Medicaid provides free or low-cost health coverage to millions of Americans, but figuring out whether you qualify can feel confusing. The rules vary by state, and recent changes to income thresholds mean more people may be eligible than they realize.
What Is Medicaid?
Medicaid is a joint federal and state program that covers medical costs for people with limited income and resources. It covers doctor visits, hospital stays, prescriptions, preventive care, and more — often with no premiums and minimal copays.
Income Limits by Category
Medicaid eligibility depends on your income, household size, and which state you live in. In expansion states, most adults with income up to 138% of the federal poverty level qualify. That is about $20,783 per year for an individual in 2026.
- Children: Generally covered up to 200-300% FPL depending on state
- Pregnant women: Covered up to 138-200% FPL in most states
- Adults (expansion states): Up to 138% FPL
- Seniors and people with disabilities: Different criteria through SSI linkage
- Parents: Varies widely by state — check your state’s specific threshold
Expansion vs. Non-Expansion States
Under the Affordable Care Act, states could choose to expand Medicaid to cover more adults. As of 2026, 40 states plus D.C. have expanded. In non-expansion states, many low-income adults without children fall into a “coverage gap” where they earn too much for traditional Medicaid but too little for marketplace subsidies.
Not sure if your state expanded? Visit HealthCare.gov or your state Medicaid agency’s website to check current eligibility rules for your area.
How to Apply
Online: Apply through HealthCare.gov or your state’s Medicaid website.
By phone: Call your state Medicaid office or the Marketplace call center at 1-800-318-2596.
In person: Visit your local Department of Social Services.
By mail: Download a paper application from your state’s website and mail it in.
What Medicaid Covers
- Inpatient and outpatient hospital services
- Physician and specialist visits
- Prescription medications
- Laboratory and X-ray services
- Preventive care and screenings
- Mental health and substance abuse treatment
- Home health services
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Relief Resource Center may receive compensation when you use links or tools on this page. All programs listed are subject to eligibility requirements and availability. This page is for informational purposes only and does not constitute legal, financial, or medical advice.