Medicaid is free or nearly free health insurance that covers doctor visits, hospital care, prescriptions, mental health treatment, and much more. If you're struggling to afford housing, you probably can't afford health care either — but Medicaid is there for you. This guide walks you through what it is, who qualifies, how to apply, and why it's so important for housing stability.
What Is Medicaid?
Medicaid is a joint federal and state health insurance program for people with low income. Unlike Medicare (which is based on age or disability), Medicaid is based on income and sometimes other factors. It covers a lot: doctor visits, hospital stays, emergency care, prescriptions, mental health care, substance use treatment, and dental care in some states. There's typically no premium or a very low premium, and many people pay nothing for doctor visits or prescriptions.
Medicaid is huge — it covers over 70 million people in the US. If you're struggling financially, you probably qualify or are close to qualifying.
Who Qualifies for Medicaid?
Medicaid eligibility rules differ between states, especially based on whether your state expanded Medicaid under the Affordable Care Act. Here's the breakdown:
In Medicaid Expansion States
About 40 states have expanded Medicaid. In these states, you generally qualify if your income is at or below 138% of the federal poverty level. For 2024, that's roughly:
- Single adult: about $1,967/month
- Parent with one child: about $2,690/month
- Parent with two children: about $3,414/month
- Parent with three children: about $4,139/month
Check your state's exact income limits — they vary slightly.
In Non-Expansion States
About 10 states have not expanded Medicaid. In these states, you typically qualify if you fall into one of these categories:
- Pregnant women — Most non-expansion states cover pregnancy care and birth
- Children under 19 — Usually covered regardless of parental income
- Parents with dependent children — But income limits are very low (often $400-600/month)
- Elderly (65+) — If income is low enough
- Blind or disabled — Through SSI or state disability programs
Non-expansion state coverage is much narrower. If you're in a non-expansion state and don't fit these categories, ask about your state's specific rules — some have exceptions or pilot programs.
Special Pathways
Even if you don't fit the standard categories:
- Disability pathway: If you receive SSI or have been denied SSI but are appealing, you may qualify through disability
- Homelessness: Some states provide Medicaid to people experiencing homelessness without an address requirement
- Immigrants: Depending on status and years in the US, you may qualify (see "Special Situations" below)
How to Apply for Medicaid
You can apply year-round — there's no "open enrollment period" like with marketplace insurance. Here are your options:
Online via Healthcare.gov
Go to healthcare.gov, click "Get Coverage," and answer the questions. The site will show you Medicaid and marketplace options available in your state. Apply directly through that page or be transferred to your state's Medicaid website.
Your State's Medicaid Website
Each state runs its own Medicaid program. Search "[your state] Medicaid apply" to find your state's Medicaid office website. You can usually apply online there, or find phone numbers and addresses to apply by phone or mail.
In Person at Your Local Office
Visit your state's Department of Family and Children Services (DFCS), Department of Social Services (DSS), or equivalent office. Staff can help you apply on the spot. This is a good option if you need help or don't have internet access.
By Phone
Call your state's Medicaid hotline (find it at healthcare.gov or your state's Medicaid website). You can apply entirely by phone with a representative.
By Mail
Your state Medicaid office can mail you an application. You fill it out and mail it back. This is slower but an option if you prefer not to apply online or by phone.
What Documents You'll Need
When you apply, have these ready (you may not need all of them, but it speeds things up):
- ID: Driver's license, passport, state ID, or tribal ID
- Social Security Number: Yours and anyone on your application (spouse, children)
- Proof of income: Recent pay stubs (last 2-4 weeks), tax returns, Self-Employment Schedule C, benefit statements (unemployment, SSI, SNAP, child support), or a letter from your employer
- Proof of residency: Utility bill, lease, mortgage statement, or bank statement with your current address
- Immigration status documents: Green card, visa, employment authorization, or other immigration documents (if applicable)
- Information about other insurance: If you have coverage elsewhere, bring those details
Don't have perfect documents? Apply anyway. Many people apply with limited documentation, and Medicaid staff can help you gather what you need.
The Approval Process
After you apply, here's what happens:
Timeline
Most states notify you of approval or denial within 30-45 days. Some states are faster (same-day or within a week). Disability-based applications can take up to 90 days. You'll get notice by mail or, if you apply online, sometimes by email.
Presumptive Eligibility
Some states offer "presumptive eligibility" — you get temporary Medicaid coverage right away (within days or weeks) while the full application is being processed. This is especially common for pregnant women and children. Ask about this when you apply.
If You're Approved
You'll get a Medicaid card in the mail with your member ID. You can use it at doctors, hospitals, pharmacies, mental health providers, and more. Coverage usually starts the first day of the month after you're approved, or sometimes retroactively (30 days back).
If You're Denied
You'll get a denial letter explaining why. You have the right to appeal. See "If You Don't Qualify" section below for next steps.
Why Medicaid Matters for Housing Stability
You might think health insurance isn't a housing issue — but it absolutely is. Here's why:
Untreated Health Conditions Lead to Housing Instability
Without health coverage, people delay or skip medical care. Untreated conditions get worse, make it harder to work, drain savings, and create crises. Health care debt can destroy your credit and finances. Medicaid breaks that cycle.
Mental Health and Substance Use Treatment Access
Medicaid covers mental health treatment, therapy, and substance use disorder treatment — often at no or low cost. These are huge stabilizing forces for people trying to access and keep housing. Untreated mental illness and addiction are major drivers of homelessness; treatment access is a major driver of stability.
