Medicaid is a government health insurance program for low-income Americans. Here's everything you need to know about how it works, who it covers, and how to apply.
What Is Medicaid?
Medicaid is a joint federal and state health insurance program that provides free or low-cost coverage to millions of Americans with limited income and resources. It is the largest source of health coverage in the United States, covering over 90 million people.
Unlike Medicare — which is based on age — Medicaid is based on income and family size. If your income falls below a certain threshold, you may qualify regardless of your age.
Who Funds Medicaid?
Medicaid is funded jointly by the federal government and individual states. The federal government sets minimum standards and pays a portion of the costs (called the Federal Medical Assistance Percentage, or FMAP). States administer their own programs and can expand benefits beyond the federal minimum.
This is why Medicaid programs vary so much from state to state — the same person might qualify in California but not in Texas.
Who Does Medicaid Cover?
Medicaid covers several groups:
Low-income children — Children are the single largest group covered by Medicaid and the Children's Health Insurance Program (CHIP).
Pregnant women — Most states provide Medicaid coverage for pregnant women at higher income limits than for other adults.
Low-income adults — In states that expanded Medicaid under the Affordable Care Act, adults earning up to 138% of the Federal Poverty Level (about $20,120/year for an individual in 2025) qualify.
Elderly and disabled individuals — Seniors with limited income and people with disabilities can qualify for Medicaid, sometimes alongside Medicare.
What Does Medicaid Cover?
Federal law requires all state Medicaid programs to cover certain services, including:
- Inpatient and outpatient hospital care
- Physician services
- Laboratory and X-ray services
- Family planning services
- Pediatric and family nurse practitioner services
- Federally Qualified Health Center (FQHC) services
States may also cover optional services such as prescription drugs, dental care, vision care, physical therapy, and transportation to medical appointments.
How Is Medicaid Different From Medicare?
Medicare and Medicaid are both government health programs, but they serve different populations:
Medicare is primarily for people 65 and older, and for younger people with certain disabilities. Eligibility is based on age or disability status, not income.
Medicaid is for people with low incomes, regardless of age. Eligibility is based on income and household size.
Some people qualify for both programs — these individuals are called "dual eligibles."
How Do I Apply for Medicaid?
You can apply for Medicaid through several channels:
1. Your state's Medicaid agency — Each state has an online portal where you can apply directly
2. Healthcare.gov — The federal marketplace can screen you for Medicaid eligibility
3. A licensed enrollment specialist — Free assistance to help you navigate the application process
4. In person — At your local Department of Social Services or health department
The application asks about your household size, income, assets, and residency. Most states process applications within 45 days (or 90 days if a disability determination is needed).
How Much Does Medicaid Cost?
For most Medicaid beneficiaries, coverage is free or nearly free. Some states charge small copayments for certain services, but these are typically under $4 per visit. Premiums are generally not charged for most adult Medicaid enrollees, though some states charge small monthly premiums for higher-income enrollees.
The Bottom Line
Medicaid is one of the most important safety net programs in the United States. If you have a low income, you may qualify — and the coverage is comprehensive. The best way to find out is to check your eligibility.