United States
Benefit
Medicaid
Medicaid provides free or low-cost health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.
At a Glance
- In states that expanded Medicaid, adults under 65 withincome up to 138% FPL qualify.
- Must be a resident of the state where applying.
- Must be a U.S. citizen, U.S. national, or qualified immigrant.
- Cannot be currently incarcerated.
- + 1 more requirements below
Eligibility Requirements
State Residency
RequiredMust be a resident of the state where applying.
state_residency
exists
Citizenship/Immigration
RequiredMust be a U.S. citizen, U.S. national, or qualified immigrant.
citizenship_status
in
[us_citizen, us_national, qualified_alien]
Not Incarcerated
RequiredCannot be currently incarcerated.
is_incarcerated
=
false
Eligibility Category
RequiredMust fall into an eligible category.
eligibility_category
in
[low_income_adult, pregnant, child_under_19, parent_caretaker, elderly_65_plus, disabled, blind]
Exempt if any:
-
OR
age< 19 -
OR
is_pregnant= true -
OR
age≥ 65 -
OR
has_disability= true -
OR
agebetween
Ruleset effective: 2024-01-01
View as JSON
{"service_id":"medicaid","effective_date":"2024-01-01","rules":[{"id":"income-adults","key":"household_income_fpl","operator":"less_than_or_equal","value":138,"unit":"percent","requirement":"required","label":"Income (Adults)","description":"In states that expanded Medicaid, adults under 65 with\nincome up to 138% FPL qualify.\n","source_url":"https://www.medicaid.gov/medicaid/eligibility/index.html"},{"id":"residency","key":"state_residency","operator":"exists","requirement":"required","label":"State Residency","description":"Must be a resident of the state where applying."},{"id":"citizenship","key":"citizenship_status","operator":"in","values":["us_citizen","us_national","qualified_alien"],"requirement":"required","label":"Citizenship/Immigration","description":"Must be a U.S. citizen, U.S. national, or qualified immigrant.\n"},{"id":"not-incarcerated","key":"is_incarcerated","operator":"equals","value":false,"requirement":"required","label":"Not Incarcerated","description":"Cannot be currently incarcerated."},{"id":"categorical-eligibility","key":"eligibility_category","operator":"in","values":["low_income_adult","pregnant","child_under_19","parent_caretaker","elderly_65_plus","disabled","blind"],"requirement":"required","label":"Eligibility Category","description":"Must fall into an eligible category.","any_of":[{"id":"cat-child","key":"age","operator":"less_than","value":19,"description":"Children under 19"},{"id":"cat-pregnant","key":"is_pregnant","operator":"equals","value":true,"description":"Pregnant individuals"},{"id":"cat-elderly","key":"age","operator":"greater_than_or_equal","value":65,"description":"Adults 65 and older"},{"id":"cat-disabled","key":"has_disability","operator":"equals","value":true,"description":"Individuals with disabilities"},{"id":"cat-adult-expansion","key":"age","operator":"between","min":19,"max":64,"description":"Adults 19-64 (expansion states)"}]}]}
Quick Info
- Agency
- CMS
- Category
- Healthcare
- Last Verified
- 2026-01-13