Medicare vs Medicaid Eligibility Estimator

ANA›Life Services Authority›National Calculator Authority›Medicare vs Medicaid Eligibility Estimator

.calc-container { max-width: 640px; margin: 2rem 0; padding: 1.5rem; background: #fff; border: 1px solid #ddd; border-radius: 8px; box-shadow: 0 1px 3px rgba(0,0,0,0.06); font-family: system-ui, -apple-system, sans-serif; } .calc-container h3 { font-family: Georgia, serif; font-size: 1.15rem; color: #1a1a1a; margin-bottom: 1rem; padding-bottom: 0.5rem; border-bottom: 2px solid var(--ac, #3d5a80); } .calc-row { display: flex; align-items: center; gap: 0.75rem; margin-bottom: 0.75rem; flex-wrap: wrap; } .calc-row label { min-width: 160px; font-size: 0.9rem; color: #333; font-weight: 500; } .calc-row input[type="number"], .calc-row select { flex: 1; min-width: 120px; max-width: 200px; padding: 0.5rem 0.6rem; border: 1px solid #ccc; border-radius: 4px; font-size: 0.9rem; font-family: system-ui, sans-serif; color: #1a1a1a; background: #fafaf8; } .calc-row input:focus, .calc-row select:focus { outline: none; border-color: var(--ac, #3d5a80); box-shadow: 0 0 0 2px rgba(26,74,138,0.12); } .calc-row .unit { font-size: 0.82rem; color: #888; min-width: 30px; } .calc-btn { display: inline-block; margin-top: 0.5rem; padding: 0.55rem 1.5rem; background: var(--ac, #3d5a80); color: #fff; border: none; border-radius: 4px; font-size: 0.9rem; font-weight: 600; cursor: pointer; font-family: system-ui, sans-serif; } .calc-btn:hover { opacity: 0.9; } .calc-result { margin-top: 1.25rem; padding: 1rem 1.25rem; background: #f0f6fc; border-left: 3px solid var(--ac, #3d5a80); border-radius: 0 6px 6px 0; display: none; } .calc-result.visible { display: block; } .calc-result-label { font-size: 0.78rem; text-transform: uppercase; letter-spacing: 0.06em; color: #666; margin-bottom: 0.25rem; } .calc-result-value { font-size: 1.6rem; font-weight: 700; color: var(--ac, #3d5a80); } .calc-result-detail { font-size: 0.85rem; color: #555; margin-top: 0.5rem; line-height: 1.5; } .calc-note { margin-top: 1rem; font-size: 0.8rem; color: #888; font-style: italic; } .calc-grid { display: grid; grid-template-columns: 1fr 1fr; gap: 0.75rem; margin-top: 0.75rem; } .calc-grid-item { padding: 0.6rem 0.8rem; background: #f8f9fa; border-radius: 4px; border: 1px solid #eee; } .calc-grid-item .label { font-size: 0.75rem; color: #888; text-transform: uppercase; letter-spacing: 0.04em; } .calc-grid-item .value { font-size: 1.1rem; font-weight: 600; color: #1a1a1a; } @media (max-width: 720px) { .calc-row { flex-direction: column; align-items: flex-start; gap: 0.3rem; } .calc-row label { min-width: auto; } .calc-row input[type="number"], .calc-row select { max-width: 100%; width: 100%; } .calc-grid { grid-template-columns: 1fr; } } .calc-chart { margin: 1rem 0; text-align: center; } .calc-chart svg { max-width: 100%; height: auto; } .calc-chart-legend { display: flex; flex-wrap: wrap; justify-content: center; gap: 0.6rem 1.2rem; margin-top: 0.6rem; font-size: 0.8rem; color: #555; } .calc-chart-legend span { display: inline-flex; align-items: center; gap: 0.3rem; } .calc-chart-legend i { display: inline-block; width: 10px; height: 10px; border-radius: 2px; font-style: normal; } .calc-related { max-width: 640px; margin: 2rem 0 1rem; padding: 1.25rem 1.5rem; background: #f8f9fa; border: 1px solid #e8e8e8; border-radius: 8px; } .calc-related h3 { font-family: Georgia, serif; font-size: 1rem; color: #1a1a1a; margin: 0 0 0.75rem; padding-bottom: 0.4rem; border-bottom: 2px solid var(--ac, #3d5a80); } .calc-related-list { list-style: none; padding: 0; margin: 0 0 0.75rem; display: grid; grid-template-columns: 1fr 1fr; gap: 0.4rem 1.5rem; } .calc-related-list li a { font-size: 0.88rem; color: var(--ac, #3d5a80); text-decoration: none; } .calc-related-list li a:hover { text-decoration: underline; } .calc-browse-all { margin: 0.5rem 0 0; font-size: 0.9rem; font-weight: 600; } .calc-browse-all a { color: var(--ac, #3d5a80); text-decoration: none; } .calc-browse-all a:hover { text-decoration: underline; } @media (max-width: 720px) { .calc-related-list { grid-template-columns: 1fr; } }

Medicare vs Medicaid Eligibility Estimator

Estimate whether you may qualify for Medicare, Medicaid, or both based on your age, disability status, income, and household size. Results are estimates based on federal guidelines.

Age

Do you have a qualifying disability or ESRD/ALS?

No Yes (receiving SSDI or diagnosed with ESRD/ALS)

Have you (or your spouse) worked and paid Medicare taxes for at least 10 years (40 quarters)?

Yes No

Household Size (number of people)

Annual Household Income ($)

Are you a U.S. citizen or qualifying legal resident (5+ years)?

