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Federal Requirements and State Options: Eligibility

Medicaid eligibility is typically defined in terms of both categorical eligibility (the populations covered) and financial eligibility (the income levels or thresholds at which the populations can be covered). Federal statute and regulations require coverage of certain eligibility groups, while others may be covered as a state option. States also have some flexibility to establish specific income and asset limits for certain eligibility groups. As a result, there is significant variation across states in terms of which optional groups are covered and at what income levels.

This fact sheet examines the various federal requirements and state options that govern Medicaid eligibility, including the eligibility groups and the income and asset requirements.

From: Federal Requirements and State Options: How states exercise flexibility under a Medicaid state plan