How to Apply for Medicaid Health Insurance Through Your State

You can apply for Medicaid at any time of year. The program provides free or low-cost health coverage to people who meet their state's eligibility rules. You can apply directly through your state Medicaid agency or use the Health Insurance Marketplace application process when appropriate.

Your state Medicaid agency is responsible for determining eligibility and administering coverage. The Centers for Medicare & Medicaid Services (CMS) oversees the federal Medicaid framework, but there is no single nationwide income limit or one application portal that directly administers every state's program.

Start by opening the official Medicaid state agency directory. Select your state and follow its enrollment instructions. You must generally live in the state where you apply and meet an applicable eligibility category.

Where should you apply for Medicaid?

There are two main application routes. Both can lead to a state Medicaid eligibility determination, but they are not identical.

Option 1: Apply through your state Medicaid agency

Use the Medicaid.gov state contact directory to locate your state agency.

The directory identifies state-specific Medicaid contacts and available eligibility and enrollment resources. Follow the official application instructions for your state. Depending on the state and eligibility category, application channels may include online services and assisted application methods.

Direct state application is especially important when your eligibility involves age 65 or older, disability, long-term services and supports, or other categories that may require different financial rules.

Option 2: Apply through the Health Insurance Marketplace

The federal HealthCare.gov Medicaid and CHIP guide explains how a Marketplace application can identify possible Medicaid eligibility.

When the Marketplace determines that someone in your household may qualify for Medicaid or CHIP, it securely sends the relevant information to the state agency. The state then contacts you about enrollment and completes the applicable eligibility process.

Some states operate their own Marketplaces. Follow the official application route provided for your state rather than assuming every resident completes enrollment on the federal Marketplace website.

If you are not eligible for Medicaid, the Marketplace application may also identify private health insurance options and potential financial assistance.

Who qualifies for Medicaid?

Medicaid eligibility depends on both financial and nonfinancial requirements. The rules differ by state and by the category under which you apply.

Common eligibility considerations include:

• State residency: You generally must reside in the state providing Medicaid.
• Income: The state evaluates income under the rules applicable to your eligibility category.
• Household composition: Family relationships and tax-filing circumstances may affect household size and income calculations.
• Age and family status: Children, pregnant women, parents, older adults, and certain other groups may have different eligibility standards.
• Disability: Some disability-related categories use different financial and verification rules.
• Citizenship or immigration status: Federal eligibility restrictions and specific state options apply.

The official Medicaid eligibility policy describes these distinctions.

Medicaid expansion versus non-expansion states

Under the Affordable Care Act, states may expand Medicaid to cover additional low-income adults under age 65. States that have adopted expansion generally cover eligible adults with income up to an effective threshold of approximately 138% of the federal poverty level, reflecting the statutory 133% threshold and the applicable income disregard.

States that have not adopted expansion may have more restrictive eligibility for adults who do not qualify through another coverage category.

Do not use 138% as a universal Medicaid eligibility limit. Children, pregnant women, older adults, people with disabilities, and other eligibility groups may have different income standards. Income thresholds also change over time.

Check your state's rules through the Medicaid eligibility directory.

What income counts for Medicaid?

For most children, pregnant women, parents, and adults, Medicaid uses Modified Adjusted Gross Income (MAGI). This approach considers taxable income and applicable tax-filing relationships.

MAGI-based Medicaid eligibility does not use an asset or resource test. However, people whose eligibility is based on age 65 or older, blindness, or disability may be evaluated under different financial rules, including applicable resource requirements.

For example, a working parent with children may be evaluated using MAGI rules, while an older adult applying for certain Medicaid benefits may need a different financial assessment. The correct route depends on the applicant's eligibility category, not simply household income.

Can noncitizens qualify for Medicaid?

Medicaid eligibility for noncitizens is subject to federal restrictions and state-specific coverage options. Under rules applicable in October 2026, federal full-benefit eligibility generally includes qualifying lawful permanent residents, Cuban or Haitian entrants, and Compact of Free Association migrants, subject to other eligibility requirements.

Some qualifying noncitizens may be subject to a five-year waiting period. States may also cover certain lawfully residing children and pregnant women under permitted options, including some people within their first five years of qualifying immigration status.

Emergency Medicaid and state-funded coverage can have different requirements from regular full-benefit Medicaid.

Because immigration-status eligibility is category-specific, contact your state agency before assuming that lawful presence alone establishes eligibility for full Medicaid benefits. The official CMS guidance on lawfully residing children and pregnant women explains relevant state options.

What documents do you need to apply?

The exact information and verification requirements depend on your state and eligibility category. Medicaid agencies use available electronic data where permitted and may request additional evidence when needed.

Prepare the following information before applying:

• Your name, date of birth, address, and contact details.
• Household members and relevant family or tax relationships.
• Current income and employment information.
• Social Security Numbers when required for applicants.
• Citizenship or qualifying immigration-status information.
• Details of existing health insurance.
• Relevant pregnancy, disability, or other eligibility information.

Depending on what the state can verify, supporting documents may include pay statements, employer information, identity records, immigration documents, or evidence related to disability or other eligibility factors.

Do not assume every applicant must submit every document before applying. Follow the specific verification request issued by your state agency.

