Medicaid · Step 2 of 3
How to apply for Medicaid: the steps, the papers and the decision
Where do I apply for Medicaid?Free · no sign-up · next page
Small gaps in an application cause long delays
Your state has to check what you write before it can decide. Federal rules give it up to 45 days for most applications. When the application is based on a disability, it can take up to 90 days. A missing paper or an unanswered letter can stretch that time.
Timing matters for another reason. Medicaid can pay for covered care you got in the three months before the month you apply. This only works if you would have qualified at the time you got the care. A recent federal law cuts that window for new applications made after a set date. For adults in the expansion group it becomes one month, and for everyone else two months. Our Medicaid eligibility page gives the exact start date. Applying soon after a hospital stay or a large bill protects more of it.
Answers to the questions from the first page
Why do the rules change from state to state? Medicaid is run by each state inside federal rules. That is why income limits, covered groups and benefits differ. All states must cover some groups, such as low-income families, qualified pregnant women and children, and people who get SSI. Most states have also chosen to cover adults under 65 with low income. A state that has not done so may still cover you if you have children, are pregnant or have a disability, so it is worth applying.
How do the application and the decision work? You fill out one application and answer questions about everyone in your household. The state checks your answers and may ask for papers. It then mails a written notice. If the answer is no, the notice explains how to ask for a fair hearing. You get a reasonable time set by your state, and never more than 90 days from the date the notice was mailed.
Where do you apply for Medicaid? Only your state Medicaid agency decides. You can reach it directly, or apply through the Marketplace online at HealthCare.gov or by phone. The Marketplace sends your details to the state when it looks like you may qualify.
How to apply for Medicaid step by step
The steps are much the same in every state. Give the same answers on every form.
- Choose one way in. Your state agency must take applications online, by phone, by mail and in person. The Marketplace takes the same kind of application online or by phone.
- List your household. The form asks about each person in your home, even people who are not applying. It also asks how you file taxes and who you claim as a dependent.
- Gather your papers. Have the Social Security number and date of birth of each person, your home and mailing address, and pay stubs or W-2 forms. Also gather proof of other income, such as unemployment, Social Security or a pension.
- Add immigration details if they apply. For anyone who is not a citizen, have the information from his or her immigration papers ready.
- Get help if you need it. An adult in your household or an authorized representative can apply for you. Someone acting for a child or for a person who cannot act alone can apply too.
If a paper is hard to find, tell the worker. Send what the state asks for by the date on its letter.
What to do right after you apply
A few habits keep the application moving and protect your rights.
- Write down the date you applied, and keep a copy of what you send.
- Open every letter from the state, and answer calls, texts and emails from it.
- If you move, give the state your new address so its letters reach you.
- If the answer is no, read the notice for the deadline to ask for a fair hearing. You can speak for yourself or bring a lawyer, a relative, a friend or another spokesperson.
- If the state says no, it usually sends your contact details to the Marketplace. You may be able to buy a plan there with help on the cost.
The next page shows where to reach your state and the Marketplace.
- eCFR, 42 CFR 435.912, Timely determination of eligibility — Decision within 90 days for disability-based applications and 45 days for all others
- eCFR, 42 CFR 435.915, Effective date — Coverage from the third month before the month of application (rule in force before the change in section 71112)
- Medicaid.gov, Eligibility Policy — Mandatory groups, MAGI income rules, citizenship and residency, effective date and 3-month retroactive coverage, medically needy spenddown in 36 states and D.C., fair hearings
- Public Law 119-21 (H.R. 1, July 4, 2025), section 71112, Reducing State Medicaid costs — Rewrites section 1902(a)(34): retroactive coverage of 1 month for the adult expansion group and 2 months for others, for applications made on or after the first day of the first quarter that begins after December 31, 2026
- CMS, CMCS Informational Bulletin, Working Families Tax Cut legislation (Public Law 119-21): summary of Medicaid and CHIP provisions (November 18, 2025) — Section 71112: retroactive coverage limited to 1 or 2 months for applications made on or after January 1, 2027; section 71109: noncitizen funding limits from October 1, 2026
- eCFR, 42 CFR 435.907, Application — Applications by internet, phone, mail, in person or other electronic means, and who may apply for you
- HealthCare.gov, Get Ready to Apply for or Re-Enroll in Your Health Insurance Marketplace Coverage (checklist) — Information to have ready: household members, addresses, Social Security numbers, immigration documents, tax filing and income
- HealthCare.gov, Medicaid & CHIP coverage — Who Medicaid covers, the immigration status change, help with bills from the last 3 months, apply any time of year, two ways to apply
- eCFR, 42 CFR 431.221, Request for hearing — A reasonable time, not more than 90 days from the date the notice is mailed
- eCFR, 42 CFR 431.206, Informing applicants and beneficiaries — Right to a fair hearing and to bring a lawyer, relative, friend or other spokesperson
- HealthCare.gov, Get Marketplace coverage if you lose or are denied Medicaid or CHIP coverage — The state sends your contact information to the Marketplace, free assisters, scam warning, lost in the past 90 days or losing in the next 60 days