EligibilityEnrollmentCoverageCostYour StateFAQs
Who is eligible?
- Children
- Non-disabled adults:
- Individuals receiving supplemental security income (SSI).
- Caretaker relatives of children under 18.
- Pregnant women.
- Individuals with disabilities.
- Other groups (optional-check with your state):
- Adults without dependent children.
- Medically needy.
- Women with breast or cervical cancer.
- Individuals with Tuberculosis.
With the passage of the ACA, states were given the option to expand eligibility to single adults with income up to $15,521 and to families with income up to $31,721.
Children’s Health Insurance Program (CHIP)
To see what income level your state uses for CHIP, use your mouse and roll over any state on the map.
Who is eligible for CHIP?
- Uninsured children up to age 19.
- Eligibility depends on income, number of people in your family, and the rules in your state.
- In almost every state, children in families with income up to $47,700 per year for a family of four are covered.
- In more than half of the states, the income eligibility can be even higher.
You can enroll in Medicaid and CHIP at any time of year.
You can see if you quality by visiting HealthCare.gov
You can fill out an application in the Health Insurance Marketplace, or you can apply directly on your State Medicaid website.
Maximum Nominal Copayment Amounts
Out-of-Pocket Costs
There are no out-of-pocket costs for the following services under Medicaid:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use
disorder services - Rehabilitative and habilitative services and devices
- Lab services
- Preventive and wellness services
- Pediatric services including oral
and vision care
These groups are do not have to pay Out-of-Pocket Costs:
- Children under age 18 (some exceptions)
- Institutionalized individuals who are required to living contribute the majority of their income toward the cost of their care
- Individuals receiving hospice care
- American Indians and Alaska Natives who have ever received a service from the Indian Health Service, tribal health programs, or under contract health services referral
- Women who are enrolled in Medicaid under the Breast and Cervical Cancer Treatment Program are exempted from alternative out-of-pocket costs only
Your State