Medicaid & CHIP

Medicaid & CHIP coverage

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.

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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.

Note: Medicaid & CHIP program names vary. Learn what they’re called in your state.

Apply for Medicaid and CHIP 2 ways

1. Through the Health Insurance Marketplace®

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.

Create an account to start a Marketplace application.

2. Through your state Medicaid agency

You can also apply directly to your state Medicaid agency. Select your state below for your Medicaid agency’s contact information.

Medicaid & CHIP basics

Medicaid basics

In all states, Medicaid provides coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
In some states, Medicaid has been expanded to cover all adults below a certain income level. Learn more about Medicaid expansion in your state and what it means for you.
Medicaid programs must follow federal guidelines, but coverage and costs may be different from state to state.
Some Medicaid programs pay for your care directly. Others use private insurance companies to provide Medicaid coverage.

Children’s Health Insurance Program (CHIP) basics

In all states, CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP covers pregnant women.
Each state works closely with its state Medicaid program.
In many cases, if you qualify for Medicaid your children will qualify for either Medicaid or CHIP.
Learn more about CHIP.

More answers: Medicaid & CHIP

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.

What services does Medicaid cover?: Medicaid benefits are different in each state. But all states provide comprehensive coverage. See what services Medicaid offers in all states.

What’s the income level to qualify for Medicaid?: It depends on the state you live in.; 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®?: Generally yes, as long as you qualify to use the Marketplace. Most people whose incomes are just above the level to qualify for Medicaid can pay very low premiums and out-of-pocket costs for private health insurance through the Marketplace. Find out if you’ll qualify for savings.

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:

Family planning
Emergency Medicaid
Tuberculosis services
Outpatient hospital services
Coronavirus disease 2019 (COVID-19) testing

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