Ukwemererwa Kwinjira muri Medicaid mu 2026: Imipaka y'Imyanya n'Inyigisho yo Gusaba

Uko ugirirwa uburenganzira bwo kwinjira muri Medicaid biterwa cyane n'intara yawe. Mu ntara 40 hamwe na Washington D.C. byazamuye Medicaid hakurikijwe itegeko ry'ubuvuzi buhendutse, abakuze bari munsi y'imyaka 65 bagira uburenganzira niba imyanya yabo ihwanye cyangwa iri munsi ya 138% by'urwego rw'ubushomeri rw'igihugu. Kuri 2026, ni hafi ya $22,025 buri mwaka ku muntu umwe cyangwa $45,540 ku muryango w'abantu bane. Mu ntara 10 zitemewe (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming), uburenganzira burushijeho kuba bukomeye. Amategeko y'ingengo y'imari ya leta yo muri 2025 anongeraho ibisabwa byo gukora gutangira muri Gicurasi 2026 ku ntara zimwe na zimwe, hamwe n'ibiro by'ingengo y'imari by'inteko ishinga amategeko bibara ko abantu bagera kuri miliyoni 5.3 bashobora gutakaza ubwishingizi mu 2034. Nk'uko Medicaid.gov ibivuga, abanyamerika hafi miliyoni 80 barimo kwiyandikisha muri Medicaid cyangwa CHIP.

Iyi nyigisho isobanura uburyo bwo kwemererwa kwinjira muri Medicaid mu 2026, harimo imipaka y'imyanya ku rwego, amategeko y'ibintu, itandukaniro hagati y'intara zizamuye n'intara zitazamuye, n'uburyo bwo gusaba. Amakuru avuye kuri Medicaid.gov, CMS, n'ibigamije muri leta.

Imipaka y'imyanya ya Medicaid yo mu 2026

Medicaid ikoresha uburyo bubiri bw'uburyo bwo kwemererwa kwinjira bitewe n'icyiciro gikubiyeho:

Medicaid ya MAGI (Modified Adjusted Gross Income). Ikoreshwa ku bakuru, abana, abagore batwite, ababyeyi, n'abakuru bamujyanye muri gahunda ya ACA. Nta myanya isabwa kuri Medicaid ya MAGI. Imyanya ibarwa nk'ikigereranyo cy'urwego rw'ubushomeri rw'igihugu.

Mu ntara za Medicaid zizamuye (intara 40 + DC), imipaka ku bakuru ni 138% FPL:

• Umukuru ufite imyanya yo mu rugo: $22,025/umwaka ($1,835/ukwezi)

• Abashakanye: $29,720/umwaka ($2,477/ukwezi)

• Umuryango w'abantu batatu: $37,440/umwaka ($3,120/ukwezi)

• Umuryango w'abantu bane: $45,540/umwaka ($3,795/ukwezi)

Medicaid itari yo MAGI. Ikoreshwa ku basaza (bafite imyaka 65+), abafite ubumuga, n'abasaba kwitabwaho igihe kirekire. Irimo imipaka y'imyanya NA tests y'ibintu:

• Imipaka y'imyanya ya Medicaid yo kwitabwaho igihe kirekire (2026): $2,982/ukwezi ku muntu umwe, $5,964/ukwezi ku bashakanye

• Urwego rw'impembo z'ibigenerwa (FBR) 2026: $994 ku muntu umwe, $1,491 ku bashakanye

• Imipaka y'ibintu (muri leta nyinshi): $2,000 ku muntu umwe

• Uburenganzira bw'umugore wo mu mudugudu: kugeza kuri $162,660

Impinduka zishingiye ku ntara. Zimwe mu ntara zemera Medicaid ya MAGI hejuru ya 138% (Connecticut, DC, Maine, Maryland, Massachusetts), mu gihe izindi zigarukira ku bice bito. Imipaka y'ibintu muri Medicaid itari yo MAGI itandukanye: Connecticut, Delaware, Louisiana, Maine, Mississippi, Vermont, n'izindi ntara nta mipaka y'ibintu. Californiya ifite imipaka y'ibintu iri hejuru ($130,000 ku muntu umwe / $195,000 ku bashakanye kuri 2026).

