Medicaid and Other Public Health Insurance Programs

Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Because each state administers its own program, there is significant variation in State Medicaid programs in terms of eligibility, what services are provided and more. Some states use different names for their Medicaid programs, such as Medi-Cal (California) or TennCare (Tennessee).

• The rules for Medicaid eligibility are different for each state. Most states offer coverage for adults with children below a certain income level, as well as pregnant women, some seniors, and people with disabilities.  As a result of healthcare reform, Medicaid eligibility is expanding in many states.
• To see if you qualify for Medicaid, fill out an application for the Health Insurance Marketplace, or call 1-800-318-2596, 24 hours a day, 7 days a week (TTY: 1-855-889-4325). A customer service representative will work with you to complete the application and enrollment process. There may be counselors in your area who can help. Visit HealthCare.gov or call 1-800-318-2596 for more information. 
• When people qualify for both Medicare and Medicaid, Medicare is the primary payer and Medicaid pays for all other medically necessary costs not covered by Medicare. Even Medicare beneficiaries who do not qualify for Medicaid may be eligible for help through a Medicare Savings Program. These programs help pay for some of the costs that Medicare doesn’t cover, and are administered through state Medicaid offices.
• In addition to Medicaid, every state operates a State Child Health Insurance Program. These also go by different names but are often referred to as S-CHIPs. Sometimes, children living in a household qualify for S-CHIP and the adult(s) qualify for Medicaid, Medicare or an Individual insurance policy with a premium tax credit. Learn more about S-CHIP coverage and how to apply on Healthcare.gov.