Medicaid: Free or low-cost health coverage.
Medicaid
Free or low-cost health coverage for eligible low-income Americans, funded jointly by federal government and states.
Reviewed by SubhaVerified
Coverage
Free or low-cost
Doctor visits, hospital care, and more
Standard processing
45 days
90 days if a disability decision is needed
Cost to apply
Free
No application fee
Where to apply
Your state
Your state Medicaid agency
Figures on this page were last verified October 16, 2026. Amounts and rules change, so confirm them with Centers for Medicare & Medicaid Services (CMS) before you apply.
What is Medicaid?
Medicaid is a joint federal-state health-insurance program administered by the Centers for Medicare and Medicaid Services (CMS) that covered about 66 million low-income Americans in June 2026, making it the largest public health insurance program in the United States.
Eligibility varies by state, but 40 states plus DC cover adults up to 138 percent of the federal poverty level (about $1,835 per month for a single adult in 2026) under the Affordable Care Act expansion.
Non-expansion states cover parents at limits ranging from about 15 percent of FPL in Texas to about 100 percent in Wisconsin and 105 percent in Tennessee.
Children qualify at about 190 to 405 percent FPL depending on state (KFF 2026 figures, which include the standard 5-point income disregard), and pregnant women at 138 percent or higher (the median is about 200 percent).
SSI-linked seniors qualify at $994 a month for one person or $1,491 for a couple in 2026, with a $2,982 monthly long-term care limit. SSI rises to $1,029 and $1,544 in January 2027. About 1.2 million adults remain in the coverage gap across 10 non-expansion states, per KFF July 2026.
Apply through healthcare.gov or your state Medicaid agency.
Medicaid is the largest public health insurance program in the United States, covering about 66 million people in June 2026 (Medicaid.gov enrollment data, updated September 2026).
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 October 2026, 40 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, October 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 1, 2027. A state can start earlier, and a state showing good-faith progress can get more time, up to December 31, 2028.
H.R. 1 also shortens backdated coverage from January 2027: 1 month for expansion adults and 2 months for children, adults 65 and older, and people with disabilities, down from 3 months today.
The Congressional Budget Office estimates the work requirement will leave 5.3 million more people uninsured in 2034. CBPP estimates 9.9 to 14.9 million people will be at risk of losing coverage and will have to take action to stay enrolled.
Who Medicaid covers, and why it depends on your state
- In the 40 states plus DC that have expanded Medicaid: adults with income under 138% of the Federal Poverty Level (about $22,025 a year for one person or $37,702 for a family of 3, using the 2026 poverty guidelines)
- 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; the median income limit for parents is 40% FPL, about $10,928 a year for a family of 3 in 2026 (KFF, July 2026)
- 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 certain non-citizens. Since October 1, 2026, federal Medicaid covers mainly green-card holders, Cuban and Haitian entrants, and COFA migrants. Green-card holders generally wait 5 years, though some states waive the wait for children and pregnant women
- State residency required, must apply in the state where you live
Only the agency that runs the program can decide eligibility.
Limits differ a lot from one state to the next. To check yours, use our Medicaid income limits 50-state chart.
What Medicaid pays for
Coverage type
Free or low-cost
About 66.0 million people enrolled in Medicaid in June 2026 (Medicaid.gov enrollment report highlights, updated September 2026).
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).
What the amount depends on
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.
Signing up for Medicaid any time of year
- 01
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.
- 02
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.
- 03
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/where-can-people-get-help-medicaid-chip.
- 04
Or apply through healthcare.gov
If your state uses HealthCare.gov, you can also apply there or by calling 1-800-318-2596. The single application screens you for Medicaid, CHIP, and marketplace subsidies all at once.
- 05
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 starts the month you applied and can be backdated up to 3 months.
For applications made from January 2027, H.R. 1 cuts backdating to 1 month for expansion adults and 2 months for everyone else.
- 06
Enroll in a managed care plan (in most states)
About 78 percent of Medicaid enrollees were in comprehensive managed care in 2024 (CMS data, via KFF). Once you are approved, your state tells you how long you have to pick a plan. If you do not choose, the state auto-assigns one.
Start with the official source
Centers for Medicare & Medicaid Services (CMS)
Medicaid questions about coverage and income
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 1, 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). A state making a good-faith effort can get a delay, but no later than December 31, 2028.
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.
From January 2027, the limit drops to 1 month for expansion adults and 2 months for others.
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 (34 jurisdictions including DC, per KFF's 2026 count), you may be able to 'spend down' higher income on medical bills and remain eligible.
Sources & further reading
- Medicaid.gov Eligibility Policy
- Medicaid.gov June 2026 Medicaid and CHIP Enrollment Data Highlights
- CBPP Policy Basics: Introduction to Medicaid (updated November 2025)
- KFF: Status of State Medicaid Expansion Decisions (October 2026)
- KFF: How Many Uninsured Are in the Coverage Gap (July 2026)
- Federal Register: Medicaid Community Engagement Requirement interim final rule (June 3, 2026)
- AHCCCS (Arizona Medicaid): H.R. 1 changes, including retroactive coverage
- ASPE: 2026 HHS Poverty Guidelines
- Medicaid.gov: Where can people get help with Medicaid and CHIP
- HealthCare.gov Medicaid Application
Use official sources to confirm current requirements and benefit amounts.
Reviewed by Subha
Every rule and figure here was checked against the sources above on October 16, 2026. Spotted something out of date? Tell us.
Not legal, tax, or financial advice. GrantsHubUSA is an independent editorial site. We are not a government agency and we do not run this program. See our full disclaimer.
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