How Our Eligibility Check Works
Medicaid eligibility depends on your state, income, household, age, and situation. Our AI assistant walks through it with you a few questions at a time.
Tell us your state
Medicaid is run by states and goes by many names—Medi-Cal (California), Apple Health (Washington), MassHealth (Massachusetts), TennCare (Tennessee), and more. Rules differ a lot between states.
Answer a few questions
The assistant only asks what it actually needs: things like your age, household size, monthly income, and whether you're pregnant, disabled, or applying for long-term care.
Get an estimate + next steps
You'll get an experimental, best-guess estimate for today's rules and for the new work requirements, alternatives if you don't qualify, and your state's contact info to confirm and apply.
Experimental: An Estimate, Not a Determination
This checker is an experimental feature—the AI can make mistakes, and Medicaid rules change often. Only your state Medicaid agency can officially determine eligibility. Our check is a free, fast way to understand where you likely stand and what to gather before you apply—always confirm with your state.
What You'll Want Handy
You don't need documents to get an estimate—rough numbers are fine. For the actual application, this is what states typically ask about.
Household basics
Your state, age, marital status, how many people are in your tax household, and how many children (under 19) live with you.
Monthly income before taxes
A rough total for your household—wages, self-employment, Social Security, unemployment. Most Medicaid categories compare this against a percentage of the Federal Poverty Level.
Health and disability status
Whether you're pregnant, receiving SSDI or otherwise disabled, on Medicare, or have conditions like ESRD (kidney failure) or ALS—these open different eligibility pathways.
Assets (65+, disabled, or long-term care)
For aged/blind/disabled and nursing-home pathways, states also look at countable assets (usually excluding your primary home) and, for long-term care, home equity.
Work, school, or volunteer hours
Under the new federal work requirements, many adults will need about 80 qualifying hours per month—so knowing your typical weekly hours helps estimate whether you'd keep coverage once they apply.
Experimental: results are estimates only—confirm with your state.
Common Ways People Qualify
Exact income limits vary by state and change yearly—these are the broad categories our assistant checks.
Children & CHIP
Children under 19 generally qualify at higher household incomes than adults (often 200% of the poverty level or more). Even when parents don't qualify, kids frequently do—through Medicaid or the Children's Health Insurance Program (CHIP).
Pregnancy
Pregnant people qualify at higher income limits in most states (often around 200% of the poverty level, sometimes higher), with coverage that continues postpartum. Pregnancy is also generally exempt from work requirements.
Adults 19–64 (Expansion States)
In the 40 states (plus DC) that expanded Medicaid, adults generally qualify with household income up to 138% of the poverty level. Ten states haven't expanded—there, childless adults often can't qualify regardless of income.
65+ or Disabled (ABD)
Aged/blind/disabled pathways look at both income and countable assets (roughly $2,000 single / $3,000 married in many states, excluding your home). Medicare Savings Programs and medically-needy "spend-down" options can help near the limits.
Long-Term Care
Nursing home and home-care (HCBS) Medicaid has its own income cap (around $3,000/month in many states), asset limits, and home-equity rules. Miller trusts and spend-down planning can help if you're just over the limits.
Medicare (65+, SSDI, ESRD, ALS)
Our assistant also checks Medicare: most people qualify at 65 with 10 years of work history, after 24 months on SSDI, or at any age with ESRD or ALS. Some people qualify for both Medicare and Medicaid ("dual eligible").
The New Work Requirements
New Federal Rules
New federal rules require many adults (ages 19–64) to complete at least 80 hours per month of qualifying activities to keep Medicaid coverage. States must implement them by January 1, 2027—a few have started earlier, and some may get extensions. Because states check the one to three months before you apply or renew, your activity in late 2026 can already count.
What Counts Toward 80 Hours
- Work (including self-employment)
- School or job training
- Volunteering / community service
- Caregiving (varies by state)
Groups Often Exempt
- Pregnant people
- People with disabilities or who are medically frail
- People on Medicare
- Children and many caretakers—see the FAQ for details
Keep Records Now
States may look back up to 3 months when checking hours. Keep pay stubs, class schedules, and volunteer logs—it's unfair paperwork, but good records are the best defense against wrongly losing coverage. If you're short of 80 hours, adding a class or regular volunteering can close the gap.
If You Don't Qualify (or Lose Coverage)
A "no" on Medicaid isn't the end of the road. The assistant will point you to alternatives like these based on your situation.
ACA Marketplace Subsidies
If your income is at or above 100% of the poverty level, premium tax credits on Healthcare.gov (or your state's marketplace) can make plans much cheaper. Losing Medicaid also triggers a Special Enrollment Period.
CHIP for Your Kids
Children often qualify for CHIP even when adults in the household earn too much for Medicaid. It's worth applying for kids regardless of your own result.
Medically Needy / Spend-Down
Over 30 states let you qualify by "spending down"—subtracting high medical bills from your income. This can work for older adults and people with disabilities who are just over the limits.
Medicare Savings Programs & Clinics
If you're on Medicare with limited income, QMB/SLMB/QI programs can pay premiums and cost-sharing. Community health centers offer sliding-scale care while you sort out coverage.
Denied or Terminated? You Can Appeal.
If your state denies your Medicaid application or ends your coverage—including over work-requirement paperwork—you have the right to a fair hearing, and deadlines matter. Our free tools can help you fight back, and your state's legal aid resources can help too.
Confirm With Your State
Ready to apply, or want the official word? Go straight to the source.
Your State's Resources
Find your state Medicaid agency, consumer assistance programs, and legal aid contacts—the assistant can also look these up for you in chat.
Find Your State's ResourcesApply Through Healthcare.gov
The Marketplace application automatically checks your Medicaid and CHIP eligibility and forwards your info to your state—one application covers both.
Learn More at Healthcare.govFind Out Where You Stand—In Minutes
Free, no account needed. Get an experimental Medicaid and Medicare eligibility estimate, plus a plan for what to do next—then confirm everything with your state.
Disclaimer: The Medicaid eligibility check is an EXPERIMENTAL feature that is under active development and can produce incorrect, incomplete, or outdated results. This page and our AI assistant provide informational estimates only—not legal, medical, or financial advice, and not an official eligibility determination. Medicaid and Medicare rules vary by state and change frequently, including the phase-in of federal work requirements. Always confirm with your state Medicaid agency or a benefits navigator before making decisions about your coverage. Last updated: August 2026.