Do I qualify for Medicaid?
You may qualify for free or low-cost care through Medicaid based on income and family size. Some states have expanded Medicaid to cover more people.
If you have Medicaid coverage, you’re considered covered under the health care law and don’t have to buy a Marketplace plan.
Medicaid coverage and expansion
In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults below a certain income level.
- First, find out if your state is expanding Medicaid and learn what that means for you.
- If your state is expanding Medicaid, use this chart to see what you may qualify for based on your income and family size.
Medicaid programs must follow federal guidelines, but they vary somewhat from state to state. Coverage and costs to you may be different from state to state. Some Medicaid programs pay for your care directly. Others use private insurance companies to provide Medicaid coverage.
Some state Medicaid programs have names that don’t say “Medicaid.” For instance, in Oklahoma it’s called SoonerCare. In Minnesota it’s called Minnesota Care.
Medicaid and the Children’s Health Insurance Program (CHIP)
In many cases, if you qualify for Medicaid your children will qualify for either Medicaid or CHIP. CHIP may also provide coverage for children whose parents make too much money to qualify for Medicaid. Learn more about CHIP.
Find out if you’re eligible for Medicaid
Even if you were told you didn't qualify for Medicaid in the past, you may qualify under the new rules. You can see if you qualify for Medicaid 2 ways:
Visit your state's Medicaid website. Use the menu at the bottom of this page to pick your state and you'll be sent to the right page. You can apply right now and find out if you qualify. If you qualify, coverage can begin immediately.
Fill out an application in the Health Insurance Marketplace. When you finish the application, we'll tell you which programs you and your family qualify for. If it looks like anyone is eligible for Medicaid and/or CHIP, we'll let the state agency know so you can enroll.
Get State Information
More answers on Medicaid
What if I'm eligible for Medicaid, but would rather buy a plan in the Marketplace?
If you're eligible for Medicaid, you don't need to buy a plan in the Health Insurance Marketplace. A Marketplace plan will be more expensive than Medicaid and usually won't give you additional coverage or benefits. You wouldn't be eligible for any savings on Marketplace insurance and would have to pay the whole cost.
Is Medicaid expanding in all states?
No. Some states are expanding their Medicaid programs to cover all adults with incomes under 133% of the federal poverty level. Other states aren't expanding Medicaid coverage. Learn whether you state is expanding Medicaid and what this means for you.
If I can’t get Medicaid, could my children qualify for Medicaid or CHIP?
Many states have separate Children’s Health Insurance Programs (CHIP), which provide health benefits for children who don't qualify for Medicaid. (Some children will qualify for Medicaid.) In some states, parents and pregnant women qualify for CHIP coverage too.
When you fill out an application for the Marketplace, we'll tell you which programs you and your family qualify for. If it looks like anyone is eligible for CHIP, we'll let the CHIP agency know so that your coverage can start right away.
If I can’t get Medicaid, can I buy Marketplace insurance?
Generally yes, as long as you qualify to use the Marketplace. Most uninsured people whose incomes are too high for Medicaid can get lower costs on private health insurance through the Marketplace. Getting lower costs depends on your family's income and household size.
But if you live in a state that isn't expanding Medicaid, have income less than 100% of the federal poverty level, and don't qualify for Medicaid under your state's current rules, you can't get lower costs on private health insurance through the Marketplace. Learn more about Medicaid expansion and what this means for you.
What if I have Medicaid now, but I only have limited benefits?
If your Medicaid coverage pays only for family planning, emergency Medicaid, tuberculosis services, or outpatient hospital services, you can apply for coverage through the Health Insurance Marketplace. You could get this coverage in addition to your Medicaid coverage. Depending on your household size and income, you may qualify for lower costs on your monthly premiums and out-of-pocket costs. Note: When you fill out a Marketplace application and are asked whether you have coverage now, don’t check the box saying you have Medicaid. Check “None of the above” instead.