◢ Healthcare program · Verified August 6, 2026
Medicaid
Free or low-cost health coverage for eligible low-income Americans, funded jointly by federal government and states.
Coverage type
Free or low-cost
Medicaid pays for all federally-mandatory services: hospital, doctor, lab, X-ray, home health, and nursing home care for adults, plus comprehensive Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) coverage for children under 21. Most enrollees pay $0 in premiums and small ($0-$8) copays. Federal law bars copays for children, pregnant people, and emergency care. All states also cover prescription drugs, and most cover dental, vision, hearing aids, and home- and community-based services, though those are technically optional under federal law.
Reach
66.7 million people enrolled in Medicaid as of April 2026 (Medicaid.gov April 2026 Enrollment Report). Includes about 2 in 5 U.S. children, 1 in 6 non-elderly adults, and 2 in 5 non-elderly adults with disabilities (CBPP, updated November 2025). About 12 million dual-eligible seniors and people with disabilities are enrolled in both Medicaid and Medicare (CMS, June 2025).
Federal program data
Time to apply
45 days (90 days if a disability determination is required)
Free · no application fee
◢ Medicaid at a glance
- Program: Medicaid
- Administered by: Centers for Medicare & Medicaid Services (CMS)
- Coverage type: Free or low-cost
- Cost to apply: Free
- Application time: 45 days (90 days if a disability determination is required)
- Who it serves: 66.7 million people enrolled in Medicaid as of April 2026 (Medicaid.gov April 2026 Enrollment Report). Includes about 2 in 5 U.S. children, 1 in 6 non-elderly adults, and 2 in 5 non-elderly adults with disabilities (CBPP, updated November 2025). About 12 million dual-eligible seniors and people with disabilities are enrolled in both Medicaid and Medicare (CMS, June 2025).
- Where to apply: Through the official Centers for Medicare & Medicaid Services (CMS) portal or your state's administering office.
◢ What this program does
Medicaid is the largest public health insurance program in the United States, covering about 66.7 million people as of April 2026 (Medicaid.gov April 2026 Enrollment Report).
It pays for doctor visits, hospital stays, prescriptions, mental health care, long-term care, and preventive services. Eligible groups include low-income adults, children, pregnant women, seniors, and people with disabilities.
Created in 1965, Medicaid is a joint federal-state program. Every state runs its own program under federal rules, so the exact income limits, covered benefits, and application process depend on where you live.
The federal government pays 50 to 77 percent of most Medicaid costs (60 percent on average in FY 2026) and 90 percent of costs for adults covered under the ACA's Medicaid expansion group (CBPP Policy Basics, updated November 2025).
As of May 2026, 41 states plus DC have adopted the ACA Medicaid expansion, extending coverage to nearly all adults under 138 percent of the federal poverty level.
Ten states have not expanded: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming (KFF, updated May 2026). In non-expansion states, adults without children generally cannot qualify no matter how low their income.
The 2025 budget reconciliation law (H.R. 1, signed July 4, 2025) adds work requirements for Medicaid expansion adults starting January 2027.
The Congressional Budget Office projects 5.3 million people will lose Medicaid coverage by 2034 because of these requirements. CBPP estimates 9.9 to 14.9 million people will be at risk of losing coverage even if they meet the work requirement, because of the paperwork burden.
◢ Who qualifies
Who qualifies for Medicaid?
- In the 41 states plus DC that have expanded Medicaid: adults with income under 138% of the Federal Poverty Level ($21,597/year for an individual, $36,777/year for a family of 3 in 2025)
- In the 10 non-expansion states (AL, FL, GA, KS, MS, SC, TN, TX, WI, WY): adults without children generally cannot qualify no matter how low their income; parents often need to earn less than 34% FPL ($9,061 for a family of 3 in 2025) to qualify
- Children through age 18: mandatory coverage up to 138% FPL, and most states cover children to higher income levels (check your state)
- Pregnant women: mandatory coverage up to 138% FPL, and many states extend to 200% FPL or higher
- Adults 65+ or with disabilities: usually eligible if receiving SSI (Supplemental Security Income). Some states use more restrictive '209(b)' eligibility rules
- US citizens or 'qualified' non-citizens (green-card holders generally wait 5 years unless they are children or pregnant)
- State residency required, must apply in the state where you live
A note on eligibility: Final eligibility is determined by the agency administering this program, not by GrantsHubUSA. Confirm current rules with Centers for Medicare & Medicaid Services (CMS) or your state's office before applying.
