Guide to Medicaid

What is Medicaid?

Medicaid is a government-run health coverage program for low-income people in the United States¹ As of early 2025, the program provided comprehensive coverage with low out-of-pocket costs to more than 71 million people.²

Medicaid is jointly funded by the federal and state governments, and administered by each state¹ so eligibility guidelines and benefits vary significantly from state to state. Click on the map or the list of states to learn more about Medicaid in your state.

	Expansion states
	States refusing

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Medicaid eligibility

Medicaid eligibility rules vary from one state to another, so a person who is eligible for Medicaid in one state might not be eligible in another. Medicaid eligibility is based primarily on income – and for some populations, both income and assets – with specific guidelines set by each state.

Can I use my Medicaid coverage in any state?

Financial eligibility for Medicaid based only on income applies to:³

• Children
• Pregnant women
• Parents of minor children
• Adults under age 65 who are eligible due to Medicaid expansion

The specific income levels that make those populations eligible for Medicaid are different in each state⁴ (and not all states have expanded Medicaid eligibility). Income limits are shown as a percentage of the (FPL) which is updated annually.⁵

Learn more: Medicaid for children: Six facts every parent should know.

In addition to the populations listed above, additional populations can qualify for Medicaid if they have both a low income and low asset/resource levels. They include:⁶

• People age 65 and older
• People whose eligibility is based on disability or blindness

For these populations, the allowable income⁷ and asset levels⁸ also vary by state.

Are you losing Medicaid eligibility? Here’s what to do next.

Who gained coverage under Medicaid expansion?

Medicaid expansion refers to state action permitted by the Affordable Care Act (ACA) to expand coverage of more low-income adults. Before 2014, low-income adults could generally qualify for Medicaid only if they fit into one of the other eligibility categories (pregnant, disabled, or the parent/caretaker of a minor child). But the ACA created a new eligibility pathway for adults under age 65 whose household income isn’t more than 138% of the federal poverty level.⁹

This was intended to be available nationwide, but a 2012 U.S. Supreme Court ruling allowed states to continue to receive their existing federal Medicaid funding even if they didn’t expand Medicaid¹⁰¹¹

This essentially made Medicaid expansion optional for states, and there are still 10 states that have not expanded Medicaid as of 2025.¹² In nine of those states, adults with income under the federal poverty level fall into a “coverage gap” if they aren’t eligible for Medicaid due to pregnancy, being a parent/caretaker of a minor child, or disability. This means that some adults in those nine states are both ineligible for Marketplace subsidies  (making coverage too expensive) because their incomes are below the poverty level, and also ineligible for Medicaid because their states have not expanded Medicaid to cover low-income adults..

Find out whether your state has implemented Medicaid expansion.

How to apply for Medicaid

You can apply for Medicaid online, by mail, over the phone, or in person, depending on where you live.¹³

You can also begin the process by visiting the health insurance Marketplace in your state (HealthCare.gov or a state-run Marketplace). In some states, you can complete Medicaid enrollment via the Marketplace website.¹⁴ But in most states, the Marketplace will transfer your information to the state Medicaid agency if it looks like you’re eligible, and Medicaid will contact you to complete the application process.¹⁵

Since Medicaid is administered separately by each state, the enrollment process and eligibility rules vary by state. But unlike other types of health coverage, Medicaid enrollment is open year-round.¹⁶ So you can apply anytime, without needing a qualifying life event.

What documents do I need to apply for Medicaid?

The specifics will vary depending on where you live, but you will likely need to provide the following information to apply for Medicaid:¹⁵

• Name, date of birth, and Social Security number for all household members applying for Medicaid.
• Proof of residence in the state where you’re applying for Medicaid.
• Proof of income, such as pay stubs or a W-2. (Depending on the circumstances, you might also need to provide proof of expenses, including medical expenses.)¹⁷
• Proof of citizenship or immigration status. (You generally need to be lawfully present in the U.S. for at least five years to be eligible for Medicaid, although that’s not always the case, especially for children and pregnant women.)¹⁸
• Details about any other government benefits you receive, such as Social Security or SNAP.
• Information about any other insurance you might have, or a coverage offer from an employer. (Some states use Medicaid funds to help eligible applicants pay for employer-sponsored health insurance.)¹⁹

What does Medicaid cover?

There are some services that Medicaid is required to cover in every state, and other services that are optional for states to cover.²⁰ As a result, Medicaid benefits differ from one state to another.

Learn more about what Medicaid covers.

Medicaid coverage typically means low or zero out-of-pocket costs for the enrollee. The specifics vary depending on the state and the care that’s provided, but total enrollee costs can’t be more than 5% of a household’s income.²¹

What is the difference between Medicare and Medicaid?

Medicare and Medicaid are both government-run health coverage programs. But they have several key differences, including:¹

Medicaid funding

Medicaid is jointly funded by the federal government and each state’s government. The funding split for traditional Medicaid (meaning everyone except the Medicaid expansion population) depends on the average per-capita income in the state, with higher federal funding going to states with lower average per-capita incomes.²⁴

For the Medicaid expansion population, the federal government pays 90% of the cost and states pay 10% of the cost. This 90/10 split does not vary by state.

When we include both the traditional Medicaid population and the Medicaid expansion population, the federal government pays roughly 50% to 80% of total Medicaid costs, depending on the state.

Frequently asked questions about Medicaid