Medicaid is changing. Here's what you need to do.
Plain-language help for all 50 states and Washington, D.C. — whether you're signing up for the first time, checking whether you're still covered, or trying to hold on to what you have.
Detailed guides are ready for all 50 states and Washington, D.C.
Free. No account needed, and we never ask for your Social Security number or case number.
Start with your situation
Showing — across this page.
Find out what's changing where you live
Every state runs Medicaid differently, calls it something different, and is on a different timeline for the new rules. Pick yours.
Each square is one state, sized equally so every state is easy to tap. A ringed square means that state's full guide is ready — click straight through to it. Prefer a list? Use the dropdown at the top of the page.
See its status and program name.
Every state is live — each square on the map is ringed and opens that state's full guide. Pick yours, or use the dropdown at the top of the page.
Four things are changing
Under the 2025 federal law known as H.R. 1, adults aged 19–64 in the Medicaid expansion group face new requirements. Here's the whole of it, in plain terms.
Hours a month
Working, going to school at least half-time, job training, or volunteering. You can mix and match to reach 80.
Or this much earned
Earn at least $580 in a month and you've met it, however many hours that took. Partial earnings count toward the 80.
Months between renewals
Renewals move from once a year to every six months for most adults in the expansion group.
Days to respond
If your state can't confirm you qualify, you get a notice and 30 days to show proof or that you're exempt.
Many people don't have to meet these rules at all
If any of these describe you, the 80-hour rule does not apply — but you may still need to tell your state, so don't assume they know.
This isn't the complete list, and states are still finalizing how they'll check. Your state may also grant short-term hardship exceptions — for a hospital stay, a natural disaster, or a lack of transport. When in doubt, call your state and ask.
The income limit, for your household
In the 40 states and D.C. that expanded Medicaid, adults qualify up to 138% of the federal poverty level. Move the counter to your household size.
›Alaska and Hawaii use higher limits — roughly 25% and 15% above these figures.
›Children, pregnant women, seniors and people with disabilities usually qualify at higher incomes than this.
Things people get wrong
- Your household isn't who lives with you. Medicaid counts who's on your tax return — you, your spouse, and anyone you claim as a dependent.
- It's this year's income that matters, not last year's. If your hours were cut or you lost a job, apply now rather than waiting.
- Seven states never expanded. In Alabama, Florida, Kansas, Mississippi, South Carolina, Texas and Wyoming, adults without children generally can't qualify at any income.
- Being over the limit isn't the end. If you earn too much for Medicaid, you may qualify for a low-cost or free marketplace plan instead.
Most people who lose coverage lose it over paperwork
Not because they stopped qualifying. A letter like this shows up, it's confusing, and the deadline passes. Here's what one looks like — and what actually matters in it.
REQUEST FOR INFORMATION — COMMUNITY ENGAGEMENT
Case number: ██████████
Date of notice: 1January 12, 2027
We are reviewing your eligibility. Our records do not show that you meet the community engagement requirement described in Section 1902(xx) of the Social Security Act.
2You must submit documentation of qualifying activities on or before February 11, 2027.
3If we do not receive this information, your benefits will be discontinued effective March 1, 2027.
4If you believe this notice is in error, or that an exemption applies to you, you may request a State Hearing.
What the data says about your program
Public federal data tells you a lot about how your state runs Medicaid — how often its paperwork goes wrong, how hard it is to find a doctor, whether you'll have to choose a plan. We translate it into things you can act on. Here's California as an example.
3 in 4 Californians who lost coverage lost it over paperwork — not because they stopped qualifying.
Keep your address current. Open every letter.
Doctors are scarce here. Expect a wait for a new-patient appointment — book before you actually need one.
Nurse practitioners need physician supervision in California.
You'll have to pick a health plan, not just enroll. If you don't choose, one gets chosen for you.
Check your doctor is in that plan's network first.
Plain answers to the big questions
The national rules first. Your state's page has the exact numbers, dates and phone numbers.
What is the Medicaid income limit for 2026?
It depends on your state and your household. In the 40 states and D.C. that expanded Medicaid, adults 19 to 64 generally qualify up to 138% of the federal poverty line — about $1,800 a month for one person and $3,800 for a family of four in 2026 (higher in Alaska and Hawaii). In the states that did not expand, parents qualify only at much lower incomes and adults without a dependent child usually have no income-based pathway. Children and pregnant women qualify at higher incomes everywhere. Pick your state above for its exact 2026 table. Full guide →
How do I apply for Medicaid?
Apply through your state's Medicaid agency — online, by phone, by mail, or in person — or through HealthCare.gov, which forwards your application to the state. It is free, you can apply any time of year, and you never need to pay anyone to help you. Every state guide on this site links straight to the official application page and phone number.
How do I renew my Medicaid, and how often?
Your state reviews your eligibility at least once a year and sends a renewal notice by mail or to your online account. Starting with renewals due on or after January 1, 2027, adults covered through Medicaid expansion renew every six months instead of yearly. Answer every notice before the date on it, even if nothing has changed, and keep your address and phone number current — most people who lose coverage lose it over paperwork, not because they stopped qualifying. Full guide →
Do I have to work to keep Medicaid?
Starting January 1, 2027, adults 19 to 64 covered through Medicaid expansion must show 80 hours a month of work, job training, school, or community service — or at least $580 a month in earnings — unless they are exempt. The rule does not apply to children, people 65 and older, most people covered on grounds of disability or pregnancy, or anyone in a state that never expanded Medicaid (with a few waiver exceptions explained on those states' pages). Some states, including Arkansas and Iowa, are starting earlier. Full guide →
Who is exempt from the Medicaid work requirement?
Parents and caretakers of a child under 14; pregnant and postpartum people; people who are medically frail or disabled; people in substance-use treatment; veterans with a total disability rating; American Indians and Alaska Natives; people already meeting SNAP or TANF work rules; and people recently incarcerated, among others. States can add exemptions but not remove the federal ones. Your state's guide lists its exact rules and how to claim an exemption. Full guide →
I got a letter saying my Medicaid is ending. What should I do?
Read the reason and the date. If it is a paperwork problem — a missed renewal, a document the state says it never received — respond right away; many states must reinstate you without a new application if you reply within 90 days. If you disagree with the decision, you can request a fair hearing, and asking before the end date usually keeps your coverage running while it is reviewed. Your state's guide has the number to call. Full guide →
Don't wait for the letter.
We'll email you ahead of the deadlines that matter in your state — renewal dates, work-rule changes, and anything else that could put your coverage at risk.