Medicaid and CHIP (health insurance for low-income people)

Medicaid is a federal–state joint program that provides free or low-cost health insurance to low-income adults, children, pregnant people, older adults, and people with disabilities. CHIP (Children's Health Insurance Program) covers children in families whose income exceeds the Medicaid limit and, in some states, pregnant people. Since October 1, 2026, immigrants' access to these programs has narrowed. On this page, you will find who can apply, the 2026 income limits, application steps, places to apply, and points to consider for those planning to apply for a green card.

• Under the law enacted in July 2025 (Public Law 119-21, Section 71109), since October 1, 2026, full Medicaid and CHIP are available only to:
  • U.S. citizens
  • green card holders (Lawful Permanent Resident, LPR)
  • Cuban and Haitian entrants
  • People living in the United States under COFA (citizens of the Marshall Islands, Micronesia, and Palau)
• In some states, pregnant people and children who are "lawfully residing" may also receive full Medicaid or CHIP.
  • "Lawfully residing": a person who is lawfully present in the United States, resides in the state where they apply, and meets the state's other requirements.
  • People present with a valid nonimmigrant visa (for example, H-1B or F-1) are also considered "lawfully present."
• Refugees and asylees can enter full Medicaid before receiving a green card only under the state's pregnancy and children's option.
• Adults present on tourist, student, or work visas cannot qualify for full Medicaid.

• Green card holders generally become eligible for Medicaid and CHIP 5 years after obtaining "qualified non-citizen" status. This is called the 5-year waiting period.
• People who were previously refugees or asylees and later obtained a green card are exempt from this waiting period.
• States may eliminate the 5-year waiting period for "lawfully residing" pregnant people and children. Ask your state's Medicaid office whether your state uses this option.
• If you are in the waiting period, you can purchase a private health plan through HealthCare.gov (Marketplace).
• Green card holders remain among the groups eligible for income-based premium reductions (premium tax credits) in the Marketplace after January 1, 2027.

• For Medicaid and CHIP, your 2026 income is used. Income is measured using "modified adjusted gross income" (MAGI). For most people, this amount is very close to adjusted gross income (AGI) on a tax return.
• The 2026 federal poverty level (FPL) for the 48 states and Washington, DC:
  • 1 person: $15,960
  • 2 people: $21,640
  • 3 people: $27,320
  • 4 people: $33,000
  • 5 people: $38,680
  • 6 people: $44,360
  • Add $5,680 for each additional person. Amounts are higher in Alaska and Hawaii.
• In states that expanded Medicaid, adults may qualify based only on income. You are eligible if household income is below 138% of the poverty level. For a one-person household, this is approximately $22,025 ($15,960 × 1.38). A few states use a different limit.
• In states that did not expand Medicaid, income alone is not enough. Pregnancy, having young children, disability, and age are considered.
• In these states, some adults with income below the poverty level may qualify for neither Medicaid nor Marketplace discounts. These people are referred to community health centers (see 16.6 Services accessible regardless of status).
• Apply even if you think you exceed the limit. Especially if you have a child, are pregnant, or have a disability, you may qualify for another state program.

• Coverage varies from state to state. The following services are available in every state:
  • routine checkups and vaccinations
  • doctor visits and prescription medication
  • dental and vision care
  • inpatient and outpatient hospital treatment
  • laboratory tests and X-rays
  • emergency services and mental health services
• Well-child checkups and dental checkups are free. Other services may require a copayment.
• Some states charge a monthly premium. The total cost cannot exceed 5% of the family's annual income.
• If your child qualifies for CHIP, you cannot receive a Marketplace discount for the child. You and your spouse may still qualify for a Marketplace discount.

1. Check first. Enter your household size and state into the income screening tool on HealthCare.gov.
2. Prepare the documents. Required documents vary by state. Usually, you will be asked for:
   • name, date of birth, and Social Security number (SSN)
   • proof of citizenship or immigration status (for example, a green card)
   • proof of income (pay stubs, W-2)
   • rent, mortgage, or utility amounts
   • other government benefits you receive
   • insurance offered by your employer or insurance you currently have
3. Choose how to apply:
   • Apply directly to your state's Medicaid agency.
   • Or create an account on HealthCare.gov and complete an application. If someone in your household appears eligible for Medicaid or CHIP, your information will be securely sent to the state. In the same application, you can also find out whether you qualify for a Marketplace discount.
   • To apply by phone, call the Marketplace call center (number below).
4. Wait for the state's decision. The state will contact you for enrollment.
5. If you are denied: the state will send you a letter and usually forward your information to the Marketplace. You can apply for a Marketplace plan without waiting.
6. You can apply for Medicaid and CHIP at any time of year. If you qualify, coverage may begin immediately.
7. Medicaid may also pay treatment costs from the last 3 months before your application. This depends on your income and expenses during that period.