Kuri makuru y'intara muri Medicaid, reba inyigisho yacu kuri Medicaid Illinois n'inyigisho z'intara (zizasohoka) kuri Californiya, Pennsylvania, Michigan, na North Carolina.

Medicaid yzamuye mu ntara zidazamuye

Aho utuye bituma ugira uburenganzira bushingiye ku myanya cyangwa uhura n'amategeko akomeye:

Intara zizamuye (intara 40 + DC): Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, DC, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina (kuva mu Kuboza 2023), North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia.

Mu ntara zizamuye:

• Abakuru bagira uburenganzira bushingiye ku myanya gusa (138% FPL)

• Nta myanya isabwa kuri Medicaid ya MAGI

• Abakuru badafite abana bagira uburenganzira uko byamera kose

• Inzira imwe yo gusaba binyuze muri leta

Intara zidazamuye (10): Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming.

Mu ntara zidazamuye:

• Abakuru akenshi bisabwa kuba ababyeyi, abasaza, cyangwa bafite ubumuga kugira ngo bagire uburenganzira

• Texas igarukira ababyeyi kuri 17% FPL (~$273/ukwezi ku muryango w'abantu batatu)

• Alabama igarukira ababyeyi kuri 18% FPL

• Abakuru badafite abana ntibagira uburenganzira uko byamera kose

Ikigereranyo cyo kwicwa. Abakuru badafite ubwishingizi bagera kuri miliyoni 1.4 mu ntara zidazamuye bagira imyanya myinshi ku buryo babona Medicaid mu ntara yabo, ariko bake cyane (munsi ya 100% FPL) ku buryo bubona inguzanyo kuva ku isoko rya ACA. Hafi 97% by'aba baturage bakoreshwa baba mu ntara zo mu majyepfo, aho Texas yonyine iba ifite 42% by'ikigereranyo cyose cyo kwicwa.

Kubijyanye n'inyigisho z'izamuka rya Medicaid n'uburyo Medicare na Medicaid bifitanye isano, reba inyigisho zacu.

Medicaid irimo iki

Medicaid irimo serivisi nyinshi z'ubuvuzi. Inyungu zihariye zitandukana ku ntara ariko serivisi zitegetswe na leta zirimo:

• Kwiyakirwa mu bitaro no hanze

• Serivisi z'abaganga

• Ibipimo by'ibigeragezo na x-ray

• Serivisi z'ibitaro byujuje ibisabwa na leta

• Serivisi zo gutegura urubyaro

• Serivisi z'ababyaza

• Serivisi z'abana

• Kwitabwaho ku bagore batwite

• Serivisi z'ibitaro by'abakuze

• Serivisi z'ubuvuzi mu rugo

• Serivisi z'ubuvuzi igihe kirekire

• Kwitabwa mu mvura by'ubutabazi

Inyungu zidafite amategeko zitandukanye ku ntara zirimo kwivuza amenyo, imiti, imbago z'amaso, serivisi zo mu mutwe, serivisi zo kwisukura, kwivuza impfu, amenyo y'ibihumure, n'izindi serivisi z'ubuvuzi.

Kubijyanye n'inyungu zihariye, reba inyigisho zacu kuri Medicaid yo mu kanwa ku bakuru, abaganga b'amenyo bakoresha Medicaid, n' abaganga b'amaso bakoresha Medicaid.

Uburyo bwo gusaba Medicaid

Ushobora gusaba Medicaid igihe cyose cy'umwaka. Nta gihe cyo kwiyandikisha gusa. Inzira 5 zo gusaba:

Intambwe ya 1: Gerageza ko uri mu cyiciro cyemewe. Abakuru benshi mu ntara zizamuye bagira uburenganzira bushingiye ku myanya gusa. Abaturage bo mu ntara zidazamuye bisabwa kuba ababyeyi b'abana bakwiriye, batwite, abasaza, cyangwa bafite ubumuga.

