Medicaid Eligibility
Who qualifies, income limits by household size, and how to apply year-round in any state.
Last updated: May 2026
Medicaid is a joint federal-state program that provides free or very low-cost health coverage to more than 80 million Americans. Eligibility rules vary by state, but most rest on a combination of income, household size, and category (child, parent, pregnant, disabled, senior, or expansion adult).
Who is eligible
- Children & CHIP: up to 200–400% FPL in most states
- Pregnant people: covered in every state, typically up to 200% FPL or higher
- Parents/caretakers: varies wildly by state, from ~25% to 138% FPL
- Expansion adults (19–64): up to 138% FPL in 41 states + DC
- Seniors 65+ and people with disabilities: typically up to 100% FPL plus an asset test
- Foster youth: covered to age 26 in every state, regardless of income
Income limits in 2026 (138% FPL)
- Household of 1 — about $20,800/year ($1,733/month)
- Household of 2 — about $28,200/year ($2,350/month)
- Household of 3 — about $35,600/year ($2,967/month)
- Household of 4 — about $43,000/year ($3,583/month)
- Add roughly $7,400 for each additional household member
Documents you'll need
- Photo ID and Social Security Number for each applicant
- Proof of citizenship or qualifying immigration status
- Most recent pay stubs, tax return, or self-employment ledger
- Proof of address in your state
- Information about any other health coverage you have
When you can apply
Medicaid has no open-enrollment window — you can apply any day of the year through your state agency, HealthCare.gov, or with help from a Zero Gap Health advisor. If you qualify, coverage usually starts the first day of the month you applied (sometimes retroactive up to three months earlier for medical bills you've already received).
If you're in a non-expansion state
In Texas, Florida, Georgia, Alabama, Tennessee, Mississippi, South Carolina, Kansas, Wyoming, and Wisconsin, traditional Medicaid for adults is limited. If you fall into the coverage gap we'll look at every option — Marketplace subsidies (if you're at or above 100% FPL), county indigent-care programs, Federally Qualified Health Centers, and pharmacy assistance programs.
See what you qualify for — free, in under 2 minutes.
Answer a few quick questions and a licensed advisor in your state will walk you through your options. No SSN required, no obligation.