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Medicaid and CHIP

See if you qualify for free or low-cost coverage.

Medicaid and CHIP cover millions of people who cannot afford private insurance. Rules are set state by state, so start with where you live and who is in your household.

Only your state Medicaid agency can decide whether you qualify. We show you what to check next and which other plans you may be able to use.

A parent and child walking together outdoors

Open all yearMedicaid and CHIP have no Open Enrollment Period. You can apply in any month, and coverage can begin as soon as your state approves you.

Eligibility

How states decide who qualifies.

Most decisions come down to household income, household size, and which category you fall into. Every state runs its own program, so the same income can qualify in one state and not in another.

2026 federal poverty guidelines for the 48 contiguous states and the District of Columbia, next to 138 percent of that amount. In states that expanded Medicaid, adults under 65 generally qualify at or below 138 percent. Alaska and Hawaii use higher guidelines.
People in householdAnnual poverty guideline138 percent of the guideline
1$15,960about $22,025
2$21,640about $29,863
3$27,320about $37,702
4$33,000about $45,540
5$38,680about $53,378
6$44,360about $61,217
Each additional personadd $5,680add about $7,838

These figures are a starting point, not a decision. Children, pregnant people, adults over 65, and people with disabilities are often covered at higher income levels, and states count income in slightly different ways. Current guidelines are published by the U.S. Department of Health and Human Services at aspe.hhs.gov.

Benefits

What Medicaid covers.

Federal rules require every state program to cover a core set of services. Coverage is typically free or close to it, with small copays in some states.

  • Doctor visits and preventive care
  • Inpatient and outpatient hospital care
  • Lab work and X-rays
  • Emergency care
  • Pregnancy, birth, and postpartum care
  • Well-child visits, shots, and screenings for children
  • Family planning services
  • Home health and nursing facility care
  • Transportation to covered medical appointments
  • Behavioral health and substance use treatment

States may also add optional benefits, and most do:

  • Prescription drug coverage
  • Adult dental and vision care
  • Physical, occupational, and speech therapy
  • Hearing aids and other devices
  • Case management and home and community based services

Which optional benefits you get, and whether you owe a small copay, depends on your state and the category you qualify under. Check your state program page below for the current list.

State programs

Find the program that runs where you live.

Medicaid goes by a different name in many states. Choose yours to open the official federal profile for that program, including the agency that runs it and how to apply.

Browse all state programs

State pages open on Medicaid.gov, the official federal Medicaid site. Each one lists the agency that runs the program in that state and how to apply.

You can also start an application at HealthCare.gov, which forwards your information to your state agency if it looks like you or your children may qualify.

Good to know

Medicaid, CHIP, and marketplace plans.

What is the difference between Medicaid and CHIP?
Medicaid covers eligible adults and children. CHIP, the Children’s Health Insurance Program, covers children in families that earn too much for Medicaid but still need low-cost coverage. Both are run by your state within federal rules, and one application is usually screened for both.
How is Medicaid different from a marketplace plan?
Medicaid is a state and federal program with little or no monthly premium for people who qualify. A marketplace plan is private insurance you buy, often with a premium tax credit that lowers the monthly cost. If your income is too high for Medicaid, a marketplace plan is usually the next place to look.
What if my state did not expand Medicaid?
Not every state covers adults up to 138 percent of the federal poverty guideline. In states that did not expand, adults generally qualify only in specific categories such as pregnancy, disability, or caring for a dependent child, and the income limits are lower. Your state agency page lists the rules that apply where you live.
When can I apply for Medicaid?
Any time. Medicaid and CHIP do not have an annual Open Enrollment Period, so you can apply in any month, and coverage can start as soon as your state approves your application.
Does it cost anything to apply?
No. Applying through your state Medicaid agency or through HealthCare.gov is free, and help from a licensed agent costs you nothing either.
Can I keep other coverage if I qualify for Medicaid?
Sometimes. You cannot get a premium tax credit for a marketplace plan during a month you are enrolled in Medicaid. Some people who qualify for Medicaid also keep separate dental, vision, or supplemental coverage. Ask your state agency how the programs work together in your case.
Browse all insurance FAQs

If you do not qualify

There is still a path to affordable coverage.

Many households land just above the Medicaid line. If that is you, a marketplace plan with a premium tax credit is usually the next step, and the credit is based on the same household income you entered here.
See marketplace plansPlans for individuals and familiesTalk to someone
  • Marketplace plans with income-based premium tax credits
  • Coverage for children through CHIP at higher income limits
  • Dental and vision plans you can buy on their own
  • A licensed agent who can compare the options with you

Above the Medicaid limit

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