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Benefits for Young People

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    Benefits for Young People

    Medicaid Eligibility for Young People

    Medicaid helps people with low income pay for their visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services. Depending on your income, your age, and whether you are disabled, blind, or pregnant, there may be more than one way for you to qualify for Medicaid.

    If you get Supplemental Security Income (SSI) or used to get SSI benefits and now qualify for SSI's 1619(b) status, you qualify for Medicaid, but you have to apply for it separately from SSI.

    If you don't get SSI benefits, there are other ways to qualify for Medicaid. The rules depend on whether you are:

    How to Apply for Medicaid

    After you learn about eligibility, you can apply for Medicaid:

    No matter how you apply, it is important to know that if you are not eligible for Medicaid, you may be able to get private insurance subsidized by the government.

    Medicaid If You Are 18 or Younger

    If you are 18 or under, there are two common ways to get Medicaid. You can qualify if:

    1. Your family has low income, regardless of whether you have a disability, or
    2. You have a disability and get Supplemental Security Income (SSI).
      • If you have a disability and need a high level of care to be able to live at home, you may qualify for Medicaid even if your family's income or resources are too high for you to get SSI.

    Income-Based Medicaid and NCU

    If you are 18 or younger and your family's income is 205% of the Federal Poverty Guidelines (FPG) or less ($5,638 per month for a family of four), you may either qualify for income-based Medicaid (if your family's income is very low) or Nevada Check Up (NCU) (if your family's income is moderate).

    For income-based Medicaid or NCU, it doesn't matter how much your family has in resources or whether you have a disability. Depending on your family's income, you may have to pay a small monthly premium for your coverage.

    If your family's income is at or below 138% of FPG ($3,795 per month for a family of four), your parents may also qualify for Medicaid.

    Use the tool below to see if your family may qualify for income-based Medicaid.

    Health Coverage Income Limits for Your Family
    Is the income limit for Nevada Check Up (NCU) 200% or 205% of FPG?

    You may see the children's income limit for Nevada Check Up (NCU) listed as 200% of the Federal Poverty Guidelines (FPG). However, when Medicaid counts your income, they’ll knock 5% of FPG off your household income if you make more than 200% of FPG. That's why we say that you can make up to 205% of FPG, because it more accurately shows how much income you could have and still get Nevada Check Up (NCU) coverage if you are under 19.

    If you are or have been enrolled in foster care
    If you are in foster care and are 17 or younger (or you are 18 and in high school or vocational school), you may qualify for Medicaid no matter how much money you make. If you are 18-25 years old and were in foster care on your 18th birthday, you also may qualify for Medicaid no matter how much money you make.

    Disability-Based Medicaid

    The most common way to get disability-based Medicaid is through Supplemental Security Income (SSI) benefits. If you meet the SSI requirements, you qualify for Medicaid. However, you have to apply for Medicaid separately from your SSI application. Note: You can apply for Medicaid before you are approved for SSI.

    You can learn more about SSI and see if you qualify on the SSI Eligibility page.

    If you are 18 or younger, have a disability, and need a high level of care to live at home instead of moving to a facility, you may qualify for Medicaid under the Katie Beckett rule, which has a higher income limit than SSI. Under the Katie Beckett rule, your parents' income and resources are not counted when determining your eligibility for Medicaid. To qualify, you must:

    • Need a level of care normally provided by a hospital, nursing home, or other care facility.
    • Have $2,000 or less in resources and gross income at or below $2,982 or less a month. Your parents' income and resources are not counted.

    Learn more about the Katie Beckett rule.

    SSI's 1619(b) rule

    If you’re on Supplemental Security Income (SSI), there is a rule called 1619(b) that lets you keep your Medicaid coverage even if your earned income becomes too high for you to keep getting an SSI cash benefit. With 1619(b), you can make up to $47,006 per year ($49,629 if blind) without losing your Medicaid.

    While 1619(b) means that you can get Medicaid while earning way more than the program’s normal income limit, your resources have to stay below SSI’s $2,000 resource limit. If your resources go above that limit, you should consider Health Insurance for Work Advancement (HIWA). Learn more about HIWA.

    Medicaid if You Are 19 or Older

    The rules for Medicaid if you're 19 or older are a little different than the rules used for people under 19. There are two common ways to get Medicaid. You can qualify if:

    1. You have low income, regardless of whether you have a disability, or
    2. You have a disability and get Supplemental Security Income (SSI).

    Income-Based Medicaid

    When you are 19 or older, you can qualify for Medicaid if your income is at or below 138% of the Federal Poverty Guidelines (FPG) ($1,835 per month if you are single). Medicaid no longer looks at your parents' income.

    If you are pregnant, you can qualify if you have income at or below 205% of FPG ($3,697 per month if you are single and pregnant with your first child; the baby is counted as a member of the family).

    For income-based Medicaid, there is no limit on how many resources you can have.

    Check if your household income is low enough for income-based Medicaid:

    Health Coverage Income Limits for Your Family

    Disability-Based Medicaid

    The most common way to get disability-based Medicaid is through Supplemental Security Income (SSI) benefits. If you meet the SSI requirements, you qualify for Medicaid. However, you have to apply for Medicaid separately from your SSI application. Note: You can apply for Medicaid before you are approved for SSI.

    Once you turn 19, Social Security will only look at your income and resources when deciding whether you qualify for SSI, and will not look at your parents’ income and resources. You may qualify for SSI and disability-based Medicaid even if you did not qualify when you were younger than 19.

    You can learn more about SSI and see if you qualify on the SSI Eligibility page.

    Note: If you used to get SSI benefits when you were under 18, but then started getting Childhood Disability Benefits (CDB) when you turned 18 and stopped qualifying for SSI, you can usually keep your Medicaid coverage.

    Try DB101's School and Work Estimator to get an idea of whether you would qualify for Medicaid.

    Tip: If you make money at work and your income or resources are too high for SSI, you should look into Health Insurance for Work Advancement (HIWA).

    Learn more

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