Intambwe ya 2: Gereranya ibikoresho byawe. Bisabwa kuri hafi ya gahunda zose:

• Kagame k'umuryango wa buri muntu

• Indangamuntu y'amafoto cyangwa uruhushya rwo gutwara

• Ihamya ry'imyanya (imyanya ya mukozi, amatangazo y'umusoro, ibaruwa y'impembo ya societe)

• Ihamya ry'aho utuye (ubwishyu bw'ibikoresho, amasezerano)

• Ihamya ryo kuba umunyamuryango cyangwa imibereho y'umwimukira

• Ku bagore batwite: kwemeza ubuzima bw'ugusama

• Ku byiciro bitari MAGI: amatangazo y'ibanki, ibikoresho by'ibintu

Intambwe ya 3: Hitamo uko wasaba. Ibyo bitandukana ku ntara ariko bisanzwe birimo:

• Online binyuze kuri portal yawe ya Medicaid

• Online binyuze kuri HealthCare.gov (ku ntara zikoresha isoko rya leta)

• Mu telefone ukoresheje leta ya Medicaid yawe

• Mu ibaruwa hamwe n'ikoreshwa ry'impapuro

• Mwihuje mu biro bya Medicaid by'aho cyangwa ibigo by'ubuzima by'umudugudu

Intambwe ya 4: Shyira umukono ku busabe bwawe kandi usubize ibyo bisabwa. Leta nyinshi zikora ubusabe mu minsi 30-45. Ubusabe bushingiye ku ubumuga bushobora gufata iminsi 90. Subiza vuba ibyo bisabwa kugira ngo wihute.

Intambwe ya 5: Buzana impamyabumenyi yawe yo kwemererwa. Niba byemewe, uzabona itangazo ryanditse hamwe n'itangira n'ID ya Medicaid. Ushobora kwiyandikisha mu itsinda ry'ubuyobozi ry'ubuyobozi bw'ubuyobozi bwawe niba leta yawe ibikoresha.

Niba wahakanye, ufite uburenganzira bwo kwishyuza. Mu rusange, ushobora gusaba gusubiramo mu minsi 30-90.

Ibisabwa mu gukora kuri Medicaid yo mu 2026

Amategeko y'ingengo y'imari ya leta yo muri 2025 (yasinywe ku ya 4 Nyakanga 2025) anongeraho ibisabwa byo gukora kuri Medicaid ku bakuru bazamuye ko bizatangira mu 2026:

• Nebraska: Gutangira muri Gicurasi 2026, abakuru bagomba kwerekana amasaha 80 buri kwezi mu bikorwa bibemerera

• Montana: Gutangira muri Nyakanga 2026, amasaha 80 bisabwa

Ibyemezo bibemerera birimo akazi, amahugurwa ku kazi, ubukorerabushake, amashuri, cyangwa kwita ku bantu. Gutanga imbabazi bisanzwe ku:

• Abagore batwite

• Abantu bafite ubumuga

• Abafasha abana bato

• Abanyeshuri bafite nibura igice cy'igihe

• Abantu bari mu buvuzi bw'ubuzima bw'ibiyobyabwenge

Ibihame bya leta by'ibimenyetso byitezwe kuva kuri CMS mu Kamena 2026. Biro by'ingengo y'imari by'inteko ishinga amategeko bibara ko abantu miliyoni 5.3 bashobora gutakaza ubwishingizi bwa Medicaid kubera ibisabwa byo gukora kugeza 2034.

Ikibazo cy'ibibazo bikunze kubazwa

Ni iyihe mibereho yo kwemererwa kwinjira muri Medicaid mu 2026?

Ku bakuru benshi mu ntara zamujyanye muri Medicaid, imibereho ni 138% by'urwego rw'ubushomeri rw'igihugu: $22,025/umwaka ku muntu umwe cyangwa $45,540 ku muryango w'abantu bane muri 2026. Medicaid yo kwitabwaho igihe kirekire ikoresha urwego rwo hejuru rw'imyanya rwa $2,982/ukwezi ku basaba umwe. Intara zidazamuye zifite imibereho ikomeye, akenshi kugeza kuri 17-50% FPL ku babyeyi.

Nshobora kubona Medicaid niba nkorera?

