What healthcare assistance programs am I eligible for in my state?
You may qualify for Medicaid if your income is under 138% of the federal poverty level ($20,783 individual / $42,630 family of four in 2024) in expansion states. CHIP covers kids in families earning up to 200-300% FPL. ACA Marketplace subsidies are now available at any income level, and Medicare Savings Programs help seniors with premiums and cost-sharing.
In This Guide:
1. Medicaid and CHIP Eligibility
Medicaid provides free or low-cost health coverage to eligible low-income adults, children, pregnant women, seniors, and people with disabilities. In the 40 states (plus DC) that expanded Medicaid under the ACA, adults under 65 qualify if household income is at or below 138% of the federal poverty level - about $20,783 for an individual or $42,630 for a family of four in 2024. Non-expansion states restrict Medicaid much more tightly. CHIP covers uninsured children in families earning too much for Medicaid but under 200-300% FPL (varies by state). Apply through Healthcare.gov or your state Medicaid agency; enrollment is open year-round.
- Check if your state expanded Medicaid at KFF.org
- Calculate your household income as a percentage of FPL
- Apply through Healthcare.gov or your state Medicaid agency
- Enroll children in CHIP if your income is 138-300% FPL
- Submit required documents: pay stubs, ID, residency proof
- Medicaid and CHIP enrollment is open year-round - no waiting for open enrollment
2. ACA Marketplace Premium Subsidies
The American Rescue Plan and Inflation Reduction Act removed the old 400% FPL income cap on premium tax credits. Subsidies now cap your premium contribution at 8.5% of household income for a benchmark Silver plan, with extra help for households under 200% FPL through cost-sharing reductions (lower deductibles and copays). A family of four earning $60,000 might pay under $100 per month for a Silver plan after subsidies. Apply through Healthcare.gov during open enrollment (November 1 to January 15) or after a qualifying life event. Even middle-income families in their 50s and 60s often qualify for substantial credits because benchmark premiums rise with age.
- Create an account at Healthcare.gov or your state exchange
- Enter household income and family size during open enrollment
- Compare Silver plans with cost-sharing reductions if under 200% FPL
- Apply premium tax credits upfront to lower monthly premiums
- Update income changes mid-year to avoid repayment at tax time
- Cost-sharing reductions apply only to Silver plans - pick Silver if under 200% FPL
- Report income drops mid-year to increase your subsidy immediately
3. Medicare Savings Programs and 340B Clinics
Medicare beneficiaries with limited income may qualify for Medicare Savings Programs (QMB, SLMB, QI) that pay Part B premiums ($174.70 per month in 2024) and sometimes deductibles, copays, and Part A premiums. Extra Help (Low-Income Subsidy) lowers Part D prescription drug costs. Income limits run roughly 135-200% of FPL depending on the program. For non-seniors, federally qualified health centers (FQHCs) and 340B pharmacies offer primary care, prescriptions, and lab work on a sliding scale regardless of insurance status. Find FQHCs at findahealthcenter.hrsa.gov. Veterans can use VA medical centers and community care, and many Indian Health Service facilities serve tribal members at no cost.
- Apply for Medicare Savings Programs through your state Medicaid office
- Apply for Extra Help (LIS) at SSA.gov for Part D prescription help
- Find a nearby FQHC at findahealthcenter.hrsa.gov
- Use 340B pharmacies for discounted prescriptions if eligible
- Veterans should enroll in VA health care at VA.gov
- Medicare Savings Programs can pay your $174.70 monthly Part B premium
- FQHCs serve everyone on a sliding scale regardless of insurance status
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