Updated December 2, 2020 Medicaid is the federal-and-state-funded health insurance program for low-income, needy Americans and their families. States jointly fund and run their programs, so Medicaid eligibility varies, depending on where you live. Medicaid eligibility requirements are broadly based on income, age, disability, pregnancy, household size and the applicant's household role. There are currently over 74 million Americans enrolled in their state's Medicaid and Children’s Health Insurance Programs (CHIP), according to Medicaid.gov.
How Medicaid works
Medicaid was created in 1965 to cover health care for Americans unable to work. The program is voluntary. States don't have to participate, though they all do. Participating states must meet parameters set by the Center for Medicare and Medicaid Services to get federal funding, but they also have a lot of control over eligibility and covered health care services.
President Barack Obama’s health care law moved to standardize Medicaid requirements, specifically so any American making up to 133% of the poverty line could qualify. But that provision was challenged and overturned by the Supreme Court. States could expand Medicaid, but they no longer had to. Thirty-five states (plus Washington, D.C.) did; 15 didn’t. And eligibility across states vary since the Trump administration announced it would allow states to impose work requirements for low-income and needy Americans receiving Medicaid.
In other words, figuring out whether you qualify for Medicaid is even more challenging than before. Enter our state-by-state guide to Medicaid, which we’ll update as changes go into effect.
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How to qualify for Medicaid
Almost every state has multiple Medicaid programs. But, as a good rule of thumb, if you make less than 100% to 200% of the federal poverty level (FPL) and are pregnant, elderly, disabled, a parent/caretaker or a child, there’s likely a program for you. And if you make less than 133% of the FPL**, there’s possibly a program for you, depending on whether your state expanded Medicaid under Obamacare. In 2019, the federal poverty levels (in all states except Alaska and Hawaii, which have higher guidelines) are:
|People in household||Poverty guideline|
|Over 8 people||Add $4,420 per extra person|
In 2019, the federal poverty level in Alaska ranges from $15,600 (for one person) to $54,310 (for eight people). The federal poverty level in Hawaii ranges from $14,380 (for one person) to $49,940 (for eight people).
How Medicaid eligibility is determined
Income eligibility is determined by your modified adjusted gross income (MAGI), which is your taxable income, plus certain deductions. Those deductions include non-taxable Social Security benefits, individual retirement contributions and tax-exempt interest. For most people, MAGI is identical or very close to your adjusted taxable income, which you can find on your tax return. Specific income requirements in dollars rise alongside the size of your household.
Our guide focuses on each state’s major programs for adults. Most are only available to state residents, U.S. citizens, permanent residents or legal immigrants (we’ve noted the exceptions).
Looking for insurance for a child? Check out our guide to the Children's Health Insurance Program (CHIP).
How to apply for Medicaid
If you’re eligible for Medicaid, you can apply all year round through your state's Medicaid website or HealthCare.gov, the federal health insurance marketplace. If you apply for Medicaid through Healthcare.gov and it looks like you qualify, the federal government will notify your state agency, which will contact you about enrollment. States also generally let you print out paper applications you can mail, fax or return directly to your local government office.
To complete your Medicaid application, you will likely need to provide documentation that you meet your state's requirements. This documentation may include:
- Your birth certificate or driver's license to serve as proof of age and citizenship
- Recent pay stubs or tax returns to serve as proof of income
- Copies of bank statements
- Proof of address, which could include a lease, utility bill statements or a copy of your mortgage
- Medical records to serve as proof of disability
States have 45 days to process your Medicaid application. They have 90 days if eligibility is tied to a disability (Disability can lead to a permanent drop in income. Policygenius can help you compare disability insurance policies to help protect against such a drop). If you don't qualify for Medicaid, you might be able to get subsidized health insurance through Healthcare.gov. However, only certain life events allow you to apply for a marketplace health care plan outside of open enrollment, which takes place from Nov. 1 to Dec. 15 each year.
We have more information on what to do if you don't qualify for Medicaid, along with health insurance alternatives, listed at the end of this article for people who can't get Medicaid or qualify for one/special enrollment. But, first, scroll down to see the major programs, eligibility requirements and application processes in your state.
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Eligibility overview: Alabama has Medicaid programs for needy children, parents, caregivers, pregnant women, elderly and disabled residents. It did not expand Medicaid to cover low-income adults outside those buckets.
Income requirements: For children and pregnant women, household income can’t exceed between $1,553 and $3,188 a month. For parents and caregivers, income can’t exceed between $192 and $393 a month. The exact cutoff varies by family size. Elderly and disabled residents are eligible if they make $2,349 or less per month and have less than $2,000 in resources (money in checking or savings, real estate, etc.) per month.
How to apply for Alabama Medicaid: You can apply for most programs directly online at Insure Alabama
Other notable programs: Medicaid Plan First, which covers family planning services, like birth control pills, annual gynecological exams, hysterectomies and vasectomies; Medicaid in the Nursing Home; Breast & Cervical Cancer Screening Program
Eligibility overview: Alaska expanded Medicaid to cover adults 19 to 64 years old who are ineligible for its other programs and making less than 133% of the federal poverty level (FPL). There are separate programs with varying eligibility requirements for pregnant women, children, parents/caretakers, elderly and disabled residents.
Income requirements: To qualify for Medicaid via expansion, your MAGI can’t exceed $1,768 per month for an individual and $2,389 per month for a two-person family. Income requirements scales from there. A family of eight can’t make more than $6,133.
How to apply for Alaska Medicaid: Residents can apply through My.Alaska.gov or via a paper application you can download from its Department of Health and Social Services website.
Other notable programs: Chronic & Acute Medical Assistance, which helps needy residents with specific chronic or terminal diseases get care; Alaska Health Insurance Premium Payment, a program that helps Medicaid recipients pay out-of-pocket costs; Adult Dental Care
Eligibility overview: Arizona expanded its Medicaid program — Arizona Health Care Cost Containment System (AHCCCS) — to cover adults who don’t qualify for its other programs, but make less than 138% of FPL. A single adult is eligible for the expansion program if you make a maximum of $1,415. Couples can make a max $1,911 per month. Separate programs cover women, children, caretaker relatives, the disabled and the elderly.
