Haris Ashley
In the US, low-income individuals and families can access free or
How to get medical insurance for low income
| Characteristics | Values |
|---|---|
| Medicaid | Free or low-cost medical benefits for eligible low-income individuals, families, children, pregnant women, the elderly, and people with disabilities |
| Children's Health Insurance Program (CHIP) | Low-cost health coverage for children in families that earn too much to qualify for Medicaid; qualifications and coverage vary by state |
| Marketplace plans | May be more affordable than expected, with most people qualifying for savings; cost depends on income and household size |
| Job-based health plans | Considered "affordable" if the monthly premium is less than 9.02% of household income as of 2025 |
| COBRA continuation coverage | Allows temporary maintenance of health coverage after employment ends, offered by some former employers |
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What You'll Learn
Medicaid and CHIP
Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage for some low-income people, families, and children. Medicaid and CHIP cover pregnant women, the elderly, and people with disabilities as well. Each state has its own requirements and rules for eligibility, and coverage and costs may differ from state to state.
Medicaid eligibility depends on a combination of factors, including income, household size, family status, disability, age, and other factors. To apply for Medicaid, you must be a resident of the state where you are applying for benefits. You can create an account with the Health Insurance Marketplace and fill out an application to see if you qualify. If it appears that anyone in your household qualifies, your information will be sent to your state agency, and they will contact you about enrollment.
Even if your income is too high for Medicaid, your child may still qualify for CHIP. CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. CHIP covers medical and dental care for uninsured children and teens up to age 19. CHIP qualifications differ in every state and depend on income, so you will need to find a CHIP program by state to apply.
If your state has expanded Medicaid, you can check if your income qualifies. If your state has not expanded Medicaid, you may still qualify based on your state's existing rules. Because each state and family situation is unique, there is no way to determine eligibility without filling out an application. If your income is just above the level to qualify for Medicaid, you may be able to pay very low premiums and out-of-pocket costs for private health insurance through the Marketplace.
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Job-based health plans
If you have a job, you may be offered health insurance by your employer. This is called a job-based health plan. In 2025, a job-based health plan is considered "affordable" if your share of the monthly premium in the lowest-cost plan offered by your employer is less than 9.02% of your household income. If your employer's plan meets this standard and is considered "affordable", you won't qualify for a premium tax credit if you buy a Marketplace insurance plan instead. Most job-based plans meet these standards.
If you have a Marketplace plan and get an offer of health insurance through your job, you may no longer qualify for savings on your Marketplace plan, even if you don't accept the job-based coverage offer. If you have an offer but haven't accepted it yet, update your Marketplace application to find out how this offer impacts your savings. If you qualify for savings, you may want to keep your Marketplace coverage. If you already accepted the offer of job-based insurance, you may want to cancel your Marketplace plan for yourself and anyone else in your household who is eligible for the new job-based coverage. You won't qualify for savings if you're enrolled in a job-based plan.
If you lose your job-based health insurance, you may be able to keep your job-based health plan through COBRA continuation coverage. COBRA coverage lets you pay to stay on your job-based health insurance for a limited time after your job ends (usually 18 months). You usually pay the full premium yourself, plus a small administrative fee. Contact your employer to learn about your COBRA options. If you've already signed up for COBRA coverage, find out if you can switch from COBRA to a Marketplace health plan.
If your new job doesn't offer health insurance, you can keep your Marketplace plan and continue to get any savings you qualify for based on your household income. Report your new job and any income changes right away to get the correct amount of savings so that you don't owe money when you file next year's taxes.
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Marketplace health plans
Under the ACA, you have special patient protection when insured through the Marketplace. Insurers cannot refuse coverage based on sex or a pre-existing condition, and there are no lifetime or annual limits on coverage for essential health benefits. Young adults can remain on their family's insurance plan until age 26.
The amount you pay for health insurance through the Marketplace depends on your income, where you live, and the size of your household. You can check if you qualify for savings on Marketplace premiums or Medicaid based on your income. In general, if you qualify for Medicaid, you will not be eligible for savings on a Marketplace plan. However, if your income is just above the level to qualify for Medicaid, you can often pay very low premiums and out-of-pocket costs for private health insurance through the Marketplace.
Marketplace plans offer a wide range of coverage options, including medical, dental, and vision. You can use your state's Marketplace website to shop, compare, and enroll in a plan that is right for you. Each state's Marketplace has its own enrollment instructions and plan options, so be sure to check your state's website for details.
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COBRA continuation coverage
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the option to continue their group health benefits for a limited time. This is particularly useful for those who need health coverage during the transition period between losing job-based coverage and beginning other health coverage.
COBRA coverage will be the same as what you had while employed, which is helpful if you want to continue seeing the same doctors and receiving the same health plan benefits. Your dependents (i.e., spouse, former spouse, or children) are also eligible for COBRA coverage, even if you (the former employee) do not sign up.
You have a 60-day window to enrol in COBRA once your employer-sponsored benefits end, and coverage is typically temporary, lasting between 18 to 36 months. During this time, you may be required to pay the entire group rate premium out of pocket, plus an administrative fee of up to 2% of the plan cost. This cost consideration is an important factor when exploring COBRA as a health coverage option.
COBRA is a helpful option for those who need temporary health coverage while transitioning between jobs or dealing with other life changes, allowing for the continuation of the same health benefits during this period.
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State-specific programs
Some states have additional state-only programs to provide medical assistance to certain low-income people who do not qualify for Medicaid. For example, states have the option to establish a "medically needy program" for individuals with significant health needs whose income is too high to qualify for Medicaid. These individuals can become eligible by "spending down" the amount of income that is above a state's medically needy income standard. Once the individual's incurred expenses exceed the difference between their income and the state's medically needy income level, they can be eligible for Medicaid, which will then pay for the cost of services that exceed the expenses the individual had to incur to become eligible.
Additionally, each state has its own Children's Health Insurance Program (CHIP) with different qualifications. CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In most cases, CHIP qualifications depend on income, but other factors may be considered as well.
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Frequently asked questions
Medicaid is a federal-state program that provides free or low-cost health coverage to low-income people, families, children, pregnant women, the elderly, and people with disabilities.
You can check your eligibility by filling out a Marketplace application. Your eligibility will depend on your income and the state you live in.
Depending on your income, you may qualify for savings on a private insurance plan. You can also check if you qualify for your state's "medically needy program".
The Children's Health Insurance Program (CHIP) provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid.
You can find low-cost health care at a nearby community health center. You may also be eligible for COBRA continuation coverage if you lost your job and your former employer offers it.
