Medicaid provides health care coverage to low-income people, pregnant women, elderly people and people with disabilities. State governments administer Medicaid under federal guidelines, and the program is funded jointly by the federal and state government.
If you're uninsured and think your income or other circumstances might qualify you for this kind of assistance, you might be wondering, "How do I apply for Medicaid?" There are two ways to apply: through your state's Medicaid agency and through the Health Insurance Marketplace.
How Do I Apply for Medicaid Through My State Agency?
You'll find the link to the website of your state's Medicaid agency on the Medicaid.gov site. The state sites have online application forms and information about how to apply. You can submit an application at any time, as there is no limited enrollment period for Medicaid.
How Do I Apply for Medicaid Through the Health Insurance Marketplace?
If your state participates in the Health Insurance Marketplace, you can create an account that will allow you to complete a Marketplace application. If the family information you supply indicates that someone qualifies for Medicaid, that data is sent automatically to your state's Medicaid agency. The agency will then contact you directly about enrollment.
Is CHIP Part of Medicaid?
The Children's Health Insurance Program, or CHIP, is separate from Medicaid, although the programs work closely together. CHIP provides low-cost health coverage to children in families with incomes too high to qualify for Medicaid.
If you apply for Medicaid and have children, you will automatically receive a notification if they are eligible for CHIP, even if your household income exceeds the limit for Medicaid. Like Medicaid, CHIP programs are administered by states with joint state and federal funding.
What Are the Medicaid Eligibility Rules?
Medicaid eligibility rules, including maximum income levels, depend on where you live, although some general rules apply everywhere. For instance, you must be a resident of the state in which you will receive Medicaid, and you must be either a U.S. citizen or a member of a qualified non-citizen group, such as legal permanent residents.
States that have not expanded Medicaid eligibility under the Affordable Care Act consider a variety of factors to determine whether a person qualifies. These can include household income and size, pregnancy, the care of young children, disability, medical need and age. In states that have expanded Medicaid, you can qualify based on income alone.
Some states also offer other pathways to Medicaid for people with high medical expenses, whose incomes are too high to otherwise qualify for assistance. Qualifications for these programs vary from state to state. Those who qualify are able to spend down their incomes by paying for uninsured health care expenses out of pocket until the amount exceeds the difference between their income and the Medicaid eligibility level.
With so many variations in state Medicaid and CHIP programs and their eligibility rules, the only sure way to know if you qualify is to apply. If you're looking for more information, check out the links below to learn more about the Medicaid and CHIP programs.