Where to start: your state Medicaid office or online portal

You sign up for Medicaid through your state, not through a federal office. Every state runs its own program with its own rules, income limits, and application process. Most states now let you start online; some still require you to mail or hand-deliver forms. The fastest way to find your state's entry point is to search "[your state name] Medicaid" or call 211, which connects you to local health programs and can tell you exactly where to go.

Many states have moved to a single online portal that handles Medicaid, CHIP (Children's Health Insurance Program), and sometimes food assistance and cash aid all in one place. These portals usually let you start an application, upload documents, and check your status without leaving home. If your state does not have an online option, you will apply in person at your local Medicaid office or through the mail.

Do not go to a hospital, clinic, or insurance company website first — they cannot enroll you in Medicaid. Your state Medicaid office is the only place that can process your application and make the decision.

Key Takeaways

  • You apply through your state Medicaid office or its online portal, not through a federal agency or private company.
  • Most states now accept online applications, though some still require mail or in-person submission.
  • You will need proof of income, citizenship or immigration status, and residency; the exact documents vary by state.
  • Processing typically takes 30 to 45 days, though some states are faster if you submit everything at once.
  • If you are denied, you have the right to request a hearing and present more information.

What documents you need to bring or upload

States require proof of three things: who you are, where you live, and how much money you make. Bring a government-issued ID (driver's license, passport, or state ID), a recent utility bill or lease showing your current address, and proof of income. Income proof can be a recent pay stub, a letter from your employer, tax returns from the past year, or a bank statement showing regular deposits.

If you are applying for a child, bring their birth certificate and Social Security number. If you are pregnant, bring documentation of the pregnancy from a doctor or clinic. If you are over 65 or have a disability, bring medical records or a letter from your doctor. States also ask for your Social Security number, immigration status, and citizenship status — have that information ready even if you do not have a document to show.

The exact list of acceptable documents varies by state. When you start your application online or in person, the office will tell you which documents they need. If you are missing something, ask whether you can submit it later or whether there is an alternative form of proof.

How the application process works, step by step

If you are applying online, you will create an account, answer questions about your household size and income, and upload documents. The system usually tells you right away if you are missing something. Once you submit, you will get a confirmation number and an estimated decision date. Most states send updates by email or text if you set that up during the application.

If you are applying by mail, fill out the state's application form (available on the state website or at the Medicaid office), attach copies of your documents, and mail it to the address on the form. Keep a copy for yourself. If you are applying in person, bring the original documents and the completed form; the office will make copies and give you a receipt with a case number.

After you submit, a caseworker will review your application. They may call or email you with questions — make sure the phone number and email you provide are ones you check regularly. If they cannot reach you, your application may be delayed or denied. If you move or change your phone number during the process, contact your state Medicaid office right away to update your information.

How long approval takes and what happens next

Most states aim to make a decision within 30 to 45 days. Some states are faster — as little as 7 to 10 days — if you submit all your documents at once and your case is straightforward. If the state needs more information from you, the clock often pauses until you send it, which can stretch the timeline to 60 days or longer.

Once you are approved, the state will send you a Medicaid card or a letter with your member ID number. You can usually start using your coverage right away, even if the physical card has not arrived. If you applied online, you can often see your member ID in your account before anything arrives in the mail. Keep that number handy — you will need it when you see a doctor or fill a prescription.

If you are denied, the state will send you a letter explaining why. You have the right to request a hearing and present more information. The letter will tell you how to request a hearing and the deadline to do so — usually 30 days. If you think the decision was wrong, do not ignore the letter; request the hearing within the deadline.

Renewing your coverage each year

Medicaid coverage is not permanent. Most states require you to renew once a year, usually on the anniversary of when you were first approved. Some states now use continuous enrollment, meaning you stay covered as long as your circumstances do not change and you do not lose touch with the program. Check your state's rules.

When it is time to renew, the state will send you a notice with instructions. Many states let you renew online the same way you applied. You will need to confirm that your income, household size, and address have not changed — or report what has changed. If you do not renew by the deadline, your coverage will end, even if you are still may be able to access.

If your income or household changes during the year — you get a job, lose a job, get married, have a baby, or move — report it to your state Medicaid office. Some changes may end your coverage; others may not affect it. It is always better to report a change than to wait for the annual renewal.

What to do if you have trouble with your application

If your online application keeps crashing or you cannot upload a document, call your state Medicaid office and ask to apply by phone or mail instead. If a caseworker is not returning your calls, ask to speak to a supervisor. If you do not speak English well, ask for an interpreter — states are required to provide one at no cost.

If you are homeless or do not have a mailing address, tell the Medicaid office. Many states will accept a shelter address, a friend's address, or a general delivery address at the post office. If you do not have a phone number, ask whether you can check your status online or pick up mail in person.

If you believe the state made a mistake — denied you when you should have been approved, or approved you for the wrong amount of coverage — you can request a hearing. You do not need a lawyer, though you can bring one. The hearing gives you a chance to explain your situation to someone other than the caseworker who made the first decision.

Frequently Asked Questions

Can I apply for Medicaid if I am not a U.S. citizen?

It depends on your immigration status. Lawful permanent residents (green card holders) and some other legal immigrants can get Medicaid. Undocumented immigrants cannot get regular Medicaid in most states, though some states offer limited coverage for emergency care or pregnancy. Ask your state Medicaid office what you need to prove your status and what coverage you may be able to get.

What if I do not have a Social Security number?

Most states require a Social Security number to apply for Medicaid. If you do not have one, ask your state Medicaid office whether you can apply without one or whether you need to get one first. Some states have exceptions for certain immigrants or refugees.

Do I have to pay anything to apply for Medicaid?

No. Applying for Medicaid is free. If someone asks you for money to help you apply, that is a scam. Your state Medicaid office does not charge a fee, and neither do 211 or other free referral services.

Can I apply if I already have private insurance?

Yes. Having private insurance does not disqualify you from Medicaid. If you are approved for both, Medicaid usually pays second, after your private insurance. Some people keep private insurance and use Medicaid as a backup.

What happens if I move to a different state?

Your Medicaid coverage ends when you move. You will need to apply in your new state. Some states have a grace period of a few days or weeks, but do not count on it — apply in your new state as soon as you move. Your new state will not automatically know about your old coverage.