How to Apply for Medicaid: Step-by-Step Guide, Documents, and What Happens Next

Before you start: do you qualify?

Medicaid is health coverage run by each state with federal funding. Eligibility depends on your state, income, household size, age, disability, pregnancy, and immigration status. The main groups are:

• Children, often at higher incomes through Medicaid or CHIP.
• Pregnant people, in every state, usually at higher income limits than other adults.
• Parents and caretakers of children.
• Adults ages 19 to 64 in the states that expanded Medicaid.
• People 65 and older and people with disabilities, who often face asset limits as well as income limits.

You must live in the state where you apply. If you are not sure you qualify, apply anyway. HealthCare.gov recommends applying even if you do not expect to qualify, because you might fit a state program, especially if you have children, are pregnant, or have a disability. For a full overview of who qualifies and what is covered, see our Medicaid guide.

Income limits in expansion states

In the 41 states, including DC, that have expanded Medicaid, adults under 65 qualify with income up to 138% of the federal poverty level. The table uses the 2026 HHS poverty guidelines for the 48 contiguous states and DC, from HHS ASPE. Alaska and Hawaii have higher guidelines.

States may update their own charts on different dates, so your state’s numbers may differ slightly. Limits for children and pregnant people are higher in every state.

The 10 states that have not expanded Medicaid, according to KFF’s tracker, are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. In those states, adults without children or a disability often cannot get Medicaid at all, and limits for parents are often far below the poverty level. If you live in Texas, see our Texas Medicaid guide for the state’s own rules.

Four ways to apply

Every state accepts applications through more than one channel. Pick the one that is easiest for you. They all lead to the same decision.

To find your state agency, use the state picker on HealthCare.gov’s Medicaid and CHIP page or USA.gov. In many states, the same office also handles SNAP and cash help, so one application may cover several programs. Our Medicaid application online guide covers the online route in more detail.

Free, trained helpers called navigators and certified application counselors can sit with you and fill out the form. Find one near you with the HealthCare.gov local help tool. Community health centers and hospitals often have staff who help patients apply.

Documents and information to have ready

USA.gov notes that what you need depends on your state. Gathering these before you start makes the application faster and cuts down on follow-up letters:

• Names and dates of birth for everyone in your household.
• Social Security numbers for everyone applying, and for others in the household if they have one.
• Proof of income, such as recent pay stubs, W-2s, a tax return, or Social Security, pension, or unemployment letters.
• Proof of citizenship or immigration status, such as a birth certificate, passport, or immigration documents.
• Proof of where you live, such as a lease, utility bill, or mail.
• Current health insurance information, including any job-based coverage offered to you.
• Asset records such as bank statements, if you are applying based on age or disability.
• Medical records or a disability award letter, if you are applying based on a disability.

If you are missing something, apply anyway. States can often check income and citizenship electronically, and they will send a letter asking for anything else.

How to apply for Medicaid, step by step

1. Find your state agency through HealthCare.gov or USA.gov, or start a HealthCare.gov application.
2. Choose how to apply: online, by phone, by mail, or in person.
3. Gather your documents, including ID, Social Security numbers, and income proof.
4. Answer every question about your household, income, and current coverage. List everyone you live with and file taxes with, even if they are not applying.
5. Ask for retroactive coverage if you have medical bills from the last three months.
6. Submit and save proof, such as a confirmation number, a screenshot, or a copy of the paper form with the date you mailed it.
7. Answer requests quickly. If the state asks for more information or schedules an interview, respond by the deadline in the letter.
8. Watch for your decision letter and pick a health plan if asked.

How long does a Medicaid decision take?

Federal regulations set the outside limits. Under 42 CFR 435.912, states must decide within 90 days for people who apply on the basis of disability and within 45 days for everyone else. Many states decide much faster, sometimes within days, especially when income can be checked electronically.

Delays usually come from missing information. The clock can pause while you gather documents, so answer every letter promptly. If you have not heard anything after 45 days, call your state agency and ask about the status of your application.

Some states offer faster paths. Pregnant people and children may be able to get temporary coverage right away at a clinic or hospital while the full application is processed. Ask the provider whether your state offers this.

Coverage for past medical bills

Medicaid can pay for care you received before you applied. HealthCare.gov says Medicaid may help pay for care from the previous 3 months if you would have qualified then. This is called retroactive coverage. Mention any recent hospital stays, ER visits, or doctor bills on your application, and give the bills to your caseworker.

That window is getting shorter. Under the 2025 federal budget law, starting January 1, 2027, new applicants can get retroactive coverage for 1 month before applying if they are expansion adults, and 2 months for others. If you have unpaid medical bills, apply as soon as you can. For bills Medicaid does not cover, see our guide to help with medical bills after insurance.

After you are approved

Your approval letter tells you which program you qualify for and when coverage starts. Next:

• Pick a health plan. Most states use managed care plans. If you do not choose one by the deadline, the state may assign you one.
• Watch for your card. You will get a Medicaid card from the state, a plan card, or both.
• Find doctors in your network. Not every provider accepts Medicaid, so check before you book.
• Ask about extra benefits, such as rides to appointments, dental, or vision care, which vary by state.
• Report changes in income, address, or household size to your state agency.

Most Medicaid services have no premium and little or no copay. Children in families that earn too much for Medicaid may be moved to CHIP; see our Children’s Health Insurance Program guide.

If your application is denied

A denial letter must explain why and tell you how to appeal. Read it closely. Many denials are for paperwork reasons, like a missing pay stub, and are easy to fix.

• Ask for a fair hearing if you think the decision is wrong. The letter gives the deadline.
• Reapply if your income or household changes. There is no limit on how often you can apply.
• Check Marketplace coverage. HealthCare.gov says that if your state denies you, it sends your information to the Marketplace, which mails you details about other coverage and possible savings.
• Use a community health center, which charges on a sliding scale based on income.

Renewals and keeping your coverage

Medicaid is not a one-time approval. Your state checks your eligibility at least once a year. Starting with renewals on or after December 31, 2026, expansion adults will be checked every six months. Many people lose coverage only because a letter went to an old address or a form was not returned.

• Keep your address, phone, and email up to date with your state agency.
• Open every letter from Medicaid and answer by the deadline.
• Report income and household changes when they happen.
• If you lose coverage for paperwork reasons, ask about reinstatement and your appeal rights right away.

Federal changes coming in 2026 and 2027

The 2025 federal budget reconciliation law changes Medicaid for many adults. The main dates, as summarized by KFF, are below. States are still writing their rules, so watch for letters from your state.

What the work requirement means for applicants

Expansion adults will need to show 80 hours a month of work, community service, job training, or school, or a mix. According to KFF’s review of the law, people who are exempt include parents and caretakers of children 13 and under, pregnant and postpartum people, and people who are medically frail. The federal government can give a state making a good-faith effort extra time, up to December 31, 2028. States may also check whether you met the requirement before approving a new application, so be ready to show pay stubs, school enrollment, or volunteer hours. If your state says you did not meet the requirement, you get 30 days to show that you did or that you are exempt.

Related guides

• What is Medicare vs. Medicaid?
• Government health insurance assistance
• Does Medicaid cover therapy?
• Medicare benefits

Frequently asked questions

This guide is general information. Medicaid rules vary by state and are changing under federal law. National Relief Program is an independent website and is not a government agency. Contact your state Medicaid agency for decisions about your case.