◢ How to apply
How do you apply for Medicaid?
- 1
Check your state's income limit
Income limits vary by state and by category (child, pregnant, parent, adult, senior). Visit your state Medicaid agency's website, or use the free healthcare.gov screener at healthcare.gov/screener.
- 2
Gather documents
Proof of income (recent paystubs, last year's tax return), Social Security number, proof of US citizenship or qualifying immigration status, proof of state residency (utility bill, lease), and information about any current health insurance.
- 3
Apply through your state Medicaid agency
Every state has an online application portal on its state Medicaid website. You can also apply in person at a local Medicaid office, by mail, or by phone. Find your state office at medicaid.gov/about-us/beneficiary-resources.
- 4
Or apply through healthcare.gov
In expansion states, you can also apply for Medicaid through the federal marketplace at healthcare.gov or by calling 1-800-318-2596. The single application screens you for Medicaid, CHIP, and marketplace subsidies all at once.
- 5
Wait for the eligibility decision
States must decide within 45 days for MAGI-based Medicaid, or 90 days if the application requires a disability determination. If approved, coverage is effective the month you applied and can be backdated up to 3 months earlier if you would have qualified then.
- 6
Enroll in a managed care plan (in most states)
About 75 percent of Medicaid enrollees are in a managed care plan (CMS, 2022). Once you are approved, your state usually gives you 30 to 60 days to pick a plan. If you do not choose, the state auto-assigns one.
Apply through the official agency
Centers for Medicare & Medicaid Services (CMS)
◢ Benefit amounts
How much Medicaid can you actually get?
The typical Medicaid benefit is Free or low-cost, per the Centers for Medicare & Medicaid Services (CMS). Medicaid pays for all federally-mandatory services: hospital, doctor, lab, X-ray, home health, and nursing home care for adults, plus comprehensive Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) coverage for children under 21. Most enrollees pay $0 in premiums and small ($0-$8) copays. Federal law bars copays for children, pregnant people, and emergency care. All states also cover prescription drugs, and most cover dental, vision, hearing aids, and home- and community-based services, though those are technically optional under federal law.
Your actual amount depends on household size, gross monthly income, allowed deductions, and where you live. Most federal assistance programs are administered by state agencies with their own income limits and processing rules.
Who receives Medicaid? 66.7 million people enrolled in Medicaid as of April 2026 (Medicaid.gov April 2026 Enrollment Report). Includes about 2 in 5 U.S. children, 1 in 6 non-elderly adults, and 2 in 5 non-elderly adults with disabilities (CBPP, updated November 2025). About 12 million dual-eligible seniors and people with disabilities are enrolled in both Medicaid and Medicare (CMS, June 2025).. Not every eligible household applies, and participation rates vary by state.
If you have never applied before because you assumed you would not qualify, the practical income limits are often higher than people expect once deductions are factored in. Most working households with children in high-cost states qualify for at least the minimum benefit.
How the amount is calculated. Federal programs use national formulas, but every state adjusts income limits, standard deductions, and household size categories under its own regulations.
The exact dollar amount you receive in Medicaid depends on which state processes your application. For state-specific numbers, check your state's administering agency on the state directory page or visit the official Centers for Medicare & Medicaid Services (CMS) site.
Application timing matters. Most Medicaid decisions take 45 days (90 days if a disability determination is required). Applying at the start of a program cycle or fiscal year usually gets you into the queue before annual funding runs low.
Some programs like LIHEAP have seasonal windows that close mid-year; others like SNAP and Medicaid process year-round with rolling eligibility.
