How you get Medicaid depends on your state and your situation

Medicaid is run by your state, not the federal government, so the process and rules differ where you live. Most states let you start the process online, by phone, or in person at your local department of social services. You will need to prove your income, household size, and citizenship or immigration status. The whole process usually takes two to four weeks, though some states are faster.

The fastest route is usually your state's online portal — search "[your state] Medicaid application" to find it. If you cannot use the internet, call your county's social services office and ask for the Medicaid unit. They can mail you a paper form or help you over the phone. Some states also let you start through community health centers or hospitals.

Key Takeaways

  • You must live in the state where you are applying, have a Social Security number or ITIN, and prove your income with recent pay stubs, tax returns, or bank statements.
  • Income limits vary by state and family size, but most states cover people earning under 130 to 200 percent of the federal poverty line.
  • Your state's online portal, your county social services office, or a 211 call can tell you whether you meet the income and citizenship rules before you submit anything.
  • Once you are approved, coverage usually starts on the first day of the month you applied or the month after, depending on your state.

What documents you need to bring or upload

Have these ready before you start your application: a photo ID or passport, your Social Security card, proof of income (recent pay stubs, tax returns from the last two years, or a letter from your employer), and proof of where you live (a utility bill, lease, or mortgage statement dated within the last 60 days). If you are unemployed, bring a letter from your last employer or unemployment paperwork.

If you are applying for a child or elderly parent, you will also need their birth certificate and Social Security number. If anyone in your household is not a U.S. citizen, bring immigration documents — a green card, visa, or work permit. Some states also ask for medical records or proof of disability if you are applying for Medicaid based on disability rather than income alone.

Most online portals let you upload photos of these documents. If you are applying by mail or in person, bring the originals or certified copies. The social services office will tell you which documents they need before you come in.

Income limits and household size rules

Medicaid covers people whose income falls below a certain level set by their state. That level depends on your household size and your state's rules. Most states cover people earning under 130 to 200 percent of the federal poverty line — for 2024, that means roughly $1,800 to $2,800 per month for a single person, though your state may be higher or lower.

Your household size includes you, your spouse if you are married, and any children under 19 who live with you. Some states count parents or other relatives; others do not. When you apply, the program will ask you to list everyone in your household and their income. Income includes wages, self-employment earnings, Social Security, unemployment benefits, child support, and rental income. Some income does not count — for example, most states do not count the first $20 of monthly income or certain disability payments.

To find your state's exact income limit, search "[your state] Medicaid income limits" or call your county social services office. Many states have online calculators that show you in seconds whether you likely meet the income rule.

Citizenship and residency requirements

You must be a U.S. citizen, a lawful permanent resident (green card holder), or in certain other immigration statuses to get Medicaid. You must also live in the state where you are applying and intend to stay there. Most states do not require you to have lived there for a certain amount of time before you apply.

If you are not a U.S. citizen, bring your immigration documents when you apply. Lawful permanent residents, refugees, asylees, and people with certain other statuses can get Medicaid in most states. Undocumented immigrants cannot get regular Medicaid in most states, though some states offer limited coverage for emergency services or pregnancy. Ask your county social services office what coverage is available in your state if you are not a citizen.

What happens after you submit your application

After you submit, the state will send you a notice by mail or email telling you whether you were approved, denied, or need to send more information. This usually takes two to four weeks. If they ask for more documents, send them as soon as you can — if you do not respond within 30 days, your application may be closed.

If you are approved, your coverage starts on the first day of the month you applied or the first day of the next month, depending on your state. You will get a Medicaid card in the mail with your member ID number. Some states send it within a week; others take two to three weeks. Until your card arrives, you can still use Medicaid at doctors and hospitals — just give them your member ID number from your approval notice.

If you are denied, the notice will explain why. You have the right to ask for a hearing to challenge the decision. The notice will tell you how to request one and how long you have to do it — usually 30 to 60 days.

Renewing your Medicaid coverage

Medicaid coverage does not last forever. Your state will send you a renewal form, usually once a year. The notice will tell you the deadline to return it — typically 30 to 60 days. You can renew online, by mail, or by phone, just like you applied.

When you renew, you will need to report any changes in your income, household size, or address. If nothing has changed, many states let you renew without sending new documents. If your income has gone up and you no longer meet the income limit, your coverage will end. Some states give you a grace period; others end it right away. Check your renewal notice to see what your state does.

If you miss the renewal deadline, your coverage will end. You can reapply at any time, but there may be a gap in coverage. Set a reminder on your phone or calendar when you get your renewal notice so you do not miss the deadline.

What to do if you are denied or lose coverage

If you are denied, the notice will explain the reason — usually income too high, not a resident of the state, or missing documents. Read it carefully. If you think the decision is wrong, you can request a hearing. Write to the address on the notice and say you want to appeal. You usually have 30 to 60 days to ask.

If your coverage ends because you did not renew or because your income went up, you can reapply at any time. Some states have a waiting period; most do not. If you lose coverage because of a major life change — you lost a job, got divorced, or had a baby — you may be able to reapply right away without waiting for the next open enrollment period.

If you need help understanding why you were denied or how to appeal, call your county social services office or contact a local legal aid organization. Many offer free help with Medicaid appeals.

Frequently Asked Questions

Can I apply for Medicaid if I am working?

Yes. Medicaid is based on income, not employment status. If your wages are low enough to meet your state's income limit, you can get Medicaid while working. Some states have special programs for working people with disabilities that let you earn more and still keep coverage.

How long does it take to get approved?

Most states process applications within two to four weeks. Some are faster — a few states approve people within days if you apply online. If the state asks for more documents, the clock usually stops until you send them. Once you send what they ask for, they have another 30 days to decide.

What if my income changes after I get Medicaid?

Tell your state right away. If your income goes up above the limit, your coverage will end — usually at the end of the month. If your income goes down, you may stay on Medicaid. Most states let you report changes online or by phone without waiting for your renewal date.

Do I have to pay anything for Medicaid?

Medicaid itself is free — there is no premium. Some states charge small copays when you see a doctor or fill a prescription, usually $1 to $5. Pregnant people and children usually pay nothing. Ask your state what copays apply to you.

What if I do not have a Social Security number?

You need a Social Security number or an Individual Taxpayer Identification Number (ITIN) to get Medicaid in most states. If you do not have one, apply for an ITIN through the IRS before you apply for Medicaid. Some states make exceptions for certain immigrants — call your county social services office to ask.