Do I qualify for Medicaid?
You qualify for Medicaid based on income and family size. If you're eligible, you get free or low-cost care and don't need to buy a Marketplace plan.
Medicaid basics
Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Medicaid programs must follow federal guidelines, but they vary somewhat from state to state.
You may qualify for Medicaid - now or in 2014
The rules for Medicaid eligibility are different for each state. Most states offer coverage for adults with children below a certain income level, as well as pregnant women, some seniors, and people with disabilities.
Under the health care law, Medicaid eligibility is expanding in many states. More people than ever will qualify for Medicaid starting in 2014.
Even if you were told you didn't qualify for Medicaid in the past, you may qualify under the new rules.
To see if you qualify for Medicaid, do one of these:
- Visit your state's Medicaid website. Use the menu at the bottom of this page to select your state and you'll be sent to the right page. You can apply right now and find out if you qualify.
But if you're not eligible now, you may qualify in 2014, when new rules take effect in many states. If you submit an application, the state will check the new rules when you apply.
- Fill out an application for the Health Insurance Marketplace. When you finish this application, we'll tell you which programs you and your family qualify for. If it looks like anyone is eligible for Medicaid, we'll let the Medicaid agency know so your coverage can start in 2014.
Get State Information
More answers on Medicaid
What if I'm eligible for Medicaid, but would rather buy a plan in the Marketplace?
If you're eligible for Medicaid, you don't need to buy a plan in the Health Insurance Marketplace. A Marketplace plan will be more expensive than Medicaid and usually won't give you additional coverage or benefits. You wouldn't be eligible for any savings on Marketplace insurance and would have to pay the whole cost.
If I can’t get Medicaid, could my children qualify for Medicaid or CHIP?
Many states have separate Children’s Health Insurance Programs (CHIP), which provide health benefits for children who don't qualify for Medicaid. (Some children will qualify for Medicaid.) In some states, parents and pregnant women qualify for CHIP coverage too.
When you fill out an application for the Marketplace, we'll tell you which programs you and your family qualify for. If it looks like anyone is eligible for CHIP, we'll let the CHIP agency know so that your coverage can start right away.
If I can’t get Medicaid, can I buy Marketplace insurance?
Yes, as long as you qualify for a Marketplace health plan. Most uninsured people who aren't eligible for Medicaid can get help with health care costs from the Marketplace, depending on the family's income and if the people who need coverage already have it through a job.
What if I have Medicaid now, but I only have limited benefits?
If your Medicaid coverage pays only for family planning, emergency Medicaid, tuberculosis services, or outpatient hospital services, you can apply for coverage through the Health Insurance Marketplace. You could get this coverage in addition to your Medicaid coverage. Depending on your household size and income, you may qualify for lower costs on your monthly premiums and out-of-pocket costs. Note: When you fill out a Marketplace application and are asked whether you have coverage now, don’t check the box saying you have Medicaid. Check “None of the above” instead.