Medicaid and CHIP enrollment figures are tracked monthly by KFF (formerly the Kaiser Family Foundation) and published in coordination with Centers for Medicare & Medicaid Services (CMS) data — and those numbers tell a clear story: tens of millions of low- and moderate-income families, children, pregnant individuals, seniors, and people with disabilities may have access to free or low-cost health coverage they haven't yet claimed. If you're wondering whether Medicaid or CHIP may be available to your household, this guide walks you through income limits, required documents, application steps, and realistic timelines.

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Data Snapshot

According to CMS enrollment data tracked by KFF's Medicaid/CHIP Monthly Enrollment Tracker, total Medicaid and CHIP enrollment reached approximately 94.5 million individuals as of recent reporting periods — a figure that reflects both the post-pandemic unwinding of continuous enrollment protections and ongoing eligibility redeterminations across states. During the COVID-19 continuous enrollment period, enrollment peaked above 94 million; as states completed redetermination processes, millions were disenrolled, though many remained eligible and were later re-enrolled or transitioned to Marketplace coverage. The federal government reported that children represented the largest share of CHIP-specific enrollees, with CHIP covering approximately 7–8 million children in a typical month. CMS publishes this data at https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html.

These numbers matter to you because they reflect real households — families who found out they were eligible and enrolled. If your income has dropped, your household size has changed, or you've never checked your eligibility, now is a practical time to do so.

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What Are Medicaid and CHIP?

Medicaid Medicaid is a joint federal-state program administered by each state under federal guidelines set by the Centers for Medicare & Medicaid Services (CMS) within the U.S. Department of Health and Human Services (HHS). It provides health coverage to eligible low-income adults, children, pregnant individuals, elderly adults, and people with disabilities. Coverage typically includes doctor visits, hospital care, mental health services, prescription drugs, and preventive care — though the exact benefits vary by state.

Children's Health Insurance Program (CHIP) CHIP is a separate but related program that provides low-cost health coverage to children in families whose income is too high to qualify for Medicaid but who cannot afford private insurance. In some states, CHIP also covers pregnant individuals. CHIP is administered by states with federal matching funds and is governed by Title XXI of the Social Security Act.

Both programs are open year-round. Unlike Marketplace plans, there is no annual open enrollment deadline — you can apply any time.

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Income Eligibility: What Percentage of FPL Do You Need to Be At?

Eligibility is calculated as a percentage of the Federal Poverty Level (FPL), which is updated annually by HHS. Here's a general breakdown — but keep in mind that your state sets its own thresholds within federal minimums:

For Children (CHIP and Medicaid) - Medicaid for children: Most states cover children up to at least 133% FPL; many go higher. - CHIP: Most states cover children in families earning between 133% and 300% FPL, and some states extend coverage up to 400% FPL or higher. - Infants: Many states cover infants (under age 1) in families up to 185–200% FPL under Medicaid.

For Adults (Medicaid Expansion States) - In the 40 states plus Washington D.C. that have adopted ACA Medicaid expansion, adults without dependent children may qualify with household income up to 138% FPL. - In non-expansion states, adult eligibility is often much more limited and may require a qualifying disability or dependent child.

For Pregnant Individuals - Most states cover pregnant individuals up to at least 138–200% FPL through Medicaid, and some states have extended this to 200–300% FPL through CHIP-funded programs.

For Seniors and People with Disabilities - Medicaid eligibility for seniors and individuals with disabilities involves additional criteria beyond income, including asset limits and functional assessments. These rules vary significantly by state.

Because FPL thresholds change annually and state rules vary, the most accurate way to check your household's potential eligibility is through your state Medicaid agency or through Healthcare.gov's screening tool.

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Documents You'll Likely Need

Gathering your documents before you start the application can prevent delays. Most state Medicaid and CHIP applications ask for:

  • Proof of identity: Driver's license, state ID, passport, or birth certificate
  • Proof of residency: Utility bill, lease agreement, or official mail showing your current address
  • Proof of income: Recent pay stubs (last 30–60 days), employer letter, self-employment records, Social Security award letters, or unemployment benefit statements
  • Proof of household size: Birth certificates for children, marriage certificate if applicable
  • Social Security numbers: For all household members applying for coverage (non-citizens may apply for children even without SSNs for adults)
  • Immigration status documentation: If applicable — lawful permanent residents and certain visa holders may qualify; undocumented individuals generally do not qualify for full Medicaid but may qualify for emergency Medicaid in most states
  • Health insurance information: Any current coverage you or household members have

Not every state requires every document upfront — some use electronic data matches to verify income and identity. But having these ready speeds things up.

