What Is Medicaid?
Medicaid is a joint federal and state program that provides free or very low-cost health coverage to people with low incomes. It's one of the largest health insurance programs in the US, covering over 80 million Americans.
Who Qualifies for Medicaid?
Eligibility depends on your state, but generally includes:
- Income: In states that expanded Medicaid under the ACA, adults with incomes up to 138% of the federal poverty level qualify (~$20,783/year for a single person in 2025)
- Children: Usually covered up to higher income levels through CHIP
- Pregnant women: Expanded eligibility in most states
- People with disabilities
- Adults 65+ (may also have Medicare)
๐ก 39 states plus DC have expanded Medicaid under the ACA. If you live in an expansion state, adults up to 138% FPL qualify regardless of family status. Check your state's eligibility rules.
What Does Medicaid Cover?
- Doctor visits and specialist care
- Hospital stays
- Prescription drugs
- Mental health and substance use treatment
- Prenatal care and delivery
- Long-term care (in some cases)
How to Apply
- Apply through your state's Medicaid agency website
- Apply through HealthCare.gov (they'll route you if you're eligible)
- Apply in person at your local Medicaid office
- Medicaid has no open enrollment period โ apply any time
Estimate Your ACA Subsidy
If you don't qualify for Medicaid, see what marketplace subsidies you may be eligible for.
Estimate Your ACA Subsidy โFrequently Asked Questions
Is Medicaid completely free?
For most recipients, Medicaid has no premiums, no deductibles, and very low or no copays. However, some states charge small premiums or copays for certain beneficiaries above the poverty level.
Can I have both Medicaid and Medicare?
Yes โ people who qualify for both are called 'dual eligible.' Medicare is typically primary and Medicaid covers costs Medicare doesn't, including premiums, copays, and long-term care. This combination can result in near-zero out-of-pocket costs.
What if my state hasn't expanded Medicaid?
In non-expansion states, adult eligibility is much more restrictive. You typically must be a parent of a dependent child, pregnant, disabled, or elderly. If you don't qualify for Medicaid in a non-expansion state and your income is above the poverty level, you may qualify for ACA marketplace subsidies instead.