If you have a disability, don’t qualify for disability benefits, and need health coverage, you have options in the Health Insurance Marketplace.

Applying for coverage through the Marketplace

When you fill out a Marketplace health coverage application, you’ll find out if you qualify for a private health plan with premium tax credits and other savings based on your income. You’ll also find out if you qualify for Medicaid coverage.

When you fill out your application, you may be asked if you:

  • Have a physical disability or mental health condition that limits your ability to work, attend school, or take care of your daily needs
  • Get help with daily living acctivities through personal assistance, a medical facility, or nursing home

If you answer “yes” to any of these questions, we’ll send your Marketplace application to your state Medicaid office to see if you qualify for Medicaid based on a disability.

If we send your application to your state Medicaid office, they may contact you for more information about your disability.

Important: Insurers offering coverage through the Marketplace can’t deny coverage or charge you more based on your answers to these disability questions. Private insurance plans in the Marketplace and all Medicaid programs cover all pre-existing health conditions from the first day your coverage takes effect.

You can also apply for Medicaid coverage directly to your state agency. Select your state from the menu on this Medicaid page for contact information.

If you don’t qualify for Medicaid based on your disability

If you don’t qualify for Medicaid based on your disability, you have 2 more options for health coverage through the Marketplace:

  • You may qualify for Medicaid based only on your income. Some states have expanded their Medicaid programs to cover all adults who make less than a certain income level. Find out if your state is expanding Medicaid and what this means for you.
  • You may qualify to enroll in a health plan through the Health Insurance Marketplace with premium tax credits and other savings that make coverage more affordable. This will depend on your household size and income.

The fee for not having coverage

Under the health care law, most people must have health coverage, pay a fee, or get an exemption from the fee. This applies regardless of disability status.

If you don’t have coverage through Medicare, Medicaid, another public program, a job, the Marketplace, or another source, you may have to pay the fee. Learn what kinds of insurance count as coverage under the health care law.

Some people can get an exemption from the fee based on low income, hardship, or other factors. Learn about exemptions from the fee.