How do I know if I qualify for Medicaid or the Medicaid expansion?

Once the insurance exchanges begin operating on October 1, their websites will provide information on Medicaid eligibility. They should also include links to the websites of state agencies that administer Medicaid programs, where you can find answers to questions and enroll. Pennsylvania does not plan to expand its Medicaid program, so the rules on eligibility will remain the same as they are now. New Jersey will expand its program, so all residents with incomes below 133% of the federal poverty level ($15,282 for an individual in 2013) will become eligible for Medicaid beginning next January 1. (The maximum income for eligibility will actually be a bit higher in practice, 138%, because the law uses a revised formula for calculating earnings.)
In the meantime, you can visit the websites of the state Medicaid agencies to check on enrollment rules. In Pennsylvania, that is the Department of Public Welfare. In New Jersey, it is the Department of Human Services. You can find the federal poverty level for 2013 for different household sizes here.


Robert I. Field, Ph.D., J.D., M.P.H. is a professor of law at the Earle Mack School of Law and professor of health management and policy at the School of Public Health at Drexel University. He also writes for The Field Clinic blog.