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How to Apply: Step-by-Step

Step 1: Find Your State Medicaid Agency Each state runs its own Medicaid and CHIP program under a different name. For example, California's program is called Medi-Cal; Texas calls it Texas Medicaid; New York uses Medicaid through NY State of Health. You can find your state's agency and application portal through Benefits.gov or directly through your state's health department website.

Step 2: Use a Screening Tool First Before completing a full application, consider using a free eligibility screening tool. Healthcare.gov offers a quick screener, and many state portals have their own. These tools ask basic questions about household size, income, and state of residence to give you a general sense of which programs may be available to you. Note that a screener result is not a determination of eligibility — only your state agency can make that determination.

Step 3: Complete the Application You can typically apply: - Online through your state Medicaid portal or Healthcare.gov - By phone through your state Medicaid agency - In person at your local Department of Social Services or community health center - By mail using a paper application

If you complete a form online or by phone and provide consent, you may be contacted to follow up on your application. By submitting a form, you may be consenting to be contacted by your state agency or an authorized enrollment assister regarding your application.

Step 4: Submit Your Documents Upload, mail, or bring in your supporting documents. Many states allow you to submit documents electronically through their portal.

Step 5: Wait for a Determination Federal rules require most states to process Medicaid applications within 45 days (or 90 days if disability is a factor). CHIP applications are often processed faster — many states aim for 2–4 weeks. You'll receive a written notice of approval or denial. If denied, you have the right to appeal.

Step 6: If Approved, Choose a Health Plan In most states, Medicaid is delivered through managed care organizations (MCOs) — private health plans that contract with the state. You'll typically be asked to choose a plan within 30 days of approval, or one will be assigned to you.

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What If You're Denied or Lose Coverage?

If you receive a denial notice or lose Medicaid coverage during a redetermination, you have options:

  • Appeal: Every state must offer a fair hearing process. Your denial letter will include instructions and deadlines — typically 30–90 days to request a hearing.
  • Reapply: If your circumstances have changed (income dropped, new dependent), you can reapply at any time.
  • Marketplace coverage: If you lose Medicaid, losing that coverage is a qualifying life event that opens a Special Enrollment Period for Marketplace plans, where you may qualify for premium tax credits.
  • Community health centers: Federally Qualified Health Centers (FQHCs) provide care on a sliding-fee scale regardless of insurance status. Find one at findahealthcenter.hrsa.gov.

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People Also Ask

Q: Can I apply for Medicaid or CHIP if I'm currently uninsured and have no income? A: Yes — having no income may actually make you more likely to meet income eligibility thresholds for Medicaid in expansion states. You can apply at any time through your state Medicaid agency. Bring documentation of your household situation, including any zero-income verification your state accepts, such as a self-attestation form.

Q: Does CHIP cover dental and vision for children? A: In most states, CHIP coverage for children includes dental and vision services, though the specific benefits and any cost-sharing (like copays) vary by state. Federal law requires CHIP to cover a benchmark benefit package that typically includes these services. Check your state's CHIP program page for the exact benefit list.

Q: How long does Medicaid coverage last once approved? A: Medicaid coverage is typically renewed annually through a redetermination process. Your state will review your eligibility each year and notify you if you need to provide updated information. Children enrolled in CHIP or Medicaid are generally guaranteed 12 months of continuous coverage before redetermination under federal rules.

Q: Can undocumented immigrants apply for Medicaid or CHIP? A: Federal Medicaid generally does not cover undocumented immigrants for full benefits, but most states provide Emergency Medicaid for emergency medical conditions regardless of immigration status. Some states have used state-only funds to extend coverage to certain groups, including children and pregnant individuals. Eligibility rules vary significantly by state.

Q: What is the difference between Medicaid and the Children's Health Insurance Program (CHIP)? A: Medicaid covers a broad population including low-income adults, children, seniors, and people with disabilities, with income limits set at lower thresholds. CHIP specifically targets children (and in some states, pregnant individuals) in families whose income is above Medicaid limits but who lack affordable private insurance. Both are administered by states with federal funding, but CHIP has a separate funding stream and may involve small premiums or copays.

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Program eligibility and availability vary by state. Not affiliated with any government agency.

Last reviewed: October 2026