Who qualifies for Medicaid, and what it covers
Published May 30, 2026
Medicaid is a joint federal and state program that provides health coverage to eligible low-income individuals and families. Because states run their own programs within federal rules, eligibility and benefits vary widely depending on where you live.
How eligibility works
Eligibility is based mainly on income and household size, and in some states on other factors. Many states have expanded Medicaid to more adults, while others have not, so the income cutoffs differ.
What it covers
Medicaid covers a broad set of services, often including doctor visits, hospital care, pregnancy care, and long-term services. Specific benefits and any small cost-sharing depend on your state.
How to enroll
Unlike Marketplace plans, Medicaid enrollment is open year-round for those who qualify. You can apply through your state Medicaid agency or the Marketplace, which forwards eligible applications.
Frequently asked questions
＋ Who qualifies for Medicaid?
Eligibility is based mainly on income and household size, and varies by state. Some states cover more adults through Medicaid expansion than others.
＋ Is Medicaid the same as Medicare?
No. Medicare is a federal program mainly for people 65 and older or with certain disabilities. Medicaid is a joint federal-state program based on income and need.
＋ When can I apply for Medicaid?
Medicaid enrollment is open year-round for those who qualify, unlike Marketplace plans that have set enrollment windows.
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Educational content only — not legal, financial, or insurance advice. Requirements and pricing vary by state.