Medicaid & CHIP

Medicaid and the Children’s Health Insurance Program (CHIP) provide free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities.

Enter your household size and state, and we'll tell you if you may 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 and CHIP any time of year.

Apply for Medicaid and CHIP 2 ways

1. Fill out an application through the 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 cost savings on a Marketplace plan. Plans may be more affordable than you think.

2. Or, apply directly through your state Medicaid agency

Medicaid & CHIP basics

Medicaid basics

• In all states, Medicaid provides coverage for some low-income people, families and children, pregnant people, the elderly, and people with disabilities.
• Some states expanded their Medicaid program to cover all adults below a certain income level. Learn more about Medicaid expansion 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.
• Medicaid may be able to help you pay for medical care from the last 3 months, even if you weren’t enrolled in Medicaid at the time you got medical care. Payment depends on your family’s income at the time.

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 people.
• Each state works closely with its state Medicaid program.
• In many cases, if you qualify for savings on a Marketplace plan, your children will qualify for either Medicaid or CHIP.
• Learn more about CHIP.

More answers: Medicaid & CHIP

What services does Medicaid cover?

Medicaid benefits are different in each state. But all states provide comprehensive coverage. Get a list of services Medicaid offers in all states.

What’s the income level to qualify for Medicaid?

If your state has not expanded Medicaid: You may qualify based on your state’s existing rules. Rules 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 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. Check if you’ll qualify for savings.

What if I'm eligible for Medicaid, but want to get Marketplace coverage instead?

A Marketplace health 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 a Marketplace plan. You’d have to pay full price for a plan.

What if I have Medicaid now, but I have only limited benefits?

• Family planning
• Treatment of an emergency medical condition
• Tuberculosis services

If you have limited Medicaid coverage, you can fill out an application through the Marketplace and find out if you qualify for full-benefit coverage through either Medicaid or a Marketplace insurance plan with savings based on your income.

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

For former foster children who turned 18 on or after January 1, 2023, states must offer the same Medicaid coverage to individuals regardless of the state in which they aged out of foster care. Some states also cover former foster children who turned 18 before January 1, 2023, from other states. 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 get Marketplace coverage instead. You may qualify for a premium tax credit or other cost savings for a Marketplace plan. Four in five customers are able to find health coverage for $10 or less a month.

• If your state agency said someone in your household isn’t eligible, you’ll get a notice explaining this.
• In most cases, the state will securely send your information to the Marketplace. We'll send you a letter about applying for Marketplace coverage. You can apply for Marketplace coverage by logging into your Marketplace account. Your application will be pre-filled with information you gave the state agency.

• 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.
• Learn about your options if you’re in this situation.