Additional requirements: Adults in the expansion group making more than 106% FPL contribute premiums of 2% of household income or $25 (whichever is lower) into a health savings account and pay strategic coinsurance of $4 to $75 for certain services. You can defer premiums payments for two months, while the total amount of copays cannot exceed 5% of your family’s income during a calendar quarter.
How to apply for Arizona Medicaid: You can apply online using the Health-e-Arizona Plus website or via a paper application.
Other notable programs: Breast and Cervical Cancer Treatment Program; Arizona Long Term Care System
Eligibility overview: Arkansas has Medicaid programs for needy children, parents, caregivers, pregnant women, elderly, blind and disabled residents. It also has an alternate private expansion program for adults making below 133% FPL. Individuals can make a maximum of $1,414 per month and families of four can make a maximum $2,903.83 per month. Income limits go up from there depending on family size.
Work requirements: Arkansas introduced work requirements for recipients of its expansion program Arkansas Works in June 2018, but a recent ruling by a federal judge blocked the proposal and is currently preventing anyone from losing coverage. Under the approved, but ultimately overturned proposal, enrollees had to put in 80 hours of "work activity" a month. Work activity is defined as "a job, job training, job searching, school, health education classes or volunteering/community engagement" or a combination of those activities, according to the state's Governor's office. Recipients were required to report their activity each month online at www.access.arkansas.gov. People who fail to do so for any three months in a calendar year would lose coverage for that year. Arkansas Governor Asa Hutchinson (R) is now urging the Trump administration to reinstate the program.
Other requirements: The expansion program, Arkansas Works, currently requires participants to pay a small premium (2% of their income). It also has a job referral program, but enrollees aren’t currently required to participate.
How to apply for Arkansas Medicaid: Residents can apply through Access.Arkansas.gov or by printing out an application from the Division of County Operations on the Department of Health Services and dropping it off at their local DHS center.
Other notable programs: Workers With Disabilities; Long-term Care; ARChoices, a nursing and home care program for the elderly and disabled; DDS Alternative Community Services, a program for the developmentally disabled who qualify for nursing home care, but choose to stay home
Eligibility overview: California expanded Medi-Cal to cover adults making 138% below the FPL. It has special programs for elderly, pregnant, disabled, blind, parent/caretaker and child residents. It’s one of the few states that extends eligibility to undocumented residents. You can get Medicaid on refugee status for a limited time, depending how long you have been in the U.S.
Income requirements: You’re eligible for Medi-Cal if you’re single and make $1,467 per month. A family of four can make up to $3,013 per month. Families with more than 12 people can add $515 per person to their monthly salary.
How to apply for California Medicaid: You can apply on the Covered California website, via mail, in-person at a local human services agency or over the phone at 1-800-300-1506.
Other notable programs: Medi-Cal for Families Program, in which families with incomes between 160% and 266% of the FPL pay a monthly $13 premium per child, capped at $39 a month per family; Denti-Cal; Vision Care
Eligibility overview: Health First Colorado covers children, parents/caretakers, pregnant women and adults without dependent children whose household income does not exceed 133% FPL. Separate programs cover elderly and disabled residents.
Income requirements: Parents/caretakers are also subject to a 133% FPL cap, while pregnant women are eligible when their income is under 260% FPL. For the expansion population, income requirements are capped at about $1,415 a month for a single individual. A family of four are limited to $2,904 per month.
Other requirements: Some Health First Colorado recipients must make small co-pays for certain services, like $2 for a primary care doctor visit. Pregnant women and children are exempt from these payments.
How to apply for Colorado Medicaid: You can apply on the Colorado PEAK website, by mail, at a local DHS office or by phone at 1-800-221-3943.
Other notable programs: Family Planning Services; Health First Colorado Buy-In Program for Working Adults with Disabilities; Health First Colorado Buy-In Program for Working Adults with Disabilities
Eligibility overview: Connecticut was the first state to expand Medicaid to adults making below 138% of the FPL. It has separate programs for pregnant women, parents/caretakers, children, the elderly and disabled.
Income requirements: A single person is eligible for Husky D (the Medicaid expansion group) if they make $1,468 per month. Pregnant women are eligible for Husky A if this is their first child and they make a maximum of $3,779 per month. Parents/caretakers in a family of two are eligible if they make no more than $2,299 a month.
How to apply for Connecticut Medicaid: You can apply online at ConnectCT or by mailing or dropping off a paper application at your local DHS office.
Other notable programs: Long-term Services & Support; Medicaid for Employees with Disabilities
Eligibility overview: Delaware expanded Medicaid to cover residents with income up to 133% of FPL. Parents and caretakers are eligible if they make 87% FPL. Pregnant women are eligible for Medicaid when they make less than the 212% FPL. It has special programs for pregnant, parent/caretaker, elderly, disabled and child residents.
Income requirements: A single adult can make a maximum $1,414 per month. Parents and caretakers with a family of two can make up to $1,250 per month. Women who are pregnant with or have one infant can make up to $2,254 per month.
How to apply for Delaware Medicaid: You can apply online at Delaware Assist, via paper application or by calling 1-800-372-2022 or 1-302-255-9500.
Other notable programs: Prescription Assistance program; Chronic Renal Disease program, which provides assistance residents diagnosed with end-stage renal disease; Long-term care Medicaid assistance
District of Columbia Medicaid
Eligibility overview: Washington, D.C., has one of the most generous Medicaid programs in the U.S., covering adults with household incomes up to 210% of the FPL as part of its expansion program. It also has programs for pregnant, parent/caretaker, elderly, disabled and child residents.
Income requirements: The expansion covers adults without dependents who make up to $2,082 a month when applying on their own. Elderly, blind or disabled D.C. residents are eligible if they make up to 100% of the FPL, or $1,063 per month for one individual, and have resources below $4,000 for one person. D.C. also covers pregnant women with incomes up to 319% of the FPL, or $3445 monthly, and parents/caretakers with incomes up to 216% of the FPL.
How to apply for Washington, D.C. Medicaid: You can apply online at DC Health Link or by visiting your closest Income Maintenance Administration Service Center.
Other notable programs: Long-term care and nursing home care services; Spend Down, a Medicaid program for people who exceed income limits, but have high medical bills; Emergency Medicaid for people who can’t qualify for standard Medicaid due to citizenship/immigration status.
