How to get Medicaid, CHIP or Marketplace health coverage
Medicaid and CHIP give free or low-cost health coverage to people with low income. Your state runs them, and you can apply any time of year. If you earn too much, you can buy a private plan through the Health Insurance Marketplace, possibly with savings, during open enrollment.
Three ways to get covered
- Medicaid is a joint federal and state program for people with low income, including families and children, pregnant women, older people and people with disabilities. States must follow federal rules, but income limits, coverage and costs differ from state to state. Some states expanded Medicaid to cover adults below a set income. Others have not.
- CHIP, the Children's Health Insurance Program, offers low-cost coverage to children and pregnant women in families that earn too much for Medicaid. Each state has its own rules about who qualifies, and its CHIP works closely with its Medicaid program.
- The Marketplace sells private health plans. Some states use HealthCare.gov. Others run their own, such as Covered California. Oregon moves to its own site, ExploreHealthOR.gov, for 2027 coverage.
1. Apply for Medicaid or CHIP
There is no deadline. You can apply any time of year, and if you qualify, coverage can start right away. HealthCare.gov urges people to apply even if they think their income is too high, especially if they have children, are pregnant or have a disability.
You can apply two ways:
- Directly through your state Medicaid agency. Find yours from health coverage.
- Through a Marketplace application. If anyone in your household looks eligible for Medicaid or CHIP, the Marketplace sends your information to the state, and the state contacts you.
Medicaid can also pay for some care from before you applied. Today that can reach back up to 3 months. For applications made on or after January 1, 2027, it shrinks to 1 month for adults in the Medicaid expansion group and 2 months for everyone else.
2. Enroll in a Marketplace plan during open enrollment
On HealthCare.gov, open enrollment for 2027 coverage runs from November 1, 2026, to January 15, 2027. Pick a plan by December 15 for coverage that starts January 1. If you enroll from December 16 to January 15, coverage starts February 1. The federal Centers for Medicare & Medicaid Services (CMS) confirmed these dates in July 2026.
States that run their own marketplace may use other dates. Covered California's open enrollment runs from November 1 to January 31.
3. Outside open enrollment: special enrollment
After open enrollment ends, you can join or change a Marketplace plan only if you have a qualifying life change. For changes in your household or lost coverage, the event generally must be within the past 60 days. Examples:
- Getting married, having a baby, or adopting or taking in a foster child
- Moving to a new ZIP code or county
- Losing other health coverage, or expecting to lose it in the next 60 days
- Losing Medicaid or CHIP in the past 90 days
If you claim a lost-coverage special enrollment, you must send documents to prove it.
What changes under Public Law 119-21
The July 2025 law, which CMS calls the Working Families Tax Cut legislation, brings several Medicaid changes with set dates.
- October 1, 2026: immigration status. Full Medicaid and CHIP are now limited to citizens and to green card holders, Cuban and Haitian entrants, and Compact of Free Association migrants. In some states, lawfully residing children and pregnant women may still qualify.
- January 1, 2027: work requirement. Adults 19 to 64 in the Medicaid expansion group must show 80 hours a month of work, community service, a work program, or at least half-time school, or enough earnings. This applies in 43 states and Washington, D.C. States may start earlier, and Nebraska already has. A state making a good-faith effort can get a temporary exemption, which must end by December 31, 2028.
- January 1, 2027: renewals every 6 months. Most expansion adults must renew their eligibility every 6 months instead of once a year, starting with renewals scheduled on or after that date.
- October 1, 2028: copays. States must charge cost sharing to expansion adults with income above the federal poverty level. It cannot be more than $35 for any service, and some services, such as primary care, are exempt.
Many people are exempt from the work requirement, including people who are pregnant or postpartum, medically frail, American Indians and Alaska Natives, former foster youth, veterans with a total disability rating, people in drug or alcohol treatment, and parents or caretakers of a child 13 or younger or of a person with a disability. People who meet TANF work rules, or who get SNAP and are subject to SNAP work rules, are also exempt.
If the state cannot confirm that you meet the requirement, it must send a notice and give you 30 days to show that you do or that you are exempt. If you do not, your application can be denied or your coverage ended. You can reapply at any time.
If you are denied or cut off
You have the right to ask for a fair hearing if your state denies your Medicaid, ends it, or changes your benefits. Your state sets the deadline, which can be no more than 90 days from the date the notice was mailed, so act quickly. If you lose Medicaid or CHIP, you may also qualify to buy a Marketplace plan through special enrollment.
Where it works differently
- Program names. California's Medicaid is Medi-Cal. Wisconsin's full Medicaid coverage is BadgerCare Plus.
- County offices. In San Luis Obispo County, California, for example, you can apply for Medi-Cal by phone, by fax or in person at a county social services office, or online through Covered California or BenefitsCal.
- State systems. In Wisconsin, you apply for BadgerCare Plus online through ACCESS, in person, by phone or by mail.
Watch out for scams
San Luis Obispo County in California warns that Medi-Cal will never ask for money to enroll or renew coverage. Apply only through your state Medicaid agency, your state's marketplace or HealthCare.gov.
State by state
The official statewide page for each state and territory. For a local office near you, search your county or city above.
Sources
- HealthCare.gov: Medicaid and CHIP coverage
- HealthCare.gov: the Children's Health Insurance Program (CHIP)
- HealthCare.gov: when can you get health insurance?
- HealthCare.gov: special enrollment periods
- HealthCare.gov: the Marketplace in your state
- CMS: statement regarding City of Columbus v. Kennedy, July 31, 2026
- CMS: Medicaid community engagement requirement interim final rule fact sheet
- CMS: nationwide framework to implement Medicaid work requirements
- CMS: informational bulletin on the Medicaid and CHIP provisions of the Working Families Tax Cut legislation
- CMS: State Medicaid Director letter on 6-month eligibility redeterminations
- Public Law 119-21, sections 71107, 71109 and 71119
- 42 CFR 431.221: request for a Medicaid fair hearing
- 42 CFR 431.220: when a hearing is required
- Covered California: open enrollment
- County of San Luis Obispo Department of Social Services: Medi-Cal
- Wisconsin Department of Health Services: BadgerCare Plus
Checked against the sources above on Oct 16, 2026. GovDir is a guide, not legal advice. The agency that handles your case has the final say.