Medicaid provides free health insurance to over 85 million Americans including low income individuals, children, pregnant women, seniors, and people with disabilities. In states that expanded Medicaid under the Affordable Care Act, individuals with incomes up to 138% of the Federal Poverty Level qualify for comprehensive coverage at no cost.
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Medicaid Eligibility
Medicaid eligibility is based on income, household size, and category (individual, child, pregnant woman, elderly, or disabled). In Medicaid expansion states, most individuals earning up to 138% FPL ($20,783/year for one person) qualify. Children generally qualify at higher income levels through Medicaid or CHIP.
What Medicaid Covers
Covered Services
- Hospital services - Inpatient and outpatient
- Doctor visits - Primary and specialty care
- Prescriptions - Medication coverage
- Lab tests and imaging - Blood work, X-rays, MRI
- Mental health - Therapy and psychiatric care
- Maternity care - Prenatal through postpartum
- Preventive care - Screenings and vaccinations
- Emergency services - ER and ambulance
- Pediatric care - Dental and vision for children
Medicaid Expansion States
Forty states and Washington D.C. have expanded Medicaid under the ACA, extending coverage to individuals earning up to 138% of the Federal Poverty Level. In non-expansion states, individuals without children may not qualify for Medicaid regardless of income, though children and pregnant women still qualify at higher limits.
Medicaid and CHIP for Children
All children in families with incomes up to at least 138% FPL qualify for Medicaid. The Children's Health Insurance Program (CHIP) extends coverage to children in families earning more. Together, Medicaid and CHIP cover over 39 million children. Children receive comprehensive benefits including dental and vision care.
How to Apply for Medicaid
Apply at HealthCare.gov, through your state Medicaid office, or by calling 1-800-318-2596. You can apply any time of year - there is no enrollment period for Medicaid. You need proof of identity, income, and citizenship/immigration status. Applications are typically processed within 45 days.
Frequently Asked Questions
In expansion states, individuals earning up to 138% FPL ($20,783/year for one person) qualify. Children qualify at higher income levels. Pregnant women, seniors, and disabled individuals have their own eligibility categories with varying income limits.
Medicaid covers doctor visits, hospital stays, prescriptions, mental health, maternity care, lab tests, emergency services, and preventive care. Children receive additional benefits including dental and vision. Dental and vision coverage for individuals varies by state.
Apply at HealthCare.gov, your state Medicaid office, or call 1-800-318-2596. You can apply any time. Bring proof of identity, income, citizenship, and household information. Most applications are processed within 45 days.