Yes No

Check Eligibility

function medCalc() { var resultDiv = document.getElementById('med-result'); resultDiv.innerHTML = '';

var age = parseFloat(document.getElementById('med-age').value); var disability = document.getElementById('med-disability').value; var workCredits = document.getElementById('med-work-credits').value; var household = parseFloat(document.getElementById('med-household').value); var income = parseFloat(document.getElementById('med-income').value); var citizen = document.getElementById('med-citizen').value;

// Validation if (isNaN(age) || age 120) { resultDiv.innerHTML = 'Please enter a valid age (0–120).

'; return; } if (isNaN(household) || household = 65 && workCredits === 'yes') { medicareEligible = true; medicareReasons.push('Age 65 or older with sufficient work history (40+ quarters of Medicare taxes).'); } else if (age >= 65 && workCredits === 'no') { medicareWarnings.push('You are 65+ but may not have enough work credits for premium-free Part A. You may be able to purchase Medicare Part A.'); } if (disability === 'yes') { medicareEligible = true; medicareReasons.push('Qualifying disability (SSDI recipients after 24-month waiting period) or ESRD/ALS diagnosis.'); } }

// ── Medicaid Eligibility ────────────────────────────────────────────────── // Federal Poverty Level (FPL) 2024 guidelines (contiguous 48 states & DC): // Base: $15,060 for household of 1 // Each additional person: +$5,380 // Standard Medicaid income threshold: 138% FPL (ACA expansion states) // Non-expansion states: varies; we use 100% FPL as conservative estimate // Children (under 19): CHIP covers up to ~200% FPL in most states // Pregnant women: typically up to 138–200% FPL // Aged/Blind/Disabled (ABD) Medicaid: typically up to 74–100% FPL

var fplBase = 15060; var fplPerAdditional = 5380; var fpl = fplBase + (household - 1) * fplPerAdditional;

// Income as % of FPL var incomePctFPL = (income / fpl) * 100;

// Expansion threshold: 138% FPL var expansionThreshold = 1.38 * fpl; // Non-expansion conservative threshold: 100% FPL var nonExpansionThreshold = 1.00 * fpl; // CHIP threshold: 200% FPL var chipThreshold = 2.00 * fpl;

var medicaidEligible = false; var medicaidLikely = false; var medicaidReasons = []; var medicaidWarnings = [];

if (citizen === 'no') { medicaidWarnings.push('Most Medicaid programs require U.S. citizenship or qualifying immigration status. Emergency Medicaid may still be available.'); } else { // Adults under 65 — ACA expansion if (age >= 19 && age = 65 || disability === 'yes') { var abdThreshold = 0.74 * fpl; // SSI-linked: ~74% FPL (federal SSI benefit level) var abdUpperThreshold = 1.00 * fpl; if (income = 65) { medicaidLikely = true; medicaidReasons.push('Some states extend Medicaid to seniors up to 138% FPL. Check your state's specific rules.'); } } }

// ── Dual Eligibility (Medicare + Medicaid) ──────────────────────────────── var dualEligible = medicareEligible && (medicaidEligible || medicaidLikely);

// ── Build Output ────────────────────────────────────────────────────────── var html = '### Eligibility Estimate ';

// FPL summary html += ''; html += 'Your Household FPL Reference:'; html += '2024 Federal Poverty Level for household of ' + household + ': $' + fpl.toLocaleString('en-US', {maximumFractionDigits: 0}) + '/year'; html += 'Your income is ' + incomePctFPL.toFixed(1) + '% of FPL.'; html += '';

// Medicare result html += ''; html += '#### Medicare: ' + (medicareEligible ? '✅ Likely Eligible' : '❌ Likely Not Eligible') + ' '; if (medicareReasons.length > 0) { html += ''; medicareReasons.forEach(function(r) { html += ''; }); html += ''; } if (medicareWarnings.length > 0) { html += ''; medicareWarnings.forEach(function(w) { html += ''; }); html += ''; } html += '';

// Medicaid result var medicaidColor = medicaidEligible ? '#2e7d32' : (medicaidLikely ? '#b45309' : '#c62828'); var medicaidLabel = medicaidEligible ? '✅ Likely Eligible' : (medicaidLikely ? '⚠️ Possibly Eligible (State-Dependent)' : '❌ Likely Not Eligible'); html += ''; html += '#### Medicaid: ' + medicaidLabel + ' '; if (medicaidReasons.length > 0) { html += ''; medicaidReasons.forEach(function(r) { html += ''; }); html += ''; } if (medicaidWarnings.length > 0) { html += ''; medicaidWarnings.forEach(function(w) { html += ''; }); html += ''; } html += '';

// Dual eligibility if (dualEligible) { html += ''; html += '#### ⭐ Dual Eligible (Medicare + Medicaid) '; html += 'You may qualify for both programs. "Dual eligible" individuals can receive coordinated benefits — Medicaid may cover Medicare premiums, deductibles, and cost-sharing through Medicare Savings Programs (MSPs).

'; html += ''; }

html += 'This is an estimate only. Actual eligibility is determined by your state Medicaid agency and the Social Security Administration. Income and asset rules vary by state and program category.

';

resultDiv.innerHTML = html; }

#### Formulas Used

Federal Poverty Level (FPL) — 2024, Contiguous 48 States & DC:

Medicare Eligibility:

Medicaid Eligibility (ACA Expansion States):

Dual Eligibility: Individuals who meet both Medicare and Medicaid criteria. Medicaid may pay Medicare Part B premiums, deductibles, and co-pays via Medicare Savings Programs.

#### Assumptions & References

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