The Audit Techniques Guide for Clergy lumps SocSec, Medicare, and Medicaid into the same category when describing the exemption. And since Medicaid is a part of SocSec, that would lead me to believe it affects the minister's eligibility. However, I could be wrong on that and I can't imagine the minster's decision would automatically affect his/her family. Also, even ministers who have filed Form 4361 cannot exempt themselves entirely. Any non-ministerial income they receive is still subject to SocSec tax and they will be entitled to SocSec benefits upon reaching retirement age. None of this addresses the fundamental question, which is that by filing Form 4361 the minister is saying he/she is opposed to any form of governmental assistance/insurance. It isn't a financial decision - it is supposed to be a decision based on principle and conviction. So if the filing of the exemption is genuine, then the issue of requesting Medicaid assistance should never arise. Interesting question, though.