Having adequate health care coverage is essential to our health and well-being, especially as we age. But if your income is limited, private health insurance may be out of reach. That’s where Medicaid comes in.

What is Medicaid?

Medicaid is a government health insurance program for people with low income and limited resources. It pays for a broad range of medical services and limits out-of-pocket costs for eligible adults, older adults, children, pregnant women, and people with disabilities. 

Medicaid plays a major role in our nation’s health care system, insuring about 67.7 million Americans.¹ This includes 7.2 million low-income older adults and 4.8 million people with disabilities who are also enrolled in Medicare.²

Medicaid programs may have different names from state to state. For example:

• California: Medi-Cal
• Massachusetts: MassHealth
• Oklahoma: SoonerCare
• Connecticut: HUSKY Health
• Tennessee: TennCare

How is Medicaid funded?

Medicaid is a federal-state partnership. It’s funded jointly by the U.S. government and individual states. Most Medicaid enrollees receive their benefits through private managed care or integrated care plans. Others receive their care through the fee-for-service system (where Medicaid pays providers directly for the services they provide).

What does Medicaid cover?

States are required by law to cover certain health care services through their Medicaid programs, including:

• Physician services (doctor visits)
• Hospital services (inpatient and outpatient)
• Lab and X-ray services
• Medication Assisted Treatment/MAT (substance use treatment)
• Nursing facility services
• Home health services

Many states also choose to cover additional services such as:

• Physical and occupational therapy
• Prosthetics
• Personal care
• Private-duty nursing services
• Dental and vision care
• Prosthetic devices
• Eyeglasses

Check with your state Medicaid office to learn more about the scope of coverage provided.

"Many families assume Medicare will cover most long-term care needs, but that's not the case. Medicaid is one of the most important resources available to older adults who need ongoing care and support,” said Daniel Davis, NCOA Associate Director, Integrated Care. “It also offers relief for those with limited means by covering some of Medicare’s out-of-pocket costs."

Who is eligible for Medicaid?

Since each state operates its own Medicaid program, guidelines may vary. Regardless of where you live, you may be able to qualify for Medicaid based on your:

• Age
• Income level
• Household size
• Disability status

Some states have broadened their Medicaid eligibility rules to cover all people below certain income levels. If you live in a state that has expanded Medicaid coverage, you may qualify for the program based on your income alone. You must also meet requirements for state residency and U.S. citizenship. If you’re not a U.S. citizen, you must be a qualified non-citizen (i.e., lawful permanent resident).

The best way to see if you qualify for Medicaid is to reach out to your state's Medicaid office or visit their website. Find Medicaid contact information for your state on Medicaid.gov.

You can also visit HealthCare.gov to check if you qualify for Medicaid based on your income.

Is Medicaid free?

One of the primary goals of Medicaid is to provide free or low-cost health care coverage to people in need. Since the program serves low-income groups, federal law limits the premiums and cost sharing states can charge many Medicaid enrollees. In general, states cannot charge premiums to most enrollees with incomes below 150% of the federal poverty level, and total out-of-pocket costs generally cannot exceed 5% of a family's income.

What is the difference between Medicaid and Medicare?

Medicaid and Medicare are two separate programs. Medicare is a federal health insurance program for older Americans. While you must be age 65 to get Medicare in most cases, it also covers younger people with specific disabilities. Medicaid serves a much broader range of populations.

Additionally, with Medicare, members usually pay a share of their health care costs through deductibles, coinsurance, and copayments. Since the Medicaid program serves low-income groups, its enrollees have minimal or no out-of-pocket costs for covered medical expenses.

Can I have both Medicare and Medicaid?

About 12 million Americans have both Medicare and Medicaid coverage.2 These people are “dual eligible.” Medicaid can cover Medicare co-payments and deductibles, lowering your out-of-pocket costs. It may also provide services not covered by Medicare, such as vision, hearing, and dental care.

If you’re dual eligible, you have multiple options for coordinating your coverage and care. The standard choice is having original Medicare (Parts A and B) with separate coverage through Medicaid. But you can also choose to enroll in a Dual Eligible Special Needs Plan (D-SNP) if one is offered in your area. Learn more about coverage options for dual eligibles.

What are the Medicare Savings Programs?

Medicare Savings Programs (MSPs) are Medicaid-administered programs for people on Medicare who have limited means. These programs help cover Medicare premiums and cost-sharing for those who don't qualify for full Medicaid. Enrollment into an MSP automatically qualifies you to receive the Medicare Part D Low Income Subsidy (LIS/Extra Help). This benefit helps pay for prescription drugs. In essence, MSPs make Medicare more affordable to those who qualify.

There are four different types of MSPs, each with different income and resource eligibility limits.

How do I apply for Medicaid?

The first step in applying for Medicaid is to check your eligibility.

If you’re eligible, you can apply through your state Medicaid agency or the Health Insurance Marketplace. Depending on where you live, applications may be available online, by phone, by mail, or in person.

Unlike Medicare, Medicaid does not have a limited enrollment period, so you can apply at any time during the year.

Find out how to apply for Medicaid in your state.

Sources

1. KFF. Medicaid Enrollment and Unwinding Tracker. May 29, 2026. Found on the internet at https://www.kff.org/medicaid/medicaid-enrollment-and-unwinding-tracker/

2. Medicaid.gov. Seniors & Medicare and Medicaid Enrollees. Found on the internet at https://www.medicaid.gov/medicaid/eligibility-policy/seniors-medicare-and-medicaid-enrollees