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Medicaid

Medicaid is a state and government program that gives health care benefits to certain low-income families.

Am I eligible for Medicaid?

You might be eligible for Medicaid if you:

  • Have income and family size that meet certain requirements (requirements depend on the state you live in)
  • Are pregnant and meet certain income requirements
  • Have a disability
  • Get Supplemental Security Income (SSI)
  • Are in the Breast and Cervical Cancer Prevention and Treatment Program

What you need to know about Medicaid

  • You can apply for Medicaid at any time. There is no enrollment period.
  • Even if you can’t get Medicaid based on income, you should apply. You might qualify for your state’s program, especially if you have children, are pregnant, or have a disability.
  • Some states increased their Medicaid program to cover all adults below a certain income level. Learn more about Medicaid expansion here.
  • All states must supply certain benefits. This list shows what services states must cover and which are optional.
  • Coverage usually starts on the date of application or on the first day of the month of application. Coverage usually stops at the end of the month in which a person is no longer eligible for coverage. Check with your state to find the exact start and end date for coverage for you or your loved one. 
  • Check if your health care provider accepts Medicaid.
  • Even if you make too much for Medicaid, your child or children may still qualify for CHIP.
  • If you have a Marketplace plan and are approved for Medicaid or CHIP, you must cancel your Marketplace coverage. But don’t cancel until you get a final approval for Medicaid and CHIP.
  • If you still want a Marketplace plan after you’re found eligible for Medicaid or CHIP, you’ll have to pay full price for your share of the Marketplace plan without premium tax credits or other cost savings.

How do I apply for Medicaid?

There are two ways you can apply for Medicaid:

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Medicaid
Website: www.medicaid.gov

This official U.S. government website offers state-specific information about this federal program.  Information provided: Medicaid eligibility and how to apply for coverage, program benefits, drug coverage, and state resources.

State Health Care Marketplaces – US Department of Health and Human Services 
Toll-free number: 1-800-318-2596 (also in Spanish)
TTY: 1-855-889-4325
Website: www.healthcare.gov

Provides information on the new insurance law, takes you through the steps of finding insurance, and much more. If you don’t have Internet access, the phone number will connect you with your state’s marketplace.

 

Medicaid. Beneficiary resources. Accessed July 26th, 2023. https://www.medicaid.gov/about-us/beneficiary-resources/index.html.

‌HealthCare.gov. Get started using Medicaid or CHIP coverage. Accessed July 27th, 2023. https://www.healthcare.gov/medicaid-chip/using-medicaid-or-chip-coverage/.

‌Medicaid. Mandatory & optional Medicaid benefits. Accessed July 27th, 2023.  https://www.medicaid.gov/medicaid/benefits/mandatory-optional-medicaid-benefits/index.html.

Medicaid. Medicaid, children’s health insurance program, & basic health program eligibility levels. Accessed July 27th, 2023. https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels/index.html.

 

Last Revised: September 30, 2023

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