Medicaid is a public health coverage program funded jointly by the federal government and individual states, designed for people and families with limited income and resources. Unlike Medicare, eligibility rules, covered benefits, and even the program's name can vary by state, since states administer their own Medicaid programs within federal guidelines.
- Eligibility is largely based on income, household size, and in some cases disability or other status.
- Many states expanded Medicaid eligibility under the Affordable Care Act to cover more low-income adults.
- Some people qualify for both Medicare and Medicaid at the same time, known as being "dual eligible."
Because each state runs its own program, the specific income cutoffs, covered services, and enrollment process can differ significantly depending on where you live. Someone applying through the ACA Marketplace who has a low income may be routed to Medicaid instead of a marketplace plan, depending on their state's eligibility rules.
A common misconception is that Medicaid works the same nationwide. Two neighboring states can have very different Medicaid income limits and covered benefits, so it's important to check your specific state's program rather than assume national rules apply.