are at least 65 years old, because Medicaid takes into account your income and your assets when determining eligibility.
Special circumstances You can also qualify for Medicaid if you were a former young person with foster family (up to 26 years old)
And can receive care against cancer via Medicaid if they have been diagnosed with breast or uterine cancer through federal screening programs.
Medicare savings programs (MSP)
Even if you are not eligible for Medicaid, you could always get help in the Medicare savings programs (MSP). These programs, managed by Medicaid state agencies, help cover the costs of health insurance such as bonuses and copays for people with income and limited savings. Again, the directives differ depending on the state.
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