Yego. Abakuru benshi bakora bagira uburenganzira muri leta zizamuye kuko imipaka y'imyanya (138% FPL) iri hejuru cyane ku rwego rwo hasi rw'umushahara w'igihugu. Umuntu umwe wahawe kugeza kuri $22,025/umwaka aba yemewe. Zimwe mu ntara zifite imipaka iri hejuru. Ibisabwa byo gukora muri 2026 muri Nebraska na Montana byibanda gusa ku bakuru bemerewe hashingiye ku myanya, atari abasaba bashya.

Bisabwa kuba ndi umunyamuryango wa Amerika kugira ngo ngire uburenganzira bwo kwinjira muri Medicaid?

Bisabwa kuba uri umunyamuryango wa Amerika, ufite uruhushya rwa burundu, cyangwa ufite uburenganzira bw'umwimukira. Abimukira benshi bemewe bagomba gutegereza imyaka 5 nyuma yo kwinjira mbere yo kugira uburenganzira bwo kwinjira muri Medicaid, nubwo abagore batwite, abana, n'impunzi badasabwa gutegereza. Zimwe mu ntara (NY, CA, IL, OR) zihabwa ubwishingizi bushowerwa na leta ku bimukira uko byamera kose.

Bimara igihe kingana iki kugira ngo byemezwe muri Medicaid?

Leta nyinshi zikora ubusabe bwa Medicaid ya MAGI mu minsi 30-45. Ubusabe bushingiye ku ubumuga bushobora gufata iminsi 90. Abagore batwite akenshi bagira uburenganzira bwo kwemeza vuba mu minsi mike. Niba byemerewe, ubwishingizi bwawe busanzwe butangira ku munsi wa mbere w'ukwezi wagisabye (cyangwa ukwezi kwabanjirije, bitewe n'amategeko y'ubwishingizi bwa mbere mu ntara yawe).

Medicaid ifite imyanya?

Medicaid ya MAGI (abakuru benshi, abana, n'abagore batwite) ntifite imyanya. Medicaid itari yo MAGI (abasaza, abafite ubumuga, kwitabwaho igihe kirekire) irimo imyanya, akenshi $2,000 ku basaba umwe. Inzu yawe nyamukuru (kugeza kuri $1,071,000 mu byemezo byinshi), imodoka imwe, ibikoresho byo mu rugo, n'ibishyinguro bikunze kwirinda mu myanya.

Nshobora kugira Medicaid na Medicare icyarimwe?

Yego. Niba ugira uburenganzira ku byombi, uri "dubble eligible". Medicaid irimo ibyo Medicare idarimo (ibiciro, kishyuzwa, ibigirwa, kwitabwaho igihe kirekire). Abafite uburenganzira bubiri bakunze kugira uburenganzira bwo kwishyurwa kwa Medicare n' impano za Medicare zikigenerwa. Kubindi bijyanye n'iki gihurizo, reba inyigisho yacu Medicare na Medicaid.

Ibisobanuro bya nyuma

Uburyo bwo kugirirwa uburenganzira muri Medicaid mu 2026 biterwa cyane n'aho utuye. Mu ntara 40 zizamuye hamwe na DC, abakuru bagira uburenganzira bafite imyanya iri munsi cyangwa ingana na 138% FPL ($22,025/umwaka ku muntu umwe, $45,540 ku muryango w'abantu bane). Mu ntara 10 zidazamuye (AL, FL, GA, KS, MS, SC, TN, TX, WI, WY), uburenganzira burushijeho kuba bukomeye, akenshi bisaba kuba umubyeyi cyangwa ufite ubumuga. Nta gihe cyo kwiyandikisha gusa; ushobora gusaba igihe cyose. Leta nyinshi zikora ubusabe mu minsi 30-45. Ibisabwa byo gukora byo mu byemezo by'ingengo y'imari byo muri 2025 bizatangira mu 2026 muri Nebraska na Montana, ibindi ntara bizagenda biza. Kubijyanye n'inyigisho zose za Medicaid, reba inyigisho zacu Medicaid, Medicaid Illinois, n'inyigisho za Medicare na Medicaid.