Do I qualify for Medicaid?

Published on August 31, 2017

Medicaid provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Many states have expanded their Medicaid programs to cover all people below certain income levels. Medicaid qualifications depend partly on whether your state has expanded its program.

Who can get Medicaid?

• No matter your state, you may qualify for Medicaid based on your income, household size, disability, family status, and other factors. But if your state has expanded Medicaid coverage, you can qualify based on your income alone.
• Enter your household size and state. We'll tell you who is eligible for Medicaid, if your state expanded and if you qualify for Medicaid based only on your income.
• If you think you have Medicaid eligibility, you can create an account and fill out a Marketplace application. If it looks like anyone in your household qualifies for Medicaid or CHIP, we'll send your information to your state agency. They'll contact you about enrollment. You can apply any time of year.
• If you don't qualify for Medicaid, we'll tell you if you qualify for financial help to buy a Marketplace health plan instead. (But unless you qualify to enroll with a
  Special Enrollment Period

  A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

  , you'll have to wait until the next Open Enrollment Period.)

What if I’m turned down by Medicaid?

• You may be able to buy a private health plan through the Marketplace instead for the 2018 plan year in the fall. You may qualify for savings based on your income through a premium tax credit and savings on out-of-pocket costs.
• If you don't qualify for either Marketplace or Medicaid savings, you still have options. Learn more here.