Delaware Medicaid Eligibility Requirements

Although states like Delaware administer the Medicaid program, most of the funding comes from the federal government. In addition, the respective state has certain control over the eligibility terms for coverage. Delaware Medicaid program provides low cost or free healthcare benefits to qualified low-income families.

Delaware Medicaid Eligibility Requirements

The coverage eligibility in Delaware is based on residency or citizenship status, income level as well as the age and the number of persons in the household.
Citizenship/Residency

Only residents of Delaware will qualify for coverage under the Medicaid program in the state. US citizens are guaranteed to get full coverage once they meet all the eligibility requirements, but the coverage will vary for legal non-citizens. On the other hand, all the non-citizens are eligible for childbirth and emergency treatment services if they can satisfy the requirements for income.

Income Level

The income requirements will depend on the applicant’s circumstances as well as the type of coverage they are applying for. Most times the limits for income are based on the federal poverty level for a household size. As a whole, a family can get coverage if the entire income is below 100% of the poverty level. In addition, a pregnant woman or a mother with a child who is under 1 year old will qualify with a household income that is below 200%, while children 1 to 6 years old will be covered if the family income is below 133%.

Still on children eligibility, the uninsured ones who are not qualified for the Medicaid program might get benefits from Delaware Healthy Children Program if the household income is less than 200% of the poverty level. With DHCP coverage, families are usually responsible for making premium payments of as much as $25 each month.

Adults

Persons who are earning at or less than 100% of the federal poverty level may qualify for coverage. Individuals who get Supplemental Security Income or families in the Temporary Assistance for Needy Families program will qualify automatically for Medicaid in Delaware. Furthermore, persons on Medicaid who no longer qualifies because of increased income can get Transitional Medicaid once their earnings fall below 185% of the poverty level.

Elderly Persons

Elderly persons can use Medicaid plan along with Medicare. Eligible adults can get benefits under the Qualified Medicare Beneficiary Program if they are earning 100 percent or less of the FPL. The Medicaid plan will pay Medicare co-insurance and co-pay premiums under the QMB program. Persons with income in the range of 120-135% of the poverty level may get benefits from the Qualifying Individual Program.

Disabled Persons

If Qualified Disabled and Working Individuals are not able to get full coverage from Delaware Medicaid program because of increased income, they might qualify for some benefits if their earnings amount to 200% of the poverty level.