Medicaid and the Children’s Health Insurance Program (CHIP) provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
Some states have expanded their Medicaid programs to cover all people below certain income levels.
See if you qualify for Medicaid based on income alone
Find out if you qualify for Medicaid based on your income. Enter your household size and state in our savings tool, and we'll tell you if you qualify for Medicaid or savings on a Marketplace plan.
Even if you don't qualify for Medicaid based on income, you should apply. You may qualify for your state's program, especially if you have children, are pregnant, or have a disability. You can apply for Medicaid any time of year — Medicaid and CHIP do not have Open Enrollment Periods.
Fill out an application through the Health Insurance Marketplace.
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.
When you submit your Marketplace application, you’ll also find out if you qualify for an individual insurance plan with savings based on your income instead. Plans may be more affordable than you think.
If I have Medicaid or CHIP, am I considered “covered” by the health care law?
Yes. If you have Medicaid or CHIP you don’t have to buy a Marketplace insurance plan. You don’t have to pay the fee that people without health coverage must pay. (Certain limited coverage Medicaid plans, like those that cover only family planning or outpatient hospital services, don’t qualify as coverage under the health care law.) Learn more about limited-coverage Medicaid programs.
If your state has expanded Medicaid: You can qualify based on income alone. See if you’ll qualify.
If your state has not expanded Medicaid: You may qualify based on your state’s existing rules. These vary from state to state and may take into account income, household size, family status (like pregnancy or caring for young children), disability, age, and other factors. Because each state and each family situation is different, there’s no way to find out if you qualify without filling out an application.
If my income’s too high for Medicaid, can I buy insurance through the Health Insurance Marketplace?
What if I'm eligible for Medicaid, but want to buy an insurance plan in the Marketplace instead?
A Marketplace insurance plan would cost more than Medicaid and usually wouldn’t offer more coverage or benefits. If you qualify for Medicaid, you aren’t eligible for savings on Marketplace insurance. You’d have to pay full price for a plan.
What if I have Medicaid now, but I have only limited benefits?
Some limited types of Medicaid coverage pay only for:
Outpatient hospital services
If you have limited Medicaid coverage, you can fill out an application through the Health Insurance Marketplace and find out if you qualify for comprehensive coverage through either Medicaid or a Marketplace insurance plan with savings based on your income.
Important: If you have limited Medicaid coverage, when you fill out a Marketplace application and are asked if you have coverage now, don’t check the box saying you have Medicaid. Check “None of the above” instead.
What rules apply to former foster children and Medicaid?
All states must offer former foster children uninterrupted Medicaid coverage until they turn 26, as long as at least one of the following is true:
They were in the foster care system and received Medicaid benefits on their 18th birthday
They aged out of the foster care system with Medicaid coverage after they were 18 or older
These rules apply after January 1, 2014.
Note: If the foster child moves to a new state, the new state’s Medicaid agency may not provide coverage. Check with your state Medicaid agency to learn more.
What if I’ve been turned down for Medicaid or CHIP coverage?
You may be able to buy a private health plan through the Marketplace instead. You may qualify for savings based on your income through a premium tax credit and savings on out-of-pocket costs. Many people can find plans for $75 or less per month.
If your state Medicaid or CHIP agency said you’re not eligible
If your state agency decides someone in your household isn’t eligible, you’ll get a notice explaining this.
In most cases, the state will send your information to the Marketplace. The Marketplace will send you a notice explaining how to submit an application for a private insurance plan. The application will be pre-filled with information you gave the state agency.
If your state hasn't expanded Medicaid coverage
If your state hasn’t expanded Medicaid and your state agency said you’re not eligible under its current rules, you may have fewer options for coverage. Depending on your income you may not qualify for savings on a private insurance plan.