Get clear, plain-English guidance on Medicaid eligibility, income & asset limits (2025), expansion status, and what’s covered vs. not covered. We break down home health, HCBS waivers (1915(c)), 1915(i) state plan services, Community First Choice (1915(k)), spend-down rules, and non-emergency medical transportation (NEMT)—with step-by-step how to apply checklists. Compare states, see FPL thresholds, and learn proven ways to keep coverage while working or moving. Designed for seniors, disabled adults, and low-income families who need benefits that actually pay—without guesswork.
Medicaid covers over 70 million Americans, but what it covers for adults depends heavily on the state you live in. In 2025, the biggest differences show up in adult dental/vision, postpartum coverage, behavioral health, long-term care at home, and expansion to low-income adults. Below is a plain-English, state-by-state guide with trusted sources. Quick answer: What … Read more
Medicare got pricier in 2025—and early 2026 projections point to another bump. The good news: Medicaid programs (QMB/SLMB/QI) and Extra Help can cover your Part B premium and most drug costs, and a new $2,000 Part D cap plus a monthly payment option can tame pharmacy shocks. Here’s exactly what changed and how to cushion … Read more
Several high-impact COVID-era benefits end in 2025. The big dates: Sept 30, 2025 (Medicare telehealth + Hospital at Home) and Dec 31, 2025 (ACA enhanced subsidies and DEA tele-prescribing). Here’s what’s expiring, who’s affected, and what to do now—with exact deadlines and prep checklists. KFF+3telehealth.hhs.gov+3American Hospital Association+3 What’s ending in 2025? (Quick answer) Bottom line: … Read more
Short version: No state newly adopted Medicaid expansion in 2025. The national count remains 41 states (including DC) expanded, 10 not. But 2025 still brought policy shifts, updated FPL numbers, and growing pressure in several holdouts. Below: the current map, what changed, and how to prepare. KFF Quick answer—any new expansion states in 2025? No. … Read more
Short answer: Working does not automatically end Medicaid. Many disabled adults can keep coverage through SSI-linked Medicaid (1619(b)), Medicaid Buy-In, MAGI pathways, medically needy spenddown, or HCBS rules that allow income up to 300% of SSI. The right door depends on your program and state. Social SecurityMedicaid+2Medicaid+2KFF Does work make you lose Medicaid? (the quick … Read more
Short answer: Millions of older Americans qualify for help but aren’t getting it. Data show low enrollment in SNAP, SSI, and Medicare Savings Programs; long waits for home care; and big holes in Medicare (dental, hearing, routine vision, long-term custodial care). Below is what the numbers say — and how to fix it today. National … Read more
Here’s the short answer: Children on Medicaid get vision, hearing, and dental nationwide under EPSDT. For adults, coverage exists in most states—but what’s included (exams, eyeglasses, hearing aids, crowns, dentures, etc.) varies by state and plan. Use the quick-lookup below and the 2-minute verification steps to confirm your benefits today. (EPSDT: Medicaid.gov.) Medicaid What Medicaid … Read more
Yes—Medicaid pays for rides to covered medical care when you have no other reasonable way to get there. This Non-Emergency Medical Transportation (NEMT) benefit can include bus passes, mileage pay, taxis/TNCs, wheelchair vans, or stretcher cars—whichever is the least costly appropriate mode for your needs. Here’s what’s covered and how to book. eCFR+1 Disclaimer: This … Read more
Appealing a Medicaid denial is time-sensitive—but very doable. Most people can request a state fair hearing and, if they act fast, keep benefits during the appeal. Your exact deadline comes from federal rules and your state’s notice. This guide shows the steps, scripts, and timelines to use. Legal Information Institute+1 Disclaimer: This guide is general … Read more
Medicare pays for short-term skilled care, not day-in, day-out help with bathing, dressing, or supervision. That’s where Medicaid steps in. Medicaid is the nation’s primary payer for long-term services and supports, funding nursing homes and in-home/community care when you qualify. Here’s how the two programs actually work together in 2025. MedicareMedicaid Disclaimer: This is general … Read more