Eligibility overview: Florida has Medicaid programs for needy parents/caretakers, children, aged or disabled residents, former foster care recipients and non-citizens with medical emergencies. It didn’t expand Medicaid to cover adults without kids or dependents.
Income requirements: Adults with children who depend on them making up to 27% FPL are eligible. Pregnant women are eligible if they are making up to 191% of the FPL. Blind and disabled individuals are eligible if they’re making up to $961 per month.
How to apply for Florida Medicaid: You can apply online at Access Florida or by mailing or dropping off a paper application to your local resource center.
Other notable programs: Medically Needy, assistance for residents who can’t qualify for Medicaid, but have high medical bills; Working disabled program; Florida Discount Drug Card program (for residents who can’t qualify for Medicaid)
Eligibility overview: Georgia has Medicaid programs for needy children, pregnant women, parents/caretakers, elderly, disabled and blind residents and people in need of nursing home care. It did not expand Medicaid to individuals outside those buckets.
Income requirements: Parents/caretakers are eligible when they make a maximum of between $310 for a family of one and $653 or a family of four per month. They can add $600 per year for each additional family member. Pregnant women are eligible when they make up to 220% of the FPL a year. That’s $3,161 per month. Aged, blind and disabled residents who receive Social Security income are subject to income limits of $783 for single people and $1,175 for couples per month with a resource limit of $2,000 and $3,000, respectively.
How to apply for Georgia Medicaid: You can apply online at Georgia Gateway.
Other notable programs: Emergency assistance for undocumented residents; Medically Needy for residents who don’t meet the income requirements, but have high medical bills; Community and nursing home care
Eligibility overview: Hawaii implemented Medicaid expansion in 2013. Medicaid, known as Quest Integration, is available to children, pregnant women, parents and caregivers and some adults, including those age 65 and older.
Income requirements: Coverage for children is allowed up to 313% of the FPL, and for pregnant women it’s up to 196% of the FPL. Parents and childless adults under the age of 65 qualify if they make up to 138% of the FPL, while for the elderly and disabled the limit is 100% (plus you can only have up to $3,000 in assets).
How to apply for Hawaii Medicaid: Residents of Hawaii can apply through the Med-QUEST Division of Hawaii’s Department of Human Services.
Other notable programs: QUEST Integration; the Medically Needy Spenddown Program; Emergency Medical Assistance for Non-Citizens; Special Medical Assistance Coverage and Programs, Premium Assistance Program; Breast and Cervical Cancer Program; Death Payment Program; Refugee Medical Assistance; Medical Assistance for Repatriates.
Eligibility overview: Medicaid is available to all residents making less than 138% of the poverty line. The ballot initiative gives the state 90 days to submit a proposal to the federal government. In the meantime, if you’re under 19 years old, pregnant, a parent, over the age of 65, or disabled according to Social Security Administration criteria, you may be eligible for Medicaid.
Income requirements: For Medicaid coverage a single adult is capped $1,468 per month and families of four can make $3,013 per month. Single aged or disabled adults over 65 have an income cap of $836 and $1,195 for couples.
How to apply for Idaho Medicaid: Medicaid is provided by the Department of Health and Welfare
Other notable programs: In addition to the Medicaid Standard Plan (for healthy low-income children and parents) and Enhanced Plan (for participants with disabilities or special needs), Idaho offers a Medicare-Medicaid Coordinated Plan for those enrolled in both programs.
Eligibility overview: Illinois expanded its Medicaid coverage, covering children, pregnant women, the disabled and low-income adults. Illinois Medicaid covers up to 147% of FPL for children, 213% for pregnant women and 138% for adults.
Income requirements: Single adults have an income cap of $1,467 per month and $1,983 for couples.
How to apply for Illinois Medicaid: Medicaid is available through the state’s health insurance exchange, GetCoveredIllinois or by calling 1-800-843-6154.
Other notable programs: FamilyCare offers health insurance to parents living with children 18 or younger. Healthcare and Family Services (HFS) Benefits is available for seniors or people with disabilities.
Eligibility overview: Hoosier Healthwise provides Medicaid coverage for children under 19 and pregnant women; Hoosier Care Connect for elderly and disabled applicants; and Healthy Indiana Plan (the expansion plan) for childless adults.
Income requirements: Monthly income limits for pregnant women range from $3,139 to $5,584; for children $2,792 to $6,712; and for adults $1,485 to $3,571. Elderly and disabled are covered up to $1,064 a month – based only on their individual income (other household members are not included).
Work requirements: Effective July 2019, adults in the expansion group must work, volunteer or go to school for 20 hours per week for eight out of 12 months of the year. Recipients have time to adjust, having to work five hours a week six months after the program launches. That number increases to 20 hours through July 2020. Pregnant women, caretakers of a young child, adults over 59 and the "medically frail" are exempt for the program.
Other requirements: Members are Healthy Indiana must contribute $1 to $20 a month into a HSA and cover co-pays for certain health care services, like doctors' visits. They also must file eligibility reconfirmation paperwork within 45 days of their plan's expiration date. Otherwise, they risk getting shut out of Healthy Indiana for three months.
How to apply for Indiana Medicaid: Indiana Medicaid is part of the Family and Social Services Administration.
Other notable programs: Additional coverage is provided by the Family Planning Eligibility Program; Emergency Services Only (for certain medical emergencies); and End-Stage Renal Disease treatment.
Eligibility overview: Every adult between the ages of 19 and 64 with income up to 133% of the FPL may be eligible for Medicaid. Iowa has additional programming for pregnant women, families, women with or survivors of breast cancer, people over 65, and disabled individuals.
Income requirements: Single adults have an income limit of $1,414 per month and families of four are limited to $2,903. Households with more than eight people add $498 per month.
How to apply for Iowa Medicaid: Iowans can apply for Medicaid through the Iowa Department of Human Services.
