How to Sign Up for Medicaid

Medicaid is the main health insurance program for people with low income, and it covers everything from doctor visits to hospital stays. But the process of signing up for Medicaid can feel confusing, especially since it’s operated by both your state and the federal government.

The good news? While the rules vary a little depending on where you live, the basic steps are the same. And once you’re approved, coverage can start right away or even retroactively. Let’s walk through exactly how it works so you know what to expect.

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First of all, who can get Medicaid?

Medicaid is designed for people with limited income and resources, but it’s not just for one group. Depending on your state, you may qualify if you’re:

• A parent or caretaker of a child

• A child or teen under 19

• Pregnant

• An adult without kids (in states that expanded Medicaid)

• An older adult or a person with a disability

Income limits are based on your household size and the federal poverty level and can vary widely — from as low as about 17% of the federal poverty level in Texas to as high as 251% of the federal poverty level in Washington, D.C. 

This big gap exists because Medicaid is run jointly by states and the federal government, giving states the power to set their own eligibility rules. So while some states keep access very limited, others expand coverage far beyond the federal minimum.

Where and how do you apply for Medicaid?

You have two main ways to apply:

1. Through your state’s Medicaid office. Each state runs its own program, so you can apply directly online, by mail, or in person.

2. Through the Health Insurance Marketplace. Go to healthcare.gov, fill out an application, and if you qualify for Medicaid, your info will be sent to your state for processing.

What information do you need?

When you apply, be ready to share:

• Your Social Security number (or immigration documents if applicable)

• Proof of income, like pay stubs or tax returns

• Household information, including who lives with you and their ages

• Health insurance info (if anyone in your household already has coverage)

The application usually takes less than an hour if you have these documents handy.

How long does it take to get approved?

Approval times vary by state, but most applications are processed within 45 days. If you’re applying based on a disability, it can take up to 90 days.

Here’s the good news: Medicaid coverage can be retroactive for up to three months before the month you applied. That means if you had unpaid medical bills during that time and you were eligible, Medicaid may cover them once you’re approved.

What happens after you apply?

• If you’re approved: You’ll get an enrollment packet in the mail explaining your benefits. Many states also let you choose a managed care plan or a primary doctor.

• If you’re denied: You’ll receive a notice explaining why, and you have the right to appeal the decision.

Coverage usually begins the month you applied or earlier if retroactive eligibility applies.

How is Medicaid different from Medicare?

People often mix up Medicaid and Medicare. Here’s the quick breakdown:

• Medicaid is based on income and sometimes disability status, and it’s run jointly by states and the federal government.

• Medicare is a federal health insurance program for people 65 and older (or younger people with certain disabilities).

Some people qualify for both, known as being “dual eligible.” In that case, Medicaid can help cover costs Medicare doesn’t, like long-term care or copayments.

We give some more space to describing the difference between Medicaid and Medicare in another BenefitKarma article.