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How do I know if I qualify for Medicaid?

Updated Sep 3, 20261 min readAnswer
On this pageShort answer What to do Common questions Related questions Sources
Short answer

Enter household size and state in HealthCare.gov's checker and it tells you whether you might qualify for Medicaid, CHIP, or marketplace savings.

Eligibility is state-specific: Medicaid covers low-income adults, families, children, pregnant women, the elderly, and people with disabilities, with expansion states qualifying most adults on income alone and non-expansion states leaving a coverage gap. Apply even if the checker says maybe not, since pregnancy, disability, or family situation can qualify you, and enrollment is open year-round. Kids often qualify through CHIP at higher incomes than their parents.

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What to do

1Run the HealthCare.gov checkerwith household size and state.
2Apply even if unsure;non-income categories can qualify you.
3No deadline:Medicaid and CHIP enroll year-round.
4Report income changes;eligibility follows your current situation.

Common questions

How do I know if I qualify for Medicaid?

The fast check takes two minutes. HealthCare.gov has a tool where you enter your household size and state, and it tells you whether you might qualify for Medicaid, CHIP, or savings on a marketplace plan, because the rules are state-specific: Medicaid and CHIP provide free or low-cost health coverage to eligible low-income adults, families and children, pregnant women, the elderly, and people with disabilities, but each state sets its own income limits and categories. In states that expanded Medicaid, most adults qualify on income alone at roughly up to 138% of the federal poverty level; in states that did not expand, adults without children can fall into a gap where they earn too much for Medicaid and too little for marketplace savings, which is exactly why the check matters. HealthCare.gov's advice is to apply even if you do not qualify based on income, because you might qualify for your state's program on other grounds, like pregnancy, disability, or family situation, and applying is the only way to get a definitive answer. Two more useful facts: Medicaid and CHIP accept applications any time of year, with no open enrollment window, and children often qualify through CHIP at higher family incomes than the adults in the same household. If income fluctuates, report changes, because eligibility follows your current situation.

About this page. Written and maintained by the Pymander Health team. Last updated September 3, 2026.

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