Other notable programs: Iowa offers a number of additional assistance programs, including the American Indian or Alaska Native Program; "Care for Kids" Early Periodic Screening, Diagnosis, and Treatment for Children (EPSDT) preventive health care services; in-person coordinated care through Health Homes; PACE (Program of All-Inclusive Care for the Elderly); and the Medically Needy Medicaid for those whose income is too high for Medicaid. Children whose family’s income is too high for Medicaid may be eligible for their state Child Health Insurance (CHIP) program, hawk-i, with an income limit of 302% of the FPL.
Eligibility overview: Depending on the group, children, pregnant women, parents and caregivers, and seniors and the disabled may be eligible for Medicaid. Single adults can qualify with income under 138% FPL.
Income requirements: Income requirements for children ages six to 18 are covered up to 133% FPL. Families of four have an income cap of $34,846 annually. Households with more than eight people can add $5,958 annually.
How to apply for Kansas Medicaid: Applicants can apply through KanCare or call 1-800-792-4884.
Eligibility overview: Eligible groups include children under 19, pregnant women, parents and caretakers, and adults 19 to 65 (the expansion set).
Income requirements: Families making less than 138% FPL can qualify for Kentucky Medicaid. A family of four is limited to $36,156 annually. Children and pregnant women are eligible at higher income levels.
Work requirements: Kentucky became the first state to have Medicaid work requirements approved by the Trump administration, but their implementation was delayed after a federal judge ruled they had been insufficiently vetted. The state received reapproval from the federal government, only to have the same judge block the requirements from taking in April for similar reasons. The state of the proposal is now in question, but it stipulates most non-disabled Medicaid beneficiaries age 19 to 64 work, volunteer, job-train, job search, go to school or participate in another qualified activity for at least 20 hours a week. Certain groups like pregnant women and primary caretakers are exempt. The state also offered an alternative way to qualify through health or financial literacy courses.
How to apply for Kentucky Medicaid: Applicants can visit the Kynect website or call 1-855-4kynect (459-6328).
Other notable programs: Medicaid Works is an assistance program for people with disabilities who work.
Eligibility overview: The state expanded Medicaid, so the baseline eligibility is adults with a household income of less than 133% of FPL.
Income requirements: In addition to the above FPL limit, children in households with monthly incomes ranging from the minimum $2,308 to maximum $4,738 for families of four. Pregnant women in households with monthly incomes ranging from $1,468 to $3,013 (household size of four) are eligible. Income limits increase depending on family size. Workers with disabilities are also eligible if their income is less than $1,064 per month and $1,437 for couples.
How to apply for Louisiana Medicaid: Online using the Louisiana Medicaid Online Application (OLA) or by calling 1-888-342-6207.
Other notable programs: Family Opportunity Act Medicaid provides health insurance to children who have disabilities in families with too much income to qualify for Medicaid or CHIP.
Eligibility overview: To be eligible for Maine’s Medicaid program, known as MaineCare, applicants must be pregnant, a parent or relative caretaker, disabled or have a disabled family member in your household or be 65 years of age or older. FPL limits range from 100% for people with disabling conditions and 162% for children under 18. Single adults making 196% FPL are eligible. Parents and caretakers making under 105% FPL and pregnant women making 214% FPL also qualify.
Note: Maine voted to expand Medicaid in November 2017, but its ballot initiative was repeatedly blocked by two-term Republican Governor Paul LePage, who previously (and also repeatedly) vetoed expansion bills passed by state legislators. LePage is slated to leave office in January. His successor, Democrat Janet Mills, has pledged to make Medicaid expansion a priority once sworn into office.
Income requirements: Single adult income is capped at $1,468 per month and families of four are capped at $2,904 monthly. Income limits increase depending on family size.
How to apply for Maine Medicaid: Applicants can visit My Maine Connection or call 1-855-797-4357.
Other notable programs: MaineCare has services specifically for people with cognitive and physical disabilities. The state also provides Maine SHIP (State Health Insurance Program) and a Medicare Savings Program.
Eligibility overview: The baseline FPL limit for adults is 138%, thanks to Medicaid expansion. Children and pregnant women are eligible at higher limits.
Income requirements: Single adults have an income cap of $1,468 per month and single parents who have children are capped at $2,245. Families of four have an income limit of $4,608 per month and pregnant women are limited to $3,794.
Other notable programs: MCHP Premium provides low-cost health insurance coverage for higher-income children up to age 19 between 200% FPL and 300% FPL; the Maryland Women's Infant and Children (WIC) Program provides food and health services to women and children.
Eligibility overview: Massachusetts combines its CHIP and Medicaid programs into one program called MassHealth. It expanded Medicaid, but coverage levels vary based on age, whether the applicant is pregnant, disabled, HIV-positive, has breast or cervical cancer or has children under 18. Some applicants with children making as much as 255% of the federal poverty level can get help paying health care from the state.
Income requirements: Adults under 65 can qualify with an income up to 133% of the FPl ($1,415 a month for an individual). Families with children or young adults under 18 can qualify with a household income up to 150% of the FPL ($1,910 for a family of two). Families with pregnant women or infants can qualify with a household income up to 200% of the FPL.
How to apply for Massachusetts Medicaid: You can apply online at MAhealthconnector.org.
Other notable programs: MassHealth also has programs that provide health services and financial assistance for families making as much as 300% of the FPL.
Eligibility overview: Michigan has Medicaid programs for low-income children, adults under 21, people with dependent children and adults who are elderly, blind or disabled. Families making below a certain income level may also qualify. Under its expansion, adults making less than 133% of the FPL can get coverage.
Income requirements: Single adults are capped at $16,000 annually and $33,000 for families of four.
How to apply for Michigan Medicaid: You can apply online at www.michigan.gov/mibridges.
Other notable programs: Michigan has a health care program called MIChild for low-income children whose families make too much to qualify for Medicaid. There is a $10 monthly premium. The state also has a program for pregnant women who don’t qualify for Medicaid called Group 2.
Eligibility overview: Minnesota’s expanded Medicaid program for people who make low incomes is called Medical Assistance. The state allows people who make more than the limit to use a “spenddown,” which lets them deduct certain medical expenses from their income. The program has income limits and, for parents who use a spenddown, seniors and blind or disabled adults, asset limits.
Income requirements: Single adults qualify with household incomes up to 133% of the FPL ($22,929 a year for a family of two). Children up to 2 years old qualify with household income up to 283% FPL. Children ages 2-18 are eligible with household incomes up to 275% FPL and pregnant women are eligible up to 278% FPL.
