Medicaid and the Children’s Health Insurance Program, called CHIP, offer free or low-cost coverage to eligible people. Medicaid can cover children, adults, pregnant people, older adults, and people with disabilities. CHIP helps children, and in some states pregnant people, in families that make too much for Medicaid.
There is no once-a-year door
You can apply for Medicaid and CHIP at any time of year. You can use HealthCare.gov or apply straight through your state Medicaid agency. A Marketplace application can send the household information to the state when somebody looks eligible.
One house can get different answers
A child may qualify for CHIP while a parent does not qualify for Medicaid. Pregnancy, disability, age, household size, and state expansion rules can change the result. Apply for the people who need coverage and let the state screen the household.
Do not stop at “I make too much for Medicaid.” Ask whether the children should be screened for CHIP.
Get the income estimate right
The application asks about household and income. The people counted can depend on tax relationships, not just who sleeps at the address. Use the HealthCare.gov household guide and the state’s instructions. If work hours bounce around, ask how to make a good current estimate.
Keep every state letter
A notice may approve one person, ask another person for proof, and deny somebody else. Read each name. Mark the due date for documents or an appeal. If you upload proof, keep the confirmation.
Ask about recent medical bills
HealthCare.gov says Medicaid may be able to help with care from the prior three months, depending on the person’s income at that time and state rules. Ask the state. Do not promise a provider that it will be covered until the state says so.
If the state says no
The state may send the information back to the Marketplace. A Medicaid or CHIP loss or denial can also create a special chance to enroll in Marketplace coverage. Read the notice and act on the date. Do not leave a Marketplace plan running at full price by accident when Medicaid starts; ask how to end it at the right time.
In an emergency, get emergency care. Do not wait for an eligibility letter when a person’s life or health is in danger.
Use free local help if the form is muddy
HealthCare.gov has a local-help finder for trained assisters. They can help with the application. They do not decide the state case.
Where we checked
Go straight to the source
- HealthCare.gov Medicaid & CHIPOfficial coverage basics, year-round application routes, and state contacts.
- HealthCare.gov application helpApplication checklist and local trained-help finder.
- Medicaid and CHIP state program namesFind the name your state uses for each program.
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