How to apply for Medicaid

Last verified: June 2026

Knowing how to apply for Medicaid is the first step toward coverage for you or your family. The process is simpler than many people expect — you can apply any time of year, there is no open enrollment period, and in most states the whole application takes under an hour online. Medicaid covers more than 77.9 million Americans, per CMS, making it the largest single source of health coverage in the country.

This guide covers all four application methods, what documents you'll need, and how long the state has to respond. It also explains a little-known rule that can get you covered for medical bills from up to three months before you applied.

Who can apply for Medicaid

Medicaid is a joint federal and state program. Federal law sets minimum eligibility rules; states set the rest. That means income limits, covered services, and costs vary by state — but some groups have federal protections that apply everywhere.

Under the Affordable Care Act, states that expanded Medicaid cover adults with household income up to 138% of the Federal Poverty Level (FPL). As of 2026, 41 states plus DC have adopted expansion. The non-expansion states still cover many groups — children, pregnant women, parents, people with disabilities, and adults 65 and older — but working-age adults without dependent children often face much stricter income thresholds in those states.

Financial eligibility for most applicants is determined using Modified Adjusted Gross Income (MAGI), a methodology the ACA introduced to replace older asset-based rules. MAGI does not include an asset test for most groups — only income and household tax-filing relationships matter. The exception: adults 65 and older and people with blindness or disability are evaluated under SSI-related income methodologies, which do include asset limits, per CMS Medicaid eligibility guidance.

Groups that can apply in every state include:

• Children under 19 with income up to at least 133% FPL (higher in most states)
• Pregnant women — income threshold varies, but federal minimum is 133% FPL
• Parents and caretaker relatives meeting the state's income standard
• Adults 65 and older with limited income
• People with a qualifying disability or blindness
• Former foster care youth in all states until age 26 if they had Medicaid at age 18

If you live in a non-expansion state and don\'t fit one of those categories, you may still qualify. Apply anyway — states have additional programs and coverage options that aren't always listed prominently.

Documents to collect before you apply

Having your documents ready before you start prevents the most common reason applications stall: requests for more information. You don't need every item on this list — what you need depends on your household — but gathering likely documents in advance saves time.

• Photo ID (driver's license, state ID, or passport)
• Proof of U.S. citizenship or eligible immigration status
• Social Security numbers for all household members applying
• Proof of state residency (utility bill, lease, bank statement)
• Recent pay stubs or employer letter showing current income
• Most recent federal tax return (if self-employed or income varies)
• Documentation of other income: Social Security, alimony, rental income
• Proof of pregnancy (if applying under pregnancy eligibility)
• Insurance card if you currently have any other coverage

States are required to check electronic data sources first before asking you for documents, per 42 CFR 435.952. That means the state should verify income through IRS records and citizenship through Social Security Administration databases before sending you a request. You won't always need to submit paper proof for everything on this list.

Four ways to apply for Medicaid

Federal regulations require states to accept applications through multiple channels. You can apply online, by phone, in person, or by mail — the choice is yours. All four methods carry the same legal weight; your eligibility is based on your information, not how you submitted it.

How long Medicaid approval takes

States must process most Medicaid applications within 45 days of the date they receive the application, per 42 CFR 435.912. Applications that require a disability determination — where the state must assess whether you meet the clinical definition of disability — get a 90-day window instead. These are federal maximum processing times; many states act faster.

The clock stops if the state sends you a request for additional information and you haven't responded. Respond as quickly as possible to keep your application moving.

Once approved, coverage is effective on your application date or the first day of the month of application. Some states use the application date; others use the first of the month — check your approval notice.

What happens after you apply

After you submit your application, the state reviews your information and checks electronic data sources (IRS, Social Security Administration, DHS) before asking you for anything. You'll receive a written notice of the state's decision.

If approved: your notice will list your coverage effective date, your managed care plan options (if your state uses managed care), and how to get a Medicaid ID card. Enroll in a plan promptly if the state gives you a choice — if you miss the window, the state typically auto-assigns you to one.

If approved for Medicaid and you currently have Marketplace coverage: per healthcare.gov, you are not eligible for premium tax credits once you qualify for full Medicaid. End your Marketplace plan when your Medicaid coverage begins to avoid repaying credits at tax time.

If your application is denied or action is delayed unreasonably, you have the right to a fair hearing. The denial notice must explain the reason and give instructions for requesting a hearing. Per CMS Medicaid eligibility guidance, states must provide individuals the right to request a fair hearing if coverage is denied or if the state fails to act with reasonable promptness.

Appealing a denial

A denial is not final. You can request a fair hearing — typically within 90 days of the denial notice, though your state may allow more time. The hearing is an administrative proceeding where you present your case to an impartial officer.

Common reasons for denial include income reported higher than the actual household income, a data mismatch between state records and your actual situation, or an incorrect household size calculation. Many denials are reversed at the hearing stage when applicants provide documentation the state didn't have.

If you are denied Medicaid coverage and live in an expansion state, you may be eligible for subsidized coverage through the Marketplace instead. Per healthcare.gov, if a state denies your Medicaid application, your contact information is sent to the Marketplace so you can be informed about plan options.

Legal aid organizations and enrollment assisters (Navigators) can help you prepare for a hearing at no cost. Find enrollment assisters at localhelp.healthcare.gov.

Applying in specific states

The steps above apply everywhere, but the specific portal, phone number, and income thresholds differ by state. A few examples of how state programs vary:

Texas has not expanded Medicaid, so working-age adults without dependent children generally cannot qualify regardless of income. Texas residents who think they qualify should apply through YourTexasBenefits.com and can also check eligibility through healthcare.gov.

Illinois expanded Medicaid and covers adults up to 138% FPL. Applications go through the Illinois Department of Healthcare and Family Services at hfs.illinois.gov, or through the state's ABE (Application for Benefits Eligibility) portal.

All states operate a Medicaid program, though the program may have a different name — Medi-Cal in California, TennCare in Tennessee, AHCCCS in Arizona. The application process follows the same federal framework regardless of what the program is called.

Checking your Medicaid status after applying

Most states let you check your application or coverage status online through the same portal where you applied. Log in with the credentials you created when you started your application.

You can also call your state Medicaid agency and provide your case number or Social Security number to get a status update over the phone.

If you applied through healthcare.gov, log in to your Marketplace account and check the status under "My Applications." The Marketplace will show whether your application was transferred to the state and what the state's response was.

Medicaid and Medicare: not the same application

Many people search for "how to apply for Medicare" when they mean Medicaid — and vice versa. The two programs are separate. Medicare is a federal health insurance program for people 65 and older and certain people under 65 with disabilities. You enroll in Medicare through the Social Security Administration, not through your state Medicaid agency.

Some people qualify for both programs — this is called "dual eligibility." If you are 65 or older and have low income, you may be entitled to Medicare as your primary coverage with Medicaid picking up costs Medicare doesn't cover, including most cost-sharing and some services Medicare excludes.

If you think you may be dual-eligible, apply for Medicaid through your state even if you are already on Medicare. The state will determine if you qualify for Medicaid's additional coverage.

A note on CHIP

The Children's Health Insurance Program (CHIP) covers children in households that earn too much for Medicaid but can't afford private coverage. CHIP is separate from Medicaid in most states but uses the same application. When you apply for Medicaid for a child, the state simultaneously screens for CHIP eligibility.

You don't need to apply to CHIP separately. Submit one application and the state determines which program — Medicaid or CHIP — the child qualifies for.

Summary of steps