How to apply for Minnesota Medicaid: You can apply online through MNSure, Minnesota’s insurance marketplace.
Other notable programs: Minnesota has a health care program for people who don’t qualify for Medicaid who make up to 200% of the FPL called MinnesotaCare.
Eligibility overview: Mississippi didn’t expand Medicaid to cover everyone under a certain income limit. But children, parents, pregnant women, disabled or elderly people may qualify.
Income requirements: Infants up to age 1 qualify for Medicaid with a household income up to 194% of the FPL ($2,860 a month for a family of two). Children ages 1 to 6 years old qualify with an income up to 143% of the FPL ($2,127 for a family of two). Children from 6 to 19 qualify with an income up to 133% of the FPL ($1,983 for a family of two.) Parents or relatives caring for dependent children qualify with a monthly household income up to $280 for an individual, plus about $78 for each additional member of the family. Pregnant women qualify with incomes up to 194% of the FPL ($2,860 a month for a family of two).
Other notable programs: Most Medicaid recipients in Mississippi get care through Mississippi Coordinated Access Network. Rather than paying for health services directly, the state contracts with insurance companies to manage care.
Eligibility overview: Missouri’s Medicaid program is called MO HealthNet. The state voted to expand Medicaid to cover everyone making up to 133% of the FPL in August 2020. People with disabilities, seniors, pregnant women, newborns, children and women with breast or cervical cancer can get coverage if they meet income requirements.
Income requirements: Single adults making up to $16,971 annually are eligible and families of four making up to $34,946 per month also qualify. Aged, blind and disabled individuals have a monthly income limit of $904 and an asset limit of $5,000. Married people who meet that criteria are capped at $1,222 per month and $10,000 asset limit.
How to apply for Missouri Medicaid: You can apply online here.
Other notable programs: Uninsured women can qualify for contraception and other family planning services with incomes up to 201% of the FPL.
Eligibility overview: Montana expanded Medicaid to cover everyone making up to 138% of the FPL. However, as part of the expansion, it requires most members to pay up to 3% of their quarterly income in copays. Every member chooses or is assigned a primary care provider under the Passport to Health program.
Income requirements: Adults can qualify with household incomes up to 138% of the FPL, or no more than $1,342 a month for an individual. A family of four is capped at $2,742 per month. Pregnant women qualify with incomes up to 157% of the FPL, or $1,539 a month. Blind and disabled people can qualify with assets worth up to $2,000 for an individual or $4,000 for a couple and incomes up to $783 a month. Elderly, blind, disabled with income less than $525 per month can qualify for the “spend down” program for their medical expenses.
How to apply for Montana Medicaid: You can apply online at apply.mt.gov.
Other notable programs: Montana’s Medicaid expansion also pushes participants to take part in jobs training.
Eligibility overview: Nebraska voted in November 2018 to expand Medicaid to all residents making less than 133% to provide Medicaid to the elderly, the disabled, pregnant women, children and parents, depending on income.
Income requirements: Parents or relatives with a dependent child can qualify with household income up to 58% of the FPL ($1,050 a month for a family of three). Pregnant women and newborns qualify with income up to 194% FPL and 162% FPL respectively. Children ages 1 through 5 can qualify with household income up to 145% of the FPL ($2,625 for a family of three). Children ages 6 through 18 qualify with income up to 133% of the FPL ($2,408 for a family of three).
How to apply for Nebraska Medicaid: You can apply online through the ACCESSNebraska page.
Eligibility overview: Nevada expanded Medicaid to households with incomes up to 138% of the FPL.
Income requirements: Households with incomes up to 138% of the federal poverty level can qualify ($16,753 annually for an individual or $34,638 for a family of four).
How to apply for Nevada Medicaid: You can apply online through Access Nevada.
Other notable programs: Nevada provides health care to children with household incomes up to 200% of the FPL through its Check Up program. That’s $50,200 annually for a family of four.
New Hampshire Medicaid
Eligibility overview: New Hampshire expanded Medicaid to cover residents making up to 133% of the FPL.
Income requirements: The New Hampshire Health Protection Program covers adults with household incomes up to 133% of the FPL ($2,408 a month for a family of three). Healthy participants get help paying for premiums in private plans, while those considered “medically frail” get standard Medicaid benefits. Children with disabilities and pregnant women qualify for Medicaid with household incomes of up to 196% of the FPL ($3,548 a month for a family of three). New Hampshire also has an expanded Medicaid program that covers children with household incomes up to 318% of the FPL ($5,756 for a family of three). Parents and caretakers have an income cap of $670 per month and $816 for couples.
Work requirements: New Hampshire had work requirements for its expansion group approved in early May. Under the waiver, adults ages 19 to 64 must work or participate in another qualifying “community engagement” activity, like education or job-training, for at least 100 hours a month to keep their benefits. The requirements are slated to go into effect January 1, 2019.
How to apply for New Hampshire Medicaid: You can apply online through the NH Easy Gateway to Services.
New Jersey Medicaid
Eligibility overview: New Jersey provides CHIP and Medicaid through its NJ FamilyCare program. The state expanded Medicaid to cover anyone earning up to 138% of the FPL.
Income requirements: Children 18 and under can qualify with household incomes up to 355% of the FPL ($7,751 a month for a family of four). Adults can qualify with incomes up to 138% of the FPL ($3,013 for a family of four or $1,468 a month for an individual.) Pregnant women qualify with incomes up to 205% of the FPL ($4,476 a month for a family of four). Elderly, blind or disabled people can qualify for Medicaid with income less than the FPL ($1,064 for an individual or $1,437 for a couple) and assets worth less than $4,000 for an individual and $6,000 for a couple.
How to apply for New Jersey Medicaid: You can apply for NJ FamilyCare online.
New Mexico Medicaid
Eligibility overview: New Mexico expanded its Medicaid program to cover all needy adults. Its Centennial Care also offers Medicaid to newborns and children up to age 18, as well as their parents and caretakers. Pregnant women may also qualify for full benefits.