Disability Documentation
If you have a disability, Medicaid can be part of your documentation for SSI, SSDI, or disability-based housing programs. Having continuous health coverage and treatment records strengthens your case.
The Bigger Picture
Housing stability depends on overall stability — financial, health, mental health, substance use recovery. Medicaid is a foundation for that.
If You Don't Qualify for Medicaid
If you don't qualify for Medicaid (especially in non-expansion states), here are your options:
Marketplace Plans with Subsidies
Go to healthcare.gov and check marketplace plans. If you don't qualify for Medicaid, you may qualify for premium tax credits that lower your cost. Some plans cost very little with subsidies.
Community Health Centers
Federally Qualified Health Centers (FQHCs) offer care on a sliding fee scale based on income. You can get medical care, dental, mental health, and more at low cost. Find one near you at findahealthcenter.hrsa.gov.
Charity Care and Hospital Programs
Hospitals often have charity care programs for uninsured patients. Ask your local hospital about it. Many write off care for people below certain income levels.
State-Funded Programs
Some states have programs for uninsured people who don't qualify for Medicaid. Ask your state Medicaid office about alternatives.
Don't Skip Healthcare Because You're Uninsured
If you're sick or injured, go to the doctor or hospital anyway. Hospital emergency departments must treat you regardless of ability to pay. Work out payment plans or apply for financial assistance after. Your health comes first.
Medicare vs Medicaid: Quick Comparison
These names sound similar but are very different:
- Medicaid: For low-income people of any age. Covers doctor, hospital, mental health, substance use treatment, etc. Free or low cost.
- Medicare: For people 65+ and some younger disabled or chronically ill people. Requires you or your spouse to have worked and paid Medicare taxes. Different eligibility and coverage.
Some people qualify for both (called "dual eligible"). If you're over 65 and low-income, apply for both Medicaid and Medicare.
Dual Eligibility
If you're 65 or older, disabled, or have ESRD (end-stage renal disease) and qualify for both Medicaid and Medicare, you're "dual eligible." You get coverage from both. Medicare is your primary insurance; Medicaid fills in gaps (like low cost-sharing). Apply for Medicaid even if you have Medicare.
Annual Recertification
Medicaid doesn't last forever — you need to renew it. Your state will tell you when your coverage ends (usually after 1-2 years). You'll get a notice to renew. Important: respond to that notice. If you don't recertify on time, you lose coverage.
Keep copies of all your renewal notices and respond on time. If you lose coverage by mistake, you can usually reapply quickly.
Special Situations
Pregnant Women
Most states provide Medicaid to pregnant women regardless of marital status or other factors. Pregnancy-related Medicaid covers prenatal care, birth, and postpartum care. Apply as soon as you know you're pregnant. Some states cover pregnancies retroactively.
Children and CHIP
Children under 19 are covered by Medicaid in most states. If your children don't qualify for Medicaid, they may qualify for CHIP (Children's Health Insurance Program), which is similar. Always apply for your kids.
Immigrants
Immigration status affects Medicaid eligibility. Here's the basic breakdown:
- Lawful permanent residents (green card holders): Generally eligible after 5 years in the US, or immediately if your state has chosen to cover them
- Work-authorized non-immigrants: Varies by status; ask your state
- People in asylum process: May qualify; some states cover all applicants immediately
- Undocumented immigrants: Do not qualify for regular Medicaid, but some states offer "emergency Medicaid" (covers emergencies only) or state-funded care programs
Immigration status is not shared with ICE. Apply for coverage even if you're undocumented. At minimum, emergency Medicaid may be available.
People Experiencing Homelessness
If you don't have a permanent address, you can still apply for Medicaid. Some states don't require an address at all; others let you use a shelter address or a care provider's address. Ask your local Medicaid office or a homeless services organization how to apply.
Tips for Success
Apply for Benefits Together
If you're applying for Medicaid, also apply for SNAP (food assistance). Many people qualify for both. The application processes are linked in many states. Apply for both at once to save time.
Keep Copies of Everything
When you apply, keep a copy of your application and all documents you submit. Get a receipt or confirmation number. This helps if there are questions or if your approval letter goes missing.
Get Help from a Medicaid Navigator or Assister
Many organizations receive funding to help people understand and apply for Medicaid and marketplace insurance. These "navigators" and "assisters" are free and impartial. Find one in your area:
- Healthcare.gov's Navigator directory
- Call 211 (dial 2-1-1 from any phone) to find local resources
- Contact your local health department or community action agency
If Something Changes
If your income, address, or household size changes, report it to your state's Medicaid office. This might affect your coverage. Don't wait — changes can happen anytime, not just at recertification.
Use Your Coverage
Get regular checkups. Treat health problems early before they become serious. Preventive care is usually free on Medicaid. Take advantage of it.
Key Takeaways
- Medicaid is free or low-cost health insurance for people with low income.
- In expansion states, you qualify if your income is at or below 138% of the federal poverty level. In non-expansion states, eligibility is narrower.
- You can apply year-round through healthcare.gov, your state's Medicaid website, in person, by phone, or by mail.
- The approval process typically takes 30-45 days; some states offer presumptive eligibility (coverage right away while processing).
- Medicaid covers doctor visits, hospital care, prescriptions, mental health, and substance use treatment — all critical for housing stability.
- Annual recertification is required. Respond to renewal notices on time or you'll lose coverage.
- If you don't qualify for Medicaid, explore marketplace plans with subsidies, community health centers, or charity care options.
- Use navigators and assisters for free help applying.