Resources

Official sources and how to prepare

Start here before you apply anywhere — these are the sources that actually process an application, plus what we've learned helps people prepare.

Medicaid.gov — The official federal Medicaid and CHIP site, including links to every state's Medicaid agency.
Healthcare.gov — The official ACA marketplace, and the fastest way to check Medicaid, CHIP, and subsidized marketplace eligibility in one application.
InsureKidsNow.gov — The official federal site specifically for CHIP and children's Medicaid, with state-by-state contact information.

Rules, thresholds and providers described here are those of the United States.

Timing

Timing that changes your outcome

Medicaid itself can be applied for year-round, but a few dates genuinely matter.

When	What happens
Anytime	Medicaid and CHIP applications are accepted year-round — unlike marketplace plans, there is no annual open enrollment window for Medicaid itself.
ACA open enrollment, typically November 1 to January 15	The main window each year to enroll in or change a marketplace plan, though a Medicaid or CHIP eligibility change can trigger a special enrollment period outside this window.
Your renewal or redetermination date	A state-set date, generally annual, when your Medicaid or CHIP coverage is re-verified — missing the response deadline is a leading cause of coverage loss.
Request-for-information or denial notice deadlines	Typically 10 to 30 days from the notice date depending on the state — always check the specific deadline printed on your own notice.

Always confirm current dates with the official source — they move.

Do this

Checklists you can work through

Before you apply for Medicaid or CHIP

Proof of identity for the applicant
Social Security numbers for household members applying
Proof of income for everyone in the household
Proof of state residency
Immigration documentation, where relevant
A list of everyone who counts as part of your Medicaid household

Before you respond to a Medicaid notice

The exact document or information requested
The response deadline printed on the notice
Which channel the notice asks you to respond through
A copy of what you submit and the date you submit it
Your state Medicaid office's phone number, in case anything is unclear
Whether the notice affects your current coverage while pending

Avoid these

Common mistakes people make

Applying before gathering documents

Collect proof of identity, income, residency, and household information first — see our document checklist guide.

Getting the Medicaid household definition wrong

Check your state's specific household rules, which are based on tax filing relationships, not just who lives together.

Not reporting a change in income or household

Report changes within your state's required window, often 10 days, to avoid a surprise adjustment later.

Missing a renewal or redetermination deadline

Keep your address current with your state Medicaid agency and respond to any renewal notice the same week you receive it.

Assuming income is too high without applying

Apply anyway — the same application checks Medicaid, CHIP, and marketplace subsidy eligibility together.

Confusing a request-for-information notice with a denial

Read the notice carefully — an RFI means your case is still open and something specific is missing, not that you've been turned down.

Plain English

Glossary

The words that get used as if everyone already knows them.

Medicaid

A joint federal-state health coverage program in the US, based mainly on income and household size, available to eligible people of any age.

Medicare

A federal health coverage program based mainly on age (65+) or certain disabilities, not based on income.

CHIP

The Children's Health Insurance Program, covering kids in households whose income is too high for Medicaid but still modest.

Medicaid expansion

A state's decision under the Affordable Care Act to extend Medicaid eligibility to most adults under about 138% of the federal poverty level; not every state adopted it.

MAGI

Modified Adjusted Gross Income — the income methodology most Medicaid categories use, aligned with federal tax rules and adjusted for household size.

Federal poverty level (FPL)

A federal income figure, adjusted for household size, used as the basis for many Medicaid, CHIP, and marketplace subsidy eligibility thresholds.

ACA marketplace

The subsidized private health insurance system accessed through Healthcare.gov, for households whose income is above their state's Medicaid line.

Redetermination

The periodic process a state uses to re-verify that a Medicaid or CHIP enrollee still meets eligibility requirements, generally annual.

Request-for-information (RFI) notice

A notice stating that a state needs additional documents or clarification before deciding a Medicaid or CHIP case; not a denial.

Denial notice

A notice stating that a Medicaid or CHIP application was decided against, including the reason and appeal rights.

Fair hearing

A formal appeal process where an independent hearing officer reviews a Medicaid denial or termination decision.

Dual eligible

A person who qualifies for both Medicare and Medicaid at the same time, generally a low-income senior or person with a disability.