Income requirements: Your income must be within 138% of the FPL. Income requirements vary with the size of the applicant’s household, with the maximum income of a one-person household capped at $1,415 per month; a four-person household at $2,904, and an eight-person household at $4,890. Maximum income requirements increase by $496 for each person in the household after the eighth.
How to apply for New Mexico Medicaid: The YesNewMexico online portal provides access to a number of public assistance programs, including Medicaid, food assistance, cash assistance and energy assistance. You can also fill out and mail in a paper application.
Other notable programs: The Brain Injury Services Fund for rehabilitation of New Mexico residents living with a brain injury; Behavioral Health Services to help residents to manage mental health, substance abuse and diabetes and Native American health care services.
New York Medicaid
Eligibility overview: New York expanded Medicaid to cover all needy adults, as well as pregnant women, infants, parents and caretaker relatives.
Income requirements: New York offers coverage to anyone earning an income within 138% of the FPL. That amounts to an income of $1,468 per month for a household of one, $2,498 for a household of three, and $5,074 for a family of eight. For each person after that, New York allows an additional $516 to be eligible for Medicaid coverage.
How to apply for New York Medicaid: You can call the official health plan marketplace, New York State of Health, at 1-855-355-5777, or the Medicaid Helpline at 1-800-541-2831. You can also apply online at the NY State of Health website, or with a Managed Care Organization, a licensed broker, or at a local social services department.
Other notable programs: Medicaid in New York may help cover the insurance premiums of people who have AIDS; the Family Planning Benefit Program for people seeking contraception, STD screening and counseling, and who aren’t already enrolled in Medicaid; Child Health Plus, a health insurance plan for kids.
North Carolina Medicaid
Eligibility overview: Medicaid in North Carolina is available to pregnant women, people aged 65 or older (who can also apply for Medicare), people who are blind, disabled or need long-term care, infants and children under age 21 and parents or caretakers. The state has not expanded Medicaid to cover all needy adults.
Income requirements: Pregnant women are limited to $2,085 for a single household and $4,280 for a family of four. For the aged, blind or disabled, or caretakers of someone with those characteristics, your income is limited to $1,064 per month for a one-person household, $1,437 for a family of two. Medicaid for families with children 0-5 is available if you make $3,017 per month for a family of two. Families with kids aged 6-18 are limited to $1,911 for a family of two and $2,904 for a family of four.
Other notable programs: Health Choice, which is for children whose families make too much to qualify for Medicaid, but can’t afford private health insurance.
North Dakota Medicaid
Eligibility overview: The state expanded Medicaid to cover all low-income adults. It has separate programs for Medicare beneficiaries; workers and children with disabilities; pregnant women, or women with breast or cervical cancer; children currently in foster care or subsidized adoption; some individuals formerly in foster care and other blind and disabled people.
Income requirements: The monthly limit for a one-person household is $517 and $1,048 for a family of four. Medically needy individuals have a single-household monthly limit of $883 and $1,813 for a family of four. Children under six have an income limit of $1,617 and $1,468 for kids under the age of 19. Single pregnant women have a limit of $1,723 and $3,537 for a family of four.
How to apply for North Dakota Medicaid: Most people can apply online, but those who meet certain qualifications and only want specific services should print out application forms and bring them to a local social services office. An application can also be requested by mail.
Other notable programs: Home- and Community-Based Long-Term Care for older or physically disabled people who have difficult living independently; Women’s Way, a breast and cervical cancer early-detection program
Eligibility overview: Ohio expanded Medicaid to cover all low-income adults, with separate programs for pregnant women, infants, children, older adults and individuals with disabilities.
Income requirements: Adults aged 19 through 64 must earn a monthly income of up to 138% of the FPL, or $1,467 per month, which increases to $3,013 per month for a family of four. Pregnant women are eligible for coverage if they earn up to 205% of the FPL, or $2,180 per month.
Other notable programs: The Alien Emergency Medical Assistance and Refugee Medical Assistance programs provide some coverage to non-citizen residents; Behavioral Health Redesign, which aims to support behavioral health care.
Eligibility overview: SoonerCare is primarily available to children, pregnant women, parents/caretakers, elderly and disabled residents. The state did not expand Medicaid to cover all needy adults.
Income requirements: Children qualify for SoonerCare with a household income of $3,018 per month for a family of two and $4,587 for a family of four. SIngle pregnant women have an income limit of $1,416 and $2,905 for a family of two. Adult caretakers have an income limit of $469 for a single household and $633 for a family of two.
How to apply for Oklahoma Medicaid: You can apply online or with a paper application form. You can also apply in person; schedule an appointment with a counselor near you on HealthCare.gov or by calling 1-800-318-2596.
Other notable programs: The Oklahoma Cares program was set up with the express purpose of treating breast and cervical cancer in women.
Eligibility overview: The state expanded the Oregon Health Plan (OHP) to cover all low-income adults. (It considered rolling back that expansion in 2017 to cover state budget gaps, but successfully funded the program through a new voter-approved tax on hospitals and health insurers.) There are also programs for children, pregnant women and the elderly or disabled.
Income requirements: The OHP is available to adults whose income is within $1,468 per month for single households and $3,013 for a family of four. Pregnant women have an income limit of $2,730 and single kids under 19 are limited to $4,383, depending on household size.
How to apply for Oregon Medicaid: You can apply online. You can also apply with a paper application or call OHP customer service to have one mailed to you: 1-800-699-9075.
Other notable programs: Oregonians enjoy a strong medical marijuana program, as well as mental health and immunization services. The Oregon Health Authority has also implemented a recovery and prevention program for abusers of drugs and alcohol, as well as counseling services for people suffering from a gambling addiction.
Eligibility overview: Pennsylvania expanded Medicaid so that its program Medical Assistance (MA) is offered to low-income adults aged 19 to 64, adults aged 65 or older of any income, blind and disabled adults and families with children under 21.
Income requirements: For expansion adults (ages 19 to 64), the income limit is $1,468 per month for an individual and $1,983 for a family of two. Pregnant women and infants under age 1 are limited to $3,162 per month for an individual or $4,803 for a family of four. Children ages 1 to 5 are limited to $3,537 for a family of four.
How to apply for Pennsylvania Medicaid: Apply online with COMPASS, Pennsylvania’s portal to its MA system as well as other services.
