Medicaid, in plain English
Medicaid is the United States' joint federal-state health coverage program for people with low incomes. The federal government sets the basic rules and pays a large share of the cost, and each state runs its own program inside those rules. That partnership is the key to understanding everything else on this site: Medicaid is one national program in name, but fifty-plus state programs in practice. Your income limit, your covered services, and even the name on your card depend on the state where you live.
Medicaid in one paragraph
If your income is low, Medicaid can pay for doctor visits, hospital care, prescriptions, and much more, usually at little or no cost to you. Children, pregnant women, parents, adults in states that expanded Medicaid, older adults, and people with disabilities can all qualify, but through different doors and at different income levels. There is no single national income limit and no single federal application. You apply through your state Medicaid agency or through HealthCare.gov, and your state decides whether you qualify.
How big is Medicaid?
In July 2025, 77.6 million people were enrolled in Medicaid and the Children's Health Insurance Program (CHIP) combined: 70.4 million in Medicaid and 7.2 million in CHIP, according to the Medicaid.gov enrollment snapshot for that month. Of those, 40.6 million were adults enrolled in Medicaid and 36.9 million were children enrolled in Medicaid or CHIP. Those numbers move every month as people gain and lose eligibility, so treat them as a snapshot, not a permanent headcount. They do show the scale: Medicaid is the largest single source of health coverage in the country, and for many low-income families it is the only coverage available at all.
The federal-state partnership, in practice
Congress created Medicaid in 1965, in the same legislation that created Medicare, as Title XIX of the Social Security Act. The federal government writes the statute and regulations, approves each state's plan, and pays part of every state's costs. For adults covered through the Affordable Care Act expansion, the federal government pays 90 percent of the cost of their care, with states paying the remaining 10 percent. For other groups the federal share varies by state. States, in turn, run enrollment, pay providers, and decide the many things federal law leaves to them: optional benefits, payment rates, managed-care arrangements, and the exact income limits for groups where federal law sets only a floor or a range.
That division explains why two people with the same income can have different answers in different states. A childless adult earning the same wage qualifies in a state that expanded Medicaid and does not qualify in a state that did not. An adult dental benefit that is comprehensive in one state may be emergency-only in another. This site therefore explains the federal rules first, then tells you where the state variation lives and how to check your own state's version.
Who Medicaid covers
| Group | The basic idea | Where to read more |
|---|---|---|
| Children | Covered through Medicaid or CHIP at higher income limits than adults, with 12 months of continuous eligibility | Children & CHIP |
| Pregnant women | Covered during pregnancy and, in most states, for 12 months after the pregnancy ends | Pregnant women |
| Expansion adults | Adults under 65 in expansion states with income up to 138 percent of the federal poverty level | Expansion & gap |
| Parents and caretakers | Covered in every state, but at much lower income limits in states that did not expand | MAGI eligibility |
| Older adults and people with disabilities | Covered under non-MAGI rules that look at income and resources, often linked to SSI | Disability & long-term care |
How this site is organized
Start with what Medicaid is, including how it differs from Medicare. MAGI eligibility explains how income is counted for most applicants. Expansion and the coverage gap explains the 138 percent rule and what happens in states that did not expand. Benefits separates the services every state must cover from the optional ones states choose. Costs covers premiums and copayments, including the 5 percent household cap. How to apply is the practical step-by-step guide, and renewals explains the yearly redetermination and the 90-day second chance. The last three guides cover children and CHIP, pregnant women, and disability and long-term care.
Three misunderstandings, cleared up at the start
Medicaid is not Medicare. Medicare is mainly federal health insurance for people aged 65 and older and for some people with disabilities, and it is not based on income. Medicaid is based mainly on income and is run by the states. Some people qualify for both; they are called dual-eligible, and this site mentions them only as a pointer, because Medicare's own rules belong to its own program. Medicaid is not one national income limit. Any website quoting a single dollar figure as "the Medicaid limit" for the whole country is misleading you. Limits are percentages of the federal poverty level, applied state by state. Medicaid is not welfare cash. It pays for health care, usually by paying your doctor, hospital, or pharmacy directly, not by sending you money.
Sources: Medicaid.gov, July 2025 Medicaid/CHIP Eligibility Operations & Enrollment Snapshot; Medicaid.gov, Program History; Centers for Medicare & Medicaid Services, Brief Summaries of Medicare & Medicaid; 42 U.S.C. section 1396a.