Medicaid is a federal healthcare program that provides free or heavily discounted health insurance to low-income people, including adults, children, elderly folks, and those with disabilities. Each state manages its own Medicaid insurance program, but the federal government establishes the program’s requirements as well as shares in funding Medicaid across the country.
Qualifying for Medicaid typically requires you to have a low income compared to the average household income in your area. So, you generally must meet your state’s income and financial asset requirements based on your age, family composition, and location.
Other factors that can determine whether you may be able to get Medicaid insurance include the following:
- Disability status
- Pregnancy status
- Enrollment in other financial assistance programs
The Children’s Health Insurance Program (CHIP) also provides low-cost health insurance to children whose families make more than the maximum household income accepted by the Medicaid insurance program, but still cannot afford to purchase private health insurance. Each state manages and funds its own CHIP health care program as well as sets additional requirements and qualifications.
Some states, for example, use CHIP to provide health insurance for pregnant women. In most states, CHIP insurance benefits are only for children; but if you are pregnant and live in a state that allows pregnant women to be covered under the CHIP program, then you may also be covered.
To get CHIP healthcare, your income must be too high for Medicaid, but too low to adequately afford private health insurance coverage for your child(ren) through your employer-sponsored insurance or other private health insurance.
The process of applying to Medicaid and/or CHIP insurance coverage typically follows the steps below:
- Learn about the program’s requirements. You can check the income requirements for your state by visiting your state’s websites for each program. For Medicaid, you can start your process at medicaid.gov, where you’ll find links to every state’s Medicaid enrollment website. For CHIP, you can start the process by visiting healthcare.gov and filling out an application or calling 1-800-318-296.
- Fill out an application. On your state’s Medicaid site, you can submit your application online, print out and mail in a paper application, or complete the application in person at a local agency office, depending on your state’s application process. To apply for CHIP, you can fill out a Health Care Marketplace application for your child at healthcare.gov. You may need to provide information about your income, residency, family composition, and more.
- Consider applying for supplemental health care coverage. If you are on a fixed income and/or retired living off of Social Security, you may qualify for a Medicare-Medicaid plan, where you have Medicare and Medicaid at the same time to cover health care costs.