Other notable programs: Substance abuse services, breast and cervical cancer screening, dental services and family planning services.
Rhode Island Medicaid
Eligibility overview: Medicaid in Rhode Island has two different components. RIte Care is the state’s managed care program, offered to parents, children and pregnant women. The second component is its Medicaid expansion, which opens up health care coverage to any Rhode Island resident (including documented immigrants) between the ages of 19 and 64 who meets the state’s income requirements.
Income requirements: Among RIte Care participants, parents with children under age 18 must earn up to 133% of the FPL and pregnant women must earn within 253% of the FPL. Adults who qualify under the Medicaid expansion must not earn more than 138% of the FPL to qualify.
How to apply for Rhode Island Medicaid: Go online to Rhode Island’s human service programs portal. You can also apply by mail, in person or over the phone.
Other notable programs: The Ryan White HIV/AIDS support program, which offers health care, housing services, cost-sharing assistance and nutrition therapy to people living with HIV and AIDS.
South Carolina Medicaid
Eligibility overview: The state’s Medicaid program Healthy Connections is available to the elderly, blind or disabled; people being treated for breast and cervical cancer; disabled children; people seeking family planning-related services, pregnant women and Medicare recipients who have difficulty paying their premiums. The state did not expand Medicaid to cover all needy adults.
Income requirements: Aged, blind and disabled people, and qualified Medicare recipients who need help with their premiums, must have income of $1,064 for a single household and $1,437 for couples. Breast and cervical cancer qualifiers are limited to a monthly income of $2,082 for single households and $4,292 for families of four. Caretakers are limited to $659 for a single household and $1,353 for families of four.
Other notable programs: BabyNet, which provides support for infants under 3 years of age who have developmental delays; Autism Spectrum Disorder Services to provide treatment for people with ASD; the South Carolina Birth Outcomes Initiative.
South Dakota Medicaid
Eligibility overview: South Dakota has Medicaid programs for low-income families, pregnant women, certain newborns, disabled residents, elderly, residents experiencing chronic renal failure, youths formerly in foster care and refugees (for up to eight months from month of entry). It did not expand Medicaid.
Income requirements: Single household low income families are limited to $616 per month and families of four are limited to $994. Pregnant women are limited to $411 for a single household and $672 for a family of four. Breast and cervical cancer patients and survivors have a monthly limit of $2,126 per month.
How to apply for South Dakota Medicaid: Residents can apply on the South Dakota Department of Social Services (DSS) website or via a paper application available on the DSS site that can be mailed, faxed or dropped off at a local DSS office. Residents can also call 1-800-305-3064 or their local DSS office to have an application mailed to their home.
Other notable programs: South Dakota Medicaid for Workers with Disabilities (MAWD); The Former Foster Care Medical Program; The Refugee South Dakota Medicaid (RMA)
Eligibility overview: Tennessee has Medicaid programs for pregnant women, children, parents/caretakers and disabled, elderly or uninsurable residents. It did not expand Medicaid to cover all low-income adults.
Income requirements: Pregnant women must be at 195% FPL and have a monthly income of up to $258 (family of two) and $325 (family of four). Parents/caretaker relatives of minor children have a monthly income limit of $1,018 (family of one) to $1,867 (family of four). Aged, blind and/or disabled residents with a household of one must have a monthly income limit of $783 and resource limit of $2,000; those with a household of two must have a monthly income limit of $1,175 a resource limit of $3,000.
How to apply for Tennessee Medicaid: Residents can apply for TennCare by calling 1-800-318-2596. If you prefer to apply by mail, there is a paper application available on the Division of TennCare website.
Other notable programs: TennCare Standard; TN Breast and Cervical Screening Program
Eligibility overview: Texas has Medicaid options for residents who are pregnant, a parent/caretaker, transitioning foster care youth, blind, disabled or older than 65. It did not expand Medicaid to cover all low-income adults.
Income requirements: Parents and caretakers with a family of four are limited to $277 for a single parent household and $285 for a dual parent household. Children 18 or younger in a family of four are limited to $2,904 per month. Pregnant women with a family of four are limited to $4,323 per month.
How to apply for Texas Medicaid: Texas residents can apply online on the YourTexasBenefits website. You can also print out an application on that site and mail it to the HHSC offices or fax it to 1-877-447-2839. If you don’t have access to a printer, you can call 1-877-541-7905 and request a paper copy be mailed to you.
Other notable programs: Women, ages 18 to 64, who are residents of Texas may be eligible for Medicaid coverage for Breast and Cervical Cancer treatments.
Eligibility overview: Programs are available for pregnant women, parents/caretakers, blind, elderly or disabled residents, children, women with breast or cervical cancer and refugees. Utah voted in December 2019 to expand Medicaid to all residents making less than 138% of the poverty line, though details on the program's rollout are not yet available. The state previously expanded Medicaid to provide coverage for single adults earning up to 5% of the FPL if they are homeless, involved in the justice system (probation, parole or court-ordered treatment for substance abuse or mental health problems) or need treatment for substance abuse or mental health problems.
Income requirements: Individuals are limited to $1,467 per month and $3,013 for a family of four.
Additional requirements: For a Utah resident to be eligible for Parent/Caretaker Relative Medicaid, the child must be deprived of parent support because of a death, absence, incapacity or underemployment of a parent/caretaker relative. To qualify as deprivation due to underemployment, the primary wage earner must be unemployed or working less than 100 hours per month.
How to apply for Utah Medicaid: To apply online, visit the Utah Department of Workforce Services (DWS) website. You can also download the application to mail or fax (1-801-526-9505). You can type in your ZIP code on this UDWS page to find the closest location.
Other notable programs: Baby Your Baby; Spenddown Program; Emergency Medicaid; Foster Care Independent Living
Eligibility overview: Vermont expanded its Medicaid program. Residents qualify if they earn up to 138% of the FPL. There are special programs for pregnant women, parents/caretakers and blind, disabled and elderly residents.
Income requirements: Single adults have a monthly income limit of $1,467 and $3,013 for a family of four. Pregnant women are limited to $3,060 for a family of two and $4,651 for a family of four. Children under 19 are limited to $6,921 in a four-person household.
