Medicaid covers people of all ages, but the rules for who qualifies depend on your age group and your state

There is no minimum age to get Medicaid — newborns can be covered from birth. There is no maximum age either. What changes based on your age is which Medicaid program you might use and what income or other requirements apply. A newborn, a working adult, and a 90-year-old can all have Medicaid, but they may may have access to through different pathways and under different rules.

Your state sets its own income limits and decides which age groups it will cover beyond the federal minimum. This means a person the same age with the same income might may have access to in one state and not in another. The federal government requires states to cover certain groups — like children under 19 and pregnant people — but states can choose to cover more.

Key Takeaways

  • Medicaid has no age minimum or maximum; newborns and seniors can both be covered, but the rules differ by age group.
  • States must cover children under 19 and pregnant people under federal law, but income limits and other rules vary by state.
  • Adults aged 19 to 64 may may have access to if your state expanded Medicaid and your income is low enough, but not all states have expanded.
  • People 65 and older usually may have access to for Medicare instead, though some people have both Medicaid and Medicare at the same time.
  • Your state's specific rules determine whether you may have access to, so checking with your state Medicaid office or using a 211 referral gives you an accurate answer for your situation.

Coverage for children and pregnant people

Federal law requires every state to cover children under 19 whose family income is at or below 138% of the federal poverty line. Many states cover children at higher income levels — some go up to 200% or more of poverty. A child born to a Medicaid-covered parent is usually covered automatically from birth, though some states require a separate enrollment step.

Pregnant people are also a mandatory group under federal law. States must cover pregnant people whose income is at or below 138% of the federal poverty line, and many states cover them at higher income levels. Coverage for pregnant people typically continues for 60 days after the pregnancy ends, whether the outcome was birth, miscarriage, or abortion.

Newborns born to a Medicaid-covered mother are automatically covered for the first year of life in most states, even if the family's income changes. After that first year, the child's coverage depends on whether the family still meets the income and other requirements.

Coverage for working-age adults (19 to 64)

This is where state rules vary most. Under the Affordable Care Act, states can choose to expand Medicaid to cover adults earning up to 138% of the federal poverty line, regardless of whether they have children or are disabled. As of now, most but not all states have expanded Medicaid. If your state has expanded, you may may have access to as an adult with no children and no disability. If your state has not expanded, you likely need to be a parent, pregnant, disabled, or elderly to may have access to.

In non-expansion states, working-age adults without children or a disability rarely may have access to, even at very low incomes. This creates a gap where someone earns too much for Medicaid but too little to afford marketplace insurance. You can check whether your state has expanded by contacting your state Medicaid office or using a 211 referral.

Some adults may have access to through disability rather than age or family status. If you receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), you may may have access to for Medicaid regardless of your state's expansion status, though the rules vary by state.

Coverage for people 65 and older

Most people 65 and older may have access to for Medicare, the federal program for seniors, rather than Medicaid. However, some older adults have both programs at the same time — these people are called "dual may be able to access." You might be dual may be able to access if your income and assets are very low, or if you need long-term care like nursing home or home health services that Medicare does not cover.

Medicaid covers long-term care costs that Medicare does not, including nursing home care, assisted living in some states, and home and community-based services. An older adult with Medicare and low income may may have access to for Medicaid to cover these services. Each state sets its own rules for how much income and assets you can have and still may have access to.

If you are 65 or older and think you might may have access to for Medicaid, contact your state Medicaid office. They can tell you whether you meet the income and asset limits and what services Medicaid would cover for you.

How to find your state's specific age and income rules

Your state Medicaid office publishes its income limits and coverage rules online, usually on the state health department website. You can also call your state Medicaid office directly — the number is on your state's Medicaid website. Have your age, income, and family size ready when you call.

A faster way to get a quick answer is to call 211 or visit 211.org. This service connects you to local resources and can tell you in one call whether you likely may have access to based on your age and income. They can also tell you how to apply and what documents to bring.

If you are applying for the first time, you will need proof of income (like recent pay stubs or tax returns), proof of citizenship or immigration status, and proof of your age and identity. Some states also ask about assets or medical expenses. Your state Medicaid office can tell you exactly what to bring before you apply.

What happens to coverage when your age changes

If you are a child on Medicaid and turn 19, your coverage does not automatically end, but your may be able to access is reviewed. You may still may have access to as an adult if your income is low enough and your state covers adults. Some states have continuous coverage periods that let you keep Medicaid for a few months after you turn 19 while your case is reviewed.

If you turn 65, you become may be able to access for Medicare. You should apply for Medicare about three months before your 65th birthday. If you also may have access to for Medicaid, the two programs will work together — Medicare pays first, and Medicaid covers some costs Medicare does not. You do not have to choose between them.

If your income or family situation changes at any time, report it to your state Medicaid office. Your coverage may change, or you may become newly may be able to access. Most states let you report changes online, by phone, or by mail.

Frequently Asked Questions

Can a newborn get Medicaid if the parents do not may have access to?

Yes. A newborn can may have access to for Medicaid based on the newborn's own income (which is usually zero) and the state's rules for children, even if the parents do not may have access to. In most states, a newborn born to a Medicaid-covered mother is automatically covered for the first year. If the mother was not covered, you can apply for the newborn separately.

What is the income limit for Medicaid in my state?

Income limits vary by state and by age group. Your state Medicaid office website lists the exact limits for children, adults, pregnant people, and seniors. You can also call 211 or your state Medicaid office to ask about your specific situation. Income limits change each year, so check your state's current rules rather than relying on old information.

If I turn 65, do I lose Medicaid?

No. At 65, you become may be able to access for Medicare, but you do not lose Medicaid if you also may have access to for it. You should apply for Medicare about three months before your 65th birthday. If you may have access to for both, they work together to cover your medical costs. Contact your state Medicaid office to make sure your coverage continues smoothly when you turn 65.

Can I get Medicaid as an adult without children or a disability?

It depends on your state. If your state has expanded Medicaid under the Affordable Care Act, you may may have access to as an adult with income up to 138% of the federal poverty line, regardless of family or disability status. If your state has not expanded, you typically need to be a parent, pregnant, disabled, or 65 or older. Call 211 or your state Medicaid office to find out whether your state has expanded.

Do I need to reapply for Medicaid every year?

Most states require you to renew your Medicaid coverage once a year, though some have moved to longer renewal periods. Your state Medicaid office will send you a notice when it is time to renew. You can usually renew online, by phone, or by mail. If you do not renew by the deadline, your coverage will end, so watch for the notice and respond on time.