PDF Application for Health Coverage and Help Paying Costs - Medicaid 2025

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Medically needy individuals can still become eligible by spending down the amount of income that is above a states medically needy income standard. Individuals spend down by incurring expenses for medical and remedial care for which they do not have health insurance.
Most states adjust premium amounts by beneficiary income, with approved possible charges ranging from approximately $5 to $74 per month. Four states (AR, AZ, MI, and MT) have approved waivers to require monthly premium payments as a percentage of income.
PremiumAssist is hired to help you apply for the Medicaid or Medicare Savings Program. We are a complimentary service provided by your health plan. In fact, we work with health plans all over the country. Our job is to act on your behalf to make the application process go as smoothly as possible for you.
Premium assistance enables states to pay premiums on behalf of employees so they can purchase a product that helps to cover the costs of some of the services for which they are eligible under Medicaid. Premium Assistance does not impact the states requirement to provide all Medicaid benefits to consumers.
Premium assistance enables states to pay premiums on behalf of employees so they can purchase a product that helps to cover the costs of some of the services for which they are eligible under Medicaid.

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What Medicaid Covers. Once an individual is deemed eligible for Medicaid coverage, generally there are no, or only very small, monthly payments, co-pays or deductibles. The program pays almost the full amount for health and long-term care, provided the medical service supplier is Medicaid-certified.
Individuals who purchase a qualified health care plan through the California health insurance marketplace, may be eligible to receive financial assistance to help pay the insurance premiums, known as the Premium Assistance Subsidy (PAS).

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