How to complete your Medicaid application

1. Locate your state agency. Use the official Medicaid state directory and open the enrollment instructions for your state.
2. Identify the people applying. Include the required household and applicant information accurately.
3. Report income and household circumstances. Provide the information requested for your eligibility category.
4. Submit the application. Follow the state's approved submission channel or the applicable Marketplace route.
5. Keep your confirmation. Save the application reference or other proof of submission.
6. Respond to requests. Supply additional information if the state cannot verify an eligibility factor.
7. Read the determination notice. Follow instructions for coverage enrollment, further verification, or an appeal.

When applying through the Marketplace, remember that a possible Medicaid eligibility finding does not necessarily mean the state has finished processing the application. The state Medicaid agency remains responsible for the final determination.

How much does Medicaid cost?

There is no fee to apply for Medicaid. Medicaid provides free or low-cost health coverage to eligible individuals and families.

Some beneficiaries may have premiums or other cost-sharing obligations where permitted by federal and state rules. The applicable amounts depend on the state, eligibility group, and services received.

Do not rely on a national premium estimate when deciding whether you can afford coverage. Your state Medicaid program provides the rules applicable to your situation.

Children who do not qualify for Medicaid may qualify for the Children's Health Insurance Program (CHIP). For that related option, see how to apply for CHIP coverage for your child.

When can you apply, and how long does approval take?

You can apply for Medicaid at any time of year. Medicaid applications are not limited to the annual Health Insurance Marketplace Open Enrollment Period.

Federal regulations establish maximum eligibility determination periods and require states to act promptly and without undue delay.

These are regulatory maximum periods, not promised processing times. The period includes time needed to obtain additional information and notify the applicant of the decision.

CMS explains these requirements in its Medicaid and CHIP eligibility determination bulletin.

If your application appears delayed, contact your state Medicaid agency to check its status and determine whether additional information is needed.

When does Medicaid coverage begin?

Under the general federal Medicaid framework, coverage for an eligible applicant is effective on the application date or the first day of the application month, depending on applicable rules.

Medicaid may also cover qualifying medical expenses from up to three months before the application month when retroactive coverage is available and the person would have met eligibility requirements during the relevant period.

Federal and state exceptions can affect retroactive coverage. Do not assume all previous medical bills are automatically covered.

If you have unpaid recent medical bills, tell your state Medicaid agency and ask whether retroactive eligibility can be evaluated under the rules applicable to your case.

What happens after Medicaid approval?

Your state Medicaid agency provides information about your eligibility, coverage and next steps. Depending on the state and program, you may receive benefits directly through Medicaid or through a managed care health plan.

Follow the instructions in your approval notice for accessing covered services, obtaining identification information and selecting a health plan if required.

Keep your contact information current and respond to future state notices about eligibility renewal or changes in circumstances.

If you also have Medicare and need help with certain Medicare expenses, a separate eligibility assessment may be relevant. See how to apply for a Medicare Savings Program.

What if your Medicaid application is denied?

If the state determines that you are not eligible, review the written notice explaining its decision. Check whether the agency used accurate income, household, residency and other eligibility information.

You have the right to request a fair hearing when you disagree with certain Medicaid eligibility decisions or when the agency fails to act with reasonable promptness.

States administer their hearing processes under federal requirements. The deadline and submission instructions for requesting a hearing depend on the applicable state procedure and should be stated in your notice.

The official Medicaid fair hearings guide explains the hearing process and available assistance.

A fair hearing challenges an agency action or failure to act. It is not the same as submitting a new application with changed circumstances.

Can you get other health insurance after a denial?

If you are not eligible for Medicaid, you may qualify for Marketplace health insurance and financial assistance, depending on your circumstances.

HealthCare.gov explains how to apply for Marketplace coverage after Medicaid or CHIP is denied or ends. Review the Marketplace coverage after Medicaid or CHIP denial guide.

When a loss of coverage qualifies for a Special Enrollment Period, you may be able to enroll outside the normal Marketplace Open Enrollment Period.

For a related application route, see how to enroll in Marketplace health insurance after losing coverage.

In states that have not expanded Medicaid, some adults with very low incomes may fall into a coverage gap. A Medicaid denial does not automatically guarantee Marketplace premium assistance.

Mistakes to avoid when applying for Medicaid

• Assuming Medicaid has a national income limit: Eligibility varies by state and applicant category.
• Waiting for Marketplace Open Enrollment: Medicaid applications are accepted throughout the year.
• Applying through the wrong state: Medicaid generally requires residency in the state providing coverage.
• Ignoring verification requests: Missing information can delay an eligibility decision.
• Assuming every applicant has the same asset rules: MAGI and non-MAGI categories use different financial methodologies.
• Assuming a Marketplace referral is final approval: The state agency must complete its eligibility determination.
• Overlooking previous medical expenses: Ask about applicable retroactive coverage rules if you have recent unpaid bills.
• Missing an appeal deadline: Read the state denial notice and follow its fair hearing instructions.

Official Medicaid application resources

These federal resources explain the Medicaid application routes and connect you with the responsible state agencies:

• State Medicaid agency directory — locate your state's official enrollment and eligibility contacts.
• HealthCare.gov Medicaid and CHIP coverage — understand state and Marketplace application routes.
• Medicaid eligibility policy — review federal eligibility requirements and state variations.
• Medicaid eligibility contacts — find out where to obtain an eligibility decision.
• Medicaid fair hearing information — understand rights after an adverse eligibility decision.