Medicaid basics
One name, but not one program — it depends on your state.
Medicaid is jointly run by the federal government and your state, which means eligibility, benefits, and even the program's name can look different depending on where you live.
Medicaid is a U.S. program with no direct Canadian equivalent. Looking for Canadian public coverage instead? See how Canadian coverage works →
Show me how it's structured ↓A federal-state partnership
Both levels of government are involved — but your state makes many of the specific decisions.
Establishes baseline rules and shares funding with every state, including certain benefits every state must cover.
Sets specific income limits, decides on optional benefits, and administers enrollment — sometimes under a different program name.
Eligibility varies significantly
Whether — and at what income level — adults qualify differs by state, partly because states made different decisions about expanding Medicaid eligibility. Your state's Medicaid agency is the authoritative source for your specific eligibility.
Common eligibility categories
You may qualify under more than one category — worth checking all that could apply to you.
Low-income adults
Income-based eligibility that varies by state.
Children & CHIP
Children in lower-income families, sometimes through the related CHIP program for families who earn slightly more.
Pregnant women
Often eligible at a higher income threshold than other adult categories.
People with disabilities
Eligibility categories specifically for individuals with qualifying disabilities.
Older adults needing long-term care
Including nursing facility and some home-based long-term care.
Dual-eligible (Medicare + Medicaid)
Some people qualify for both — Medicaid can help cover Medicare's gaps and cost-sharing. See Medicare basics →
Mandatory vs. state-optional benefits
Every state must cover certain services; others are up to the state.
- Hospital and physician services
- Lab and X-ray services
- Nursing facility care
- Home health services
- Adult dental care
- Vision care for adults
- Certain therapy or rehabilitation services
- Some prescription drug details
Coverage generally needs to be renewed
Watch for renewal notices
Medicaid eligibility is generally reviewed periodically, and missing a renewal form or deadline can result in a coverage gap — even if you're still eligible. Keep your contact information updated with your state's Medicaid agency.
What are you trying to do?
Check my state's eligibility rules
Renew my Medicaid coverage
Check if a service is covered
Read the guide →Understand Medicare too
Read the guide →Appeal a coverage decision
Read the guide →Resolve an insurance problem
Browse the Hub →Common questions about Medicaid
Is Medicaid the same as Medicare?
No — Medicare is generally based on age or disability, while Medicaid is generally based on income. Some people qualify for both.
Can I have Medicaid and private insurance at the same time?
In some circumstances, yes — Medicaid can sometimes act as a secondary payer. Check with your state's Medicaid agency for how this works in your situation.
What happens if my income changes during the year?
You're generally expected to report significant income changes, which can affect your ongoing eligibility — check your state's specific reporting requirements.
Does Medicaid cover care received in another state?
Generally limited — Medicaid is typically state-specific, so care outside your enrolled state may not be covered except in emergencies. Confirm with your state's program before traveling for planned care.
Know your category. Know your next step.
Understanding which eligibility category might apply to you is the first step toward getting the coverage you need.