What if your amount seems wrong? Every state provides a written notice explaining the calculation, and every applicant has the right to a fair hearing to challenge a benefit amount or denial.
Bring the notice, your income documents, and any deduction receipts to the hearing. Most challenges succeed when a household proves a deduction was not applied.
◢ Quick facts
- Application time
- 45 days (90 days if a disability determination is required)
- Cost to apply
- Free
- Administering agency
- Centers for Medicare & Medicaid Services (CMS)
- Last verified
- August 6, 2026
◢ Frequently asked
Common Medicaid questions
Medicaid is for people with low income (of any age); Medicare is for people 65+ or with certain long-term disabilities. About 12 million dual-eligible people are enrolled in both programs (CMS, June 2025). Medicaid is jointly funded by the federal government and states, and is administered by each state; Medicare is federally funded and federally administered.
Starting January 2027, adults enrolled through the ACA's Medicaid expansion group must meet work requirements to keep their coverage, under H.R. 1 (signed July 4, 2025). Non-expansion enrollees (children, pregnant women, seniors, disabled adults, some parents) are exempt. Some states may implement work requirements sooner through Section 1115 waivers.
All state Medicaid programs cover a federally-mandatory package: hospital, doctor, lab, X-ray, home health, and nursing home care for adults, plus comprehensive Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) coverage for children under 21. All states also cover prescription drugs. Most cover dental, vision, hearing aids, and home- and community-based services, though these are technically optional under federal law.
Federal law requires states to decide within 45 days for a regular Medicaid application, or 90 days if a disability determination is required. Coverage begins the month you applied, and can be backdated up to 3 months earlier if you would have qualified during those months.
Report income changes within 10 days (rules vary by state). Medicaid does not cut off the moment you cross the income line. You are usually given a chance to switch to marketplace subsidies at healthcare.gov instead. In states with a 'medically needy' program (about 36 states plus DC), you may be able to 'spend down' higher income on medical bills and remain eligible.
◢ Primary sources
Where every claim comes from
Every fact on this page is verifiable against one of the primary sources below. Follow any link to confirm, that's our standing commitment.
- 01Medicaid.gov Eligibility Policy
www.medicaid.gov/medicaid/eligibility-policy/
- 02Medicaid.gov April 2026 Enrollment Report
www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/monthly-medicaid-chip-application-eligibility-determination-and-enrollment-reports-data
- 03CBPP Policy Basics: Introduction to Medicaid (updated November 2025)
www.cbpp.org/research/health/policy-basics-introduction-to-medicaid
- 04KFF: Status of State Medicaid Expansion Decisions (May 2026)
www.kff.org/medicaid/status-of-state-medicaid-expansion-decisions/
- 05HealthCare.gov Medicaid Application
www.healthcare.gov/medicaid-chip/
◢ Related guide
Long-form guide
Read our deep-dive Medicaid guide
Editorial fact-check
This program profile was verified on August 6, 2026.
Every eligibility rule, dollar amount, and deadline on this page was cross-checked against the primary sources listed above before publication, and is reviewed on a rolling schedule as federal and state rules change. Spotted something out of date? Tell us , corrections typically ship within 48 hours.
Not legal, tax, or financial advice. GrantsHubUSA is an independent editorial blog, we're not a government agency and we don't administer this program. Always confirm current eligibility, deadlines, and benefit amounts with the administering agency before applying. See our full disclaimer.
◢ Other programs
More aid you might qualify for
Supplemental Security Income (SSI)
Monthly federal cash payments for disabled, blind, or 65+ Americans with very limited income and resources, funded by general Treasury (not Social Security payroll taxes).
$994 individual / $1,491 couple
Housing Choice Voucher (Section 8)
Federal rental subsidy that pays your landlord directly, covers the gap between 30% of your household income and fair market rent.
Varies
Supplemental Nutrition Assistance Program (SNAP)
Monthly food benefits delivered on an EBT card, the largest US anti-hunger program, formerly known as food stamps.
$298/mo