Find Out if You’re Eligible for Medicaid

Most Americans at or near the poverty line qualify for Medicaid. However, some states restrict eligibility to individuals who both meet certain income requirements and are pregnant women, have families with children, are senior citizens age 65 and older, or have certain disabilities.

You must also be a U.S. citizen or a permanent resident who has lived in America for at least five years to access Medicaid benefits in most cases.

Medicaid income limits

In most of America, an individual earning $20,120 or less per year or a family of four with an annual income of $41,400 or lower is eligible to enroll in Medicaid. Both Hawaii and Alaska have separate earning limits to account for the higher cost of living in those areas.

Medicaid eligibility income chart 2023

Medicaid uses the federal poverty level (FPL) as a baseline to determine eligibility. The Affordable Care Act gave states the option to expand coverage to anyone earning up to 138% of the FPL. Forty states and Washington, D.C., have taken that option.

In the following 10 states, you can only qualify for Medicaid if you meet certain income eligibility criteria and you are a pregnant woman, a person with a disability, a family with children or 65 years or older:

Who else is eligible for Medicaid?

In all 50 states, Medicaid provides coverage for eligible low-income families with school-age children, people with disabilities, pregnant women and senior citizens age 65 and up.

Families with children

Families with children who have lower incomes qualify for Medicaid. Coverage typically ends after the child turns 18, although in some cases it may extend up to age 21.

Children in foster care at the age of 18 can get free Medicaid coverage until they turn 26.

Many of the services provided by Medicaid are targeted toward children and adolescents. All states have to provide:

Families who fail to meet the income standards for Medicaid may qualify for the Children’s Health Insurance Program (CHIP). The two programs are functionally similar. However, families with incomes up to four times the federal poverty level can qualify for CHIP. For example, a family of four living anywhere in the U.S. but Hawaii and Alaska can qualify for CHIP with an income of $120,000 or less.

Pregnant women

Pregnant women who fall in a low income bracket qualify for Medicaid. However, income limits vary by state. For example, the cutoff point in Iowa is nearly three times as high as the threshold for Idaho.

The Children's Health Insurance Program (CHIP) also extends coverage to some pregnant women whose earnings exceed the Medicaid limits.

Covered services include:

Medicaid coverage extends for at least two months after you give birth. Twenty-six states and Washington, D.C., offer extended postpartum coverage that lasts for 12 months.

After Medicaid coverage ends, you can sign up for private health insurance through HealthCare.gov or your state’s health insurance exchange. You do not have to wait for open enrollment because you will have what's called a special enrollment period that lasts for 60 days from the end of your Medicaid coverage.

Individuals with qualifying disabilities

Medicaid provides coverage for many disabilities including various physical conditions, developmental disabilities, behavioral disorders and mental illnesses. Check with your state Medicaid department for a full list.

In many states, if you qualify for disability payments paid out through the Social Security Administration, you will also qualify for Medicaid.

Seniors age 65 and up

Medicaid is available to individuals age 65 and over who also meet certain income requirements. If you qualify for Supplemental Security Income (SSI), a Social Security program, then you’re automatically eligible to enroll in Medicaid.

Unlike Medicaid, Medicare is open to all senior citizens aged 65 and up regardless of their financial circumstances. Medicare provides affordable insurance to the elderly. However, you will still be responsible for a portion of the costs.

You can qualify for both Medicaid and Medicare. Dual eligibility entitles you to coverage from both sources. In such cases, Medicaid acts as a second form of insurance that kicks in when Medicare falls short. Medicaid may also cover your Medicare copayments and coinsurance.

How to apply for Medicaid

You can apply for Medicaid directly through HealthCare.gov or through your state’s Medicaid program website. Many states have unique names for their Medicaid and CHIP programs. For example, in California Medicaid is called Medi-Cal.

Complete the following steps to get started:

Medicaid does not have an open enrollment period. You can apply for the program at any point during the year.

Frequently asked questions

Sources

Information about Medicaid eligibility is based on the Medicaid website for Medicaid eligibility requirements. Additional sources include the Centers for Medicare & Medicaid Services (CMS) for information about dual Medicare and Medicaid requirements.