US Medical Term · insurance
Eligibility Criteria
Criterios de Elegibilidad
In 9 languages
| Language | Term |
|---|---|
| English | Eligibility Criteria |
| Spanish (Español) | Criterios de Elegibilidad |
| Chinese (中文) | 资格标准 |
| Korean (한국어) | 자격 기준 |
| Vietnamese (Tiếng Việt) | Tiêu chí đủ điều kiện |
| Filipino (Tagalog) | Pamantayan sa Pagiging Karapat-dapat |
| Portuguese (Português) | Critérios de Elegibilidade |
| Thai (ภาษาไทย) | เกณฑ์ความมีสิทธิ์ |
| Japanese (日本語) | 資格基準 |
What it means
Eligibility criteria are the formal rules that define who may enroll in or benefit from a health plan, government program, or clinical trial. They may include age ranges, income limits, residency requirements, diagnostic codes, or prior treatment history. Medicaid eligibility criteria vary by state and typically consider household size, income as a percentage of the federal poverty level, citizenship, and disability status. The ACA Marketplace uses income criteria to determine subsidy amounts. Clinical trials list specific inclusion and exclusion criteria in their protocols. Meeting all criteria does not guarantee enrollment if a plan is at capacity or if the enrollment period has closed. Always verify criteria before completing a lengthy application.
How to say it
Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:
The eligibility criteria for Medicaid in this state include income below 138% of the federal poverty level.
Los criterios de elegibilidad para Medicaid en este estado incluyen ingresos por debajo del 138% del nivel de pobreza federal.
This clinical trial's eligibility criteria exclude patients who have previously received chemotherapy.
Los criterios de elegibilidad de este ensayo clínico excluyen a los pacientes que han recibido quimioterapia previamente.
Meeting all eligibility criteria does not guarantee enrollment if the open enrollment period has already closed.
Cumplir todos los criterios de elegibilidad no garantiza la inscripción si el período de inscripción abierta ya ha cerrado.
Where you'll see it
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Sources
Last reviewed: September 2026