Medicaid & CHIP coverage

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

Medicaid basics

• In all states, Medicaid provides coverage for low-income people, including families and children, pregnant women, the elderly, and people with disabilities.
• Some states expanded their Medicaid program to cover adults below a certain income level. Learn more about Medicaid expansion and what it means for you.
• Medicaid programs must follow federal guidelines, but eligible income levels, 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.
• Medicaid benefits are different in each state, but all states provide comprehensive coverage. Get a list of services Medicaid offers in all states.

CHIP basics

• In certain states, CHIP provides low-cost health coverage to children and pregnant women in families that earn too much money to qualify for Medicaid. Learn more about what CHIP covers.
• 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.

Even if you don't qualify for 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. You can apply for Medicaid and CHIP any time of year.

Some states have expanded their Medicaid programs to cover all people with household incomes below a certain level. Others haven't.

Even if your state hasn't expanded Medicaid, you should fill out an application. Each state has coverage options that consider income, household size, family status (like pregnancy or caring for young children), disability, age, and other factors. 

Apply for Medicaid and CHIP one of these ways:

Fill out an application through the Marketplace

• If it looks like anyone in your household qualifies for Medicaid or CHIP, we’ll securely send your information to your state agency. Your state will 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.
• If you’re denied Medicaid or CHIP coverage, your state securely sends your contact information to the Marketplace. We’ll use it to mail you a letter about getting Marketplace coverage.

Create an account to start a Marketplace application.

Apply directly through your state Medicaid agency

Select your state below to get your Medicaid agency’s contact information.

More answers: Medicaid & CHIP

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 might qualify for savings.

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

If you qualify for Medicaid, you aren't eligible for savings on a Marketplace plan.

If you already have Marketplace coverage, end it when your Medicaid starts. 

If you want to keep both, tell your state agency. Consider these things first:

• You may no longer qualify for CHIP if you keep your Marketplace plan.
• If you have qualifying health coverage through Medicaid or CHIP coverage, you’ll pay full price for your Marketplace plan premium and covered services.
• If you have limited benefits through Medicaid, you may qualify for lower costs on your Marketplace plan based on your income and other factors. 

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

Some limited types of Medicaid coverage pay only for:

• 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 plan with savings based on your income.

What rules apply to former foster care children and Medicaid?

All states must offer young people transitioning from foster care to independent adulthood (former foster care children) 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 had 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 care 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 care children from other states who turned 18 before January 1, 2023. 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 5 people can find health coverage for $10 or less a month.

If your state Medicaid or CHIP agency said you’re not eligible

• If you're not eligible, you'll get a letter from your state.
• In most cases, your state will securely send your information to the Marketplace. We'll send you a letter about applying for Marketplace coverage. We may also follow up with you by phone, text, or email, if you gave that contact information to your state. But, you don't need to wait for us to contact you to apply and enroll in Marketplace coverage.

If your state hasn't expanded Medicaid coverage

• If your state hasn’t expanded Medicaid and you’re not eligible, you may have fewer options for coverage. Depending on your income you might not qualify for savings on a private insurance plan.
• Learn about your options if you’re in this situation.