• Some types of Medicaid pay only for family planning, treatment of an emergency medical condition, or tuberculosis services. If this applies to you, you can apply through the Marketplace to find out whether you qualify for broader coverage.
• Emergency Medicaid: For people who meet the state's income and residency requirements but do not have an eligible immigration status, Medicaid may cover treatment of an emergency medical condition. The 2025 law preserved this exception.
• Everyone who goes to an emergency department is examined and stabilized regardless of ability to pay. Details: see 16.6 Services accessible regardless of status.

• October 1, 2026: full Medicaid and CHIP are available only to the statuses listed above.
• 2026 tax year: the Marketplace premium discount exception for lawful immigrants whose income is below the poverty level but who cannot receive Medicaid because of their immigration status was eliminated.
• January 1, 2027: Marketplace premium discounts will be available only to green card holders, Cuban/Haitian entrants, and people covered by COFA. Plans can be purchased with other lawful statuses (for example, H-1B or F-1), but no discount will be available.
• By January 1, 2027, at the latest: a "community engagement" (work) requirement begins for adults ages 19–64 covered by Medicaid expansion. States may begin this requirement earlier.
  • At least 80 hours per month of work, volunteer service, or a work program is required. Continuing part-time education or earning monthly income equal to 80 hours at the minimum wage also satisfies the requirement.
  • Pregnant people and people in the postpartum period, people caring for a child age 13 or younger or a disabled relative, people with disabilities, and people with serious illnesses are among the exceptions.
• For the same group, eligibility will be reassessed every 6 months for renewals scheduled on or after January 1, 2027.
• The 2027 Marketplace open enrollment period begins November 1, 2026, and ends January 15, 2027. For coverage beginning January 1, the deadline is December 15.

• Medicaid and CHIP received on or after September 18, 2026 may be considered in a "public charge" assessment. Medicaid received before this date counts only if it was long-term institutional care paid for by the government (for example, nursing home care). Details: see 16.5 "Public charge".
• USCIS does not count benefits received by your child or another relative as benefits received by you. However, if a child receives benefits because your income is low, the officer may consider that low income as part of your financial circumstances.
• A sponsor who signed Form I-864 (financial sponsorship affidavit) for you may be required to repay the cost of Medicaid and CHIP you receive. If the sponsor does not pay, the agency providing the benefits may sue the sponsor. Emergency Medicaid is not included.

• HealthCare.gov Marketplace call center — Medicaid/CHIP and Marketplace applications and questions
  • Phone: +1 800 318 2596 (TTY: +1 855 889 4325)
  • Hours: 24 hours a day, 7 days a week (except federal holidays)
  • Questions and documents are not accepted by email. Documents are uploaded through your HealthCare.gov account.
• Your state's Medicaid agency — direct applications, renewals, and document submission
  • Web: list of state Medicaid agencies
• Local application assistance — trained people and organizations that provide free help with applications
  • Web: Find Local Help
• CHIP information for children
  • Web: InsureKidsNow.gov

• Applying based on a guide or brochure written before October 2026.
• Not applying at all because you think your income is too high. State programs for pregnant people, children, and people with disabilities may use different limits.
• Not canceling your Marketplace plan after Medicaid begins. If you have both types of coverage, you will pay the full price of the Marketplace plan.
• Failing to include proof of immigration status with the application.
• Receiving benefits without consulting anyone while your green card process is pending, or, conversely, giving up in fear of insurance to which your child is entitled.
• Failing to ask about your state's pregnancy and children's option while you are in the waiting period.

• I work with an H-1B visa. Can my child receive Medicaid? If your child was born in the United States, they are a U.S. citizen and can apply as a citizen. If the child also has a visa, they can apply only in states that cover "lawfully residing" children.
• I received my green card 2 years ago. Can I receive Medicaid? Generally, you cannot receive it until the 5-year waiting period is complete. During this time, you can purchase a Marketplace plan. If you were previously a refugee or asylee, there is no waiting period.
• Can I keep a Marketplace plan while I have Medicaid? You can, but if you have full Medicaid, you cannot receive a Marketplace discount and must pay the full price of the plan. If your child has CHIP coverage, keeping a Marketplace plan may affect the child's CHIP eligibility.
• In which month of the year can I apply? You can apply for Medicaid and CHIP every month. The open enrollment period is only for Marketplace plans.
• Will receiving Medicaid affect my green card application? Medicaid received after September 18, 2026, may be considered in the assessment; it is not by itself a reason for denial. Consult an immigration attorney before making a decision.
• Will Medicaid pay for treatment I received previously? Medicaid may pay costs from the 3 months before your application based on your income and expenses during that period.

• Income-based eligibility check (HealthCare.gov)
• Create a HealthCare.gov account
• State Medicaid and CHIP agencies
• List of immigration statuses eligible for the Marketplace
• Find local application assistance
• Find a community health center (HRSA)
• Full text of Public Law 119-21 (PDF)