How to get Medicaid
Apply any time of year, for free, at HealthCare.gov or through your state Medicaid agency. In the 41 states (including DC) that expanded Medicaid, adults can qualify on income alone, up to about 138% of the poverty line.123
Starting by January 1, 2027, many adults 19 to 64 covered through expansion must show work, school or community service each month. Former foster youth, people in addiction treatment or with a substance use disorder, and people released from jail or prison in the last 3 months are exempt.45
Updated October 2026. Rules differ by state, so call your office before you go. Questions? We're here: call or text 888-860-RISE.
Still inside? Ask about coverage before release
21 states and DC have federal approval to cover some health care for up to 90 days before release: Arizona, California, Colorado, DC, Hawaii, Illinois, Kentucky, Louisiana, Maryland, Massachusetts, Minnesota, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oregon, Pennsylvania, Utah, Vermont, Washington and West Virginia. Maine was approved in September 2026 for up to 60 days.78
These programs must include case management, medication for addiction with counseling, and a 30-day supply of your prescriptions when you leave. States in them must suspend your Medicaid while you're inside, not end it.9
Under 21, or a former foster youth under 26, and your case has been decided? Since January 2025, states must offer screenings in the 30 days before release, and case management for 30 days before and at least 30 days after.10
States that cover care before release
Pink: the 21 states and DC on Medicaid.gov's list of approved reentry programs, plus Maine, approved in September 2026 for up to 60 days. Tap a state to see local help there.78
Your steps, in order
- 1
Apply at HealthCare.gov or your state Medicaid agency
You can apply any time of year. HealthCare.gov says to apply even if you don't think you'll qualify.1
- 2
Gather what your state asks for
States ask for different papers, so check your state's list. These are the ones people are most often asked for.
Bring- ID and Social Security number
- Proof of income, if you have any
- Immigration documents, if you're not a citizen
- Release papers, if you're leaving jail or prison
- Proof you were in foster care at 18, if you aged out
- Proof you're in treatment, or of another exemption, if one applies
- 3
Be ready for the 2027 work rule, or your exemption
Starting by January 1, 2027, adults 19 to 64 covered through expansion may need to show at least one month of work, school or service before the month they apply, unless they're exempt. Some states may start earlier.564
Exempt groups include former foster youth under 26; parents or caregivers of a child 13 or younger or of a disabled person; people who are pregnant or postpartum; people who are medically frail, which includes a substance use disorder or a disabling mental disorder; people in drug or alcohol treatment; people who meet SNAP or TANF work rules; and anyone who was in jail or prison at any point in the past 3 months.45
- 4
Apply soon after you need care
For applications from January 1, 2027, coverage reaches back only 1 month before the month you apply if you're an expansion adult, or 2 months for others. Don't wait on a medical bill.4
- 5
Keep your coverage
Expansion adults will renew every 6 months for renewals on or after January 1, 2027. Open your mail and report changes so you don't lose coverage.4
What it costs
| Item | Cost |
|---|---|
| Applying | Free |
| Coverage | Free or low cost |
| Expansion adults, from October 1, 2028 | Federal law requires some cost sharing |
If this is you
Situations that change the rules. Medicaid is run by each state, so ask your state agency how they apply where you live.
Leaving prison or jail
You're treated as meeting the work rule for the first 3 months after release. In reentry-program states, coverage can start up to 90 days before release, with a 30-day supply of medications when you leave.49
Aging out of foster care
You're covered until 26 with no income test. If you turned 18 on or after January 1, 2023, foster care and Medicaid in any state count, so you qualify wherever you live now. You're exempt from the work rule.114
In addiction treatment or recovery
People in drug or alcohol treatment, and people who are medically frail including with a substance use disorder, are exempt from the work rule.4
Parents and caregivers
Parents and caregivers of a child 13 or younger, or of a disabled person, are exempt from the work rule. So are people who are pregnant or postpartum.4
Survivors of trafficking who aren't citizens
Since October 1, 2026, federal Medicaid covers only citizens and nationals, green-card holders, Cuban and Haitian entrants and COFA residents. Certified survivors without a green card are no longer covered by federal Medicaid. Ask about state-funded options, or call or text 888-860-RISE.412
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Questions people ask
Is there a deadline to apply for Medicaid?
No. You can apply for Medicaid any time of year, for free, at HealthCare.gov or through your state agency.
Do I have to work to keep Medicaid?
Starting by January 1, 2027, many adults 19 to 64 covered through expansion must show work, school or service each month. Many people are exempt, including former foster youth, people in addiction treatment, parents of children 13 and under, and people released from jail or prison in the last 3 months.
Will I lose Medicaid while I'm in jail or prison?
For people under 21, states can't end it, only suspend it. For adults it depends on the state, but states with reentry programs must suspend rather than end coverage.
I aged out of foster care in another state. Am I covered?
Yes, if you turned 18 on or after January 1, 2023 and had Medicaid in foster care. Coverage runs to 26 with no income test.
Can I get Medicaid if my income is above the limit?
Apply anyway. HealthCare.gov says to apply even if you don't think you'll qualify, because rules and limits differ by state and by group.
Keep going: more first-step guides
Sources
Official pages, read in October 2026. Rules change. If something here looks out of date, please let us know at hello@riseaid.org and we'll fix it.
- 1.HealthCare.gov. Medicaid & CHIP coverage
- 2.HealthCare.gov. Medicaid expansion and what it means for you
- 3.KFF (updated October 1, 2026). Status of state Medicaid expansion decisions
- 4.Public Law 119-21 (GovInfo). Sections 71107, 71109, 71112, 71119 and 71120: Medicaid renewals, eligibility, retroactive coverage, community engagement and cost sharing
- 5.Centers for Medicare & Medicaid Services (June 2026). Medicaid community engagement requirement: interim final rule fact sheet (CMS-2454-IFC)
- 6.Medicaid.gov. Community engagement (section 71119) overview
- 7.Medicaid.gov. Reentry section 1115 demonstrations
- 8.Centers for Medicare & Medicaid Services (September 25, 2026). Approval letter: Maine reentry demonstration
- 9.Centers for Medicare & Medicaid Services (April 2023). State Medicaid Director letter 23-003: reentry section 1115 demonstrations
- 10.Centers for Medicare & Medicaid Services (July 2024). State Health Official letter 24-004: services for eligible juveniles before and after release
- 11.Centers for Medicare & Medicaid Services (December 2022). Medicaid coverage of youth formerly in foster care
- 12.HHS Office on Trafficking in Persons. Certification letters