Guam Application for Presumptive Eligibility for Medicaid
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FAQ
Medicaid and the State Children's Health Insurance Program (CHIP) operate in the five U.S. territories? American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI).
Federal rules for Medicaid benefits generally apply to Guam, and its Medicaid program provides all mandatory and many optional benefits, including dental coverage and prescription drugs. Guam is the only territory that covers all mandatory benefits, including nursing facility services.
Medicaid and Medicare programs are available on Guam. There is also a locally funded Medically Indigent Program (MIP) designed to pay for low-income families' medical expenses without other health insurance. Those who don't qualify for assistance may opt for private insurance.
Travel within the U.S. If you have Original Medicare, you have coverage anywhere in the U.S. and its territories. This includes all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.
This is $1,536 per month for a family of four or approximately 61 percent of the federal poverty level, which is $2,500 per month for a family of four in 2021 (ASPE 2021). Guam has expanded Medicaid eligibility to the new adult group under the Patient Protection and Affordable Care Act (ACA, P.L.
The MIP is a 100% locally-funded program established by Public Law (P.L.) 17-83 in December 1984 to provide hospital access and medical services to those who lack sufficient income and cannot afford to pay for health care. The program is intended as the last resort for those in need.
Guam provides Medicare cost-sharing assistance to dually eligible individuals who are eligible for full Medicaid benefits.
