Where to start: your state Medicaid office or healthcare.gov

You sign up for Medicaid through your state's Medicaid program, not through a federal office. Each state runs its own program with its own rules, income limits, and application process. The fastest way to find your state's application is to visit healthcare.gov and enter your state name — the site will direct you to the right office and tell you whether your state uses its own application or the federal form.

Some states use a single online portal for all benefits (called SNAP, Medicaid, and TANF together). Others have separate Medicaid offices. A few allow you to start an application on healthcare.gov itself. Calling your state's Medicaid hotline — which healthcare.gov provides — is the most direct way to confirm what documents you need and whether the program is currently taking new members, since some states pause enrollment at certain times of year.

If you are over 65 or have a disability, you may also be routed toward Medicare or a combined Medicare-Medicaid program. The healthcare.gov site will flag this during the intake questions, so answer those questions honestly even if you think you want Medicaid instead.

Key Takeaways

  • Your state Medicaid office is where you submit your information; healthcare.gov tells you which office that is and what form to use.
  • You will need proof of income (recent pay stubs, tax return, or a letter from your employer), proof of citizenship or immigration status, and proof of where you live.
  • Income limits vary by state and by family size; your state's Medicaid office can tell you the exact threshold before you start.
  • Processing usually takes two to four weeks, though some states are faster; you can check the status by calling or logging into your account online.
  • If you are denied, you have the right to a hearing where you can present new information or challenge the decision.

Documents you will need to bring or upload

Medicaid programs require proof of three things: who you are, where you live, and what you earn. The exact documents accepted vary by state, but most programs take the same types of evidence.

For proof of income, bring recent pay stubs (usually the last two months), a tax return from the past year, a letter from your employer on company letterhead stating your salary, or a benefit statement if you receive Social Security, unemployment, or child support. If you are self-employed, bring your tax return and a profit-and-loss statement. If you have no income, you may need a signed statement saying so.

For proof of citizenship or immigration status, bring a birth certificate, passport, naturalization papers, or a state ID. If you are not a U.S. citizen, bring your immigration documents (green card, work permit, visa, or asylum paperwork). Some states accept a combination of documents; your state office will tell you what counts.

For proof of residence, bring a recent utility bill, lease, mortgage statement, or property tax bill with your name and current address. A bank statement or mail from a government agency also works in most states. The document usually needs to be from the past 60 days.

How to submit your application

Most states now let you start online through their Medicaid portal or through healthcare.gov. Some still require you to mail a paper form or visit an office in person. Your state's Medicaid hotline will tell you which method is fastest right now.

Online applications are usually the quickest route. You create an account, answer questions about your household, income, and assets, and upload documents as you go. The system often tells you immediately whether you appear to meet the income limit, though that is not a final decision. You get a confirmation number and can check your status online or by phone.

Paper applications require you to print the form (usually available on your state's Medicaid website), fill it out by hand, and mail it to the address listed. Include copies of your documents — never send originals. Keep a copy for yourself and consider mailing it certified so you have proof of delivery. Processing takes longer this way, usually four to six weeks.

In-person applications are available at your local Medicaid office or sometimes at community health centers. Bring all your documents and be ready to wait. An advantage is that staff can tell you on the spot if something is missing, so you can fix it immediately rather than waiting for a letter.

What happens after you submit

After you submit, your state will send you a notice by mail or email (depending on how you applied) within two to four weeks. The notice will say whether you are approved, denied, or need to provide more information. If you are approved, the notice will tell you your coverage start date and how to find doctors and hospitals in your plan.

If the state asks for more information, respond within the deadline they give you — usually 10 to 30 days. Missing the deadline can result in denial even if you would have been approved. If you cannot find a document, call your state's Medicaid office and ask whether something else will work instead.

You can check the status of your application by logging into your online account (if your state has one) or by calling the Medicaid hotline. Have your application number or Social Security number ready. Some states also send text or email updates automatically.

Income limits and what counts as income

Medicaid income limits vary significantly by state. Some states cover people earning up to 138% of the federal poverty line; others cover only those at or below 100%. For a single adult in 2024, the federal poverty line is around $15,000 per year, but your state's limit could be higher or lower.

Your state's Medicaid office publishes its exact income limits by household size. Call them or check their website before you start your application so you know whether you are likely to be approved. Income limits also change yearly, usually on January 1st.

Not all money counts as income. Medicaid typically counts wages, self-employment earnings, Social Security, unemployment benefits, child support, and pension or retirement payments. It usually does not count food stamps (SNAP), housing vouchers, or one-time payments like tax refunds or insurance settlements. Some states have different rules, so ask your Medicaid office what counts in your state.

If you are denied or need to appeal

If your application is denied, the notice will explain why — usually because your income is too high, you did not provide required documents, or you do not meet your state's citizenship rules. The notice will also tell you how to request a hearing, which is a chance to present your case to an independent reviewer.

You have a set number of days (usually 30 to 60) to request a hearing. Do this in writing if possible, and keep a copy. At the hearing, you can bring new documents, explain your situation, and challenge the state's decision. Many people win on appeal because they can show documents or circumstances the state missed the first time.

If you were denied because of missing documents, you can reapply once you have them. There is no penalty for reapplying, and your new application starts fresh.

Coverage for family members and children

When you apply, you list everyone in your household. Your spouse, children, and sometimes other relatives can be covered under the same application. Income and asset limits apply to the whole household, not to each person individually.

Children often have higher income limits than adults in the same state. Some states cover children up to 200% of the poverty line even if parents are not covered. If you have children, mention this when you call your state's Medicaid office — they may be able to cover your kids even if you do not may have access to.

Pregnant people are also often covered under higher income limits in many states. If you are pregnant, tell the Medicaid office during your application.

Frequently Asked Questions

Can I start coverage before my application is approved?

No. Coverage begins on the date your state approves your application, not the date you submit it. Some states backdate coverage to the first day of the month you applied if you are approved within 30 days, but this varies. Ask your state's Medicaid office about their backdating policy.

What if my income changes after I am approved?

You must report changes to your state Medicaid office, usually within 30 days. If your income goes up, you may lose coverage or have to pay more. If it goes down, you may become covered for a better plan. Your state will send you a form to report changes, or you can update your information online if your state has a portal.

Do I have to reapply every year?

Yes. Most states require you to renew your Medicaid coverage once a year, usually on the anniversary of your approval date. Your state will send you a renewal form by mail or email. If you do not return it by the deadline, your coverage will end. Some states now allow online renewal, which is faster than mailing a paper form.

What if I do not have a Social Security number?

You can still apply for Medicaid in most states. You will need other proof of identity and citizenship, such as a passport or birth certificate. Call your state's Medicaid office to ask what documents they accept instead of a Social Security number.

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

It depends on your immigration status. Lawful permanent residents (green card holders) and some visa holders can get Medicaid. Undocumented immigrants are not covered by regular Medicaid in most states, though some states offer limited coverage for emergency care or pregnancy. Call your state's Medicaid office with your immigration documents to find out what you are covered for.