Medicaid is a joint federal and state program that, together with the Children’s Health Insurance Program (CHIP), provides health coverage to over 72.5 million Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States.
Medicaid Eligibility
Modified Adjusted Gross Income (MAGI) is the basis for determining Medicaid income eligibility for most children, pregnant women, parents, and adults. Some are exempt from the MAGI-based income counting rules, including those whose eligibility is based on blindness, disability, or age (65 and older).
Certain Medicaid eligibility groups don’t require a determination of income. Their coverage may be based on enrollment in another program, such as SSI or the breast and cervical cancer treatment and prevention program. Children for whom an adoption assistance agreement is in effect under title IV-E of the Social Security Act are automatically eligible. Young adults who meet the requirements for eligibility as a former foster care recipient are also eligible at any income level.
Aside from income, there are a few other factors that must be met to be eligible for Medicaid. Medicaid recipients generally must be:
- Residents of the state in which they are receiving Medicaid.
- Either citizens of the United States or certain qualified non-citizens, such as lawful permanent residents.
In addition, some eligibility groups are limited by age, or by pregnancy or parenting status.
Applying for Medicaid
The easiest way to apply for Medicaid is through the Health Insurance Marketplace or directly with your state Medicaid agency. To begin, visit Healthcare.gov or locate and select your state on the Medicaid map to be directed to your state’s enrollment portal and be shown Medicaid contact information.
Most states will generally ask you for the following information on your Medicaid application:
- Full legal name
- Date of birth
- Social Security number (or document numbers for any legal immigrants who need insurance)
- Employer and income information for everyone in your family (i.e., paystubs, W-2 forms, or wage and tax statements)
- Policy numbers for any current health insurance
- Information about any job-related health insurance available to your family
If you have any questions while your application is being processed, your state Medicaid program will be able to help you. Contact the office where you applied. If you don’t have the contact information for your state readily available, you can find that information on Medicaid.gov. Please contact your state for all state-related Medicaid questions.