How to apply for Vermont Medicaid: You can apply for Medicaid for Children and Adults by filling out an online application on the Vermont Health Connect site or by calling Vermont Health Connect at 1-855-899-9600.
Other notable programs: Dr. Dynasaur is available for kids and pregnant women.
Eligibility overview: Virginians eligible for Medicaid through the state's expansion initiative and make 138% FPL could apply for coverage.
Income requirements: Single earners are eligible if they make $1,467 or less per month. Families of three are limited to $2,487 per month.
How to apply for Virginia Medicaid: Apply through Cover Virginia or call 1-855-242-8282
Eligibility overview: Washington Apple Health (Medicaid) covers adults making 138% FPL, people over 65, blind and disabled individuals, pregnant women and parents/caretakers.
Income requirements: Single adults are limited to $1,467 per month and $3,013 for a family of four. Aged, blind and disabled individuals are limited to $783 for one person and $1,175 for couples. Pregnant women are limited to $2,845 or $4,323 for a family of four. Parents and caretakers are limited to $511 for single households and $658 for couples.
How to apply for Washington Medicaid: Apply online through Washington Healthplanfinder or call 1-855-923-4633.
Other notable programs: Foster care: Children placed in licensed foster care are eligible to receive Medicaid until age 21, and those who were in foster care and receiving Medicaid on their 18th birthday are eligible to remain covered until 26.
West Virginia Medicaid
Eligibility overview: West Virginia expanded Medicaid under Obamacare. Eligibility is available for infants under age 1 making 163% FPL, children 1-6 making 146% FPL, children 6-19 making 138% FPL, pregnant women making 190% FPL, the elderly and disabled, adults with dependents as well as those without dependents. Everyone receiving benefits must meet income limitations.
Income requirements: Individual adults must make $1,467 per month or less in a single household, $1,983 for a two-person household. Pregnant women are limited to $2,730 and infants are limited to $2,342 in a two-person household. Children ages 1-6 are limited to $2,098 in two-person families and kids 6-19 are limited to $1,983 in a two-person household.
How to apply for West Virginia Medicaid: West Virginia’s inROADS website. Federal Medicaid call center: 1-800-318- 2596 or make an appointment to visit a DHHR office in person: 1-877-716-1212.
Other notable programs: Women diagnosed with breast or cervical cancer under the age of 65 without other health insurance may qualify for Medicaid as long as they meet certain non-financial requirements. Medicaid may also help some Medicare recipients cover the cost of copayments and deductible premiums for Medicare Part A or B.
Eligibility overview: While Wisconsin did not expand Medicaid under Obamacare, the state covers everyone under the federal poverty line via the state’s BadgerCare program. Democratic Gov. Tony Evers has vowed to formally expand Medicaid under the ACA, but his current plan is being blocked by the state's Republican-led legislature.
Income requirements: Individuals making 135% FPL are limited to $1,435 per month and $1,939 for couples.
How to apply for Wisconsin Medicaid: Apply online through Wisconsin’s Access site
Other notable programs: Wisconsin also has separate programs dedicated to covering children in foster care (Care4Kids) and the elderly and disabled (FamilyCare).
Eligibility overview: Residents are eligible if they are parents/caretakers, children, pregnant, elderly, disabled or eligible under the Breast and Cervical Cancer Early Detection Program. The state did not expand Medicaid to cover all needy adults.
**Income requirements:**Pregnant women and children are capped at 300% FPL and are limited to $6,549.99 per month.
How to apply for Wyoming Medicaid: You can apply online on the state’s Department of Health website.
Other notable programs: Medicare Savings program; Pregnant by Choice, which provides family-planning services to women making up to 159% of the FPL; Nursing Home/Assisted Living care.
What to do if you don't qualify for Medicaid
If you don't qualify for Medicaid, you can possibly get subsidized health care through the Obamacare marketplaces during a special enrollment or open enrollment period. Americans who make between 100% and 400% of the FPL qualify for a premium tax credit that can significantly lower the cost of a plan.
Federal open enrollment for 2019 health care plans ended on Dec. 15, 2018, though some state exchanges are open longer and Nevada sells health insurance all year round. Learn 2020 open enrollments dates by state. Healthcare.gov, the federal exchange, usually opens from November 1 to December 15 each year.
If you can't find affordable health care on your marketplace during open enrollment, you have a few back-up options.
Short-term health insurance: Originally designed to prevent short-term health insurance gaps, these plans are cheaper, but much less comprehensive than traditional coverage. They don't have to cover Obamacare's ten essential benefits or pre-existing conditions. Following changes by the Trump administration, short-term health plans can last from three months to potentially three years. (Policygenius partner Agile can help you compare the costs of short-term health insurance plans across companies.)
Limited benefit plans: These plans cover a very small portion of the costs associated with certain "medical events", like a doctor's visit or ambulance ride. Both the number of events and dollar amounts covered are capped.
Prescription discount cards: While these cards won't help you pay for inpatient or outpatient care, they do help you get medication at discounted rates.
Healthcare sharing ministries: A faith-based alternative to health insurance in which individuals and families pay a monthly “sharing amount” similar to a health insurance premium and use those funds to cover ministry-approved medical expenses.
COBRA: The Consolidated Omnibus Budget Reconciliation Act (COBRA) lets you keep your health insurance from a soon-to-be-ex-employer for up to 36 months, though you're expected to pay the full cost of the policy.
You can learn more about these health insurance alternatives here.
Medicaid vs. Medicare
Remember, there is a federal insurance program in place for Americans 65 and over: Medicare. This program also insures younger individuals with specific disabilities or illnesses. Learn more about the key differences between Medicaid and Medicare.
Medicare isn't free: Beneficiaries are expected to pay premiums, deductibles and copays/coinsurance. However, many states offer qualified low-income, needy Americans assistance for Medicare costs through their Medicaid programs.
If you qualify for Medicare, our partner Via Benefits can help you compare and buy Medicare plans in your area.
Additional reporting by Myelle Lansat, Colin Lalley, Myles Ma, Alex Moore, Brooke Niemeyer and Zack Sigel.
Disclosure: This post contains references to products or services from one or more of our advertisers or partners. While these codes earn us a small fee at no additional cost to you, we only refer products we love.
Image: Michele Constantini