If your income is low, you may qualify for free or near-free health insurance through Medicaid, CHIP, or subsidized ACA marketplace plans. In 2026, tens of millions of Americans are covered through these programs, and many people who are currently uninsured would qualify if they applied.
This guide covers every major program, current income limits, and how to check your eligibility today.
What Programs Offer Free Health Insurance for Low-Income People?
Three federal programs provide free or heavily subsidized health coverage to people with low or moderate incomes:
- Medicaid - Free coverage for eligible adults, children, pregnant women, seniors, and people with disabilities
- CHIP - Free or low-cost coverage for children and some pregnant women
- ACA Marketplace Plans - Subsidized private plans; at certain income levels, premiums drop to $0
The right program depends on your income, household size, state, and age. Most families qualify for at least one.
Medicaid: Free Health Insurance for Low-Income Adults and Families
Medicaid is the largest source of free health insurance in the United States. In expansion states, most adults with incomes up to 138% of the Federal Poverty Level (FPL) qualify at no cost.
2026 Medicaid Income Limits
The 2026 Federal Poverty Level for the 48 contiguous states is $15,960 per year for a single person. Medicaid expansion states cover adults up to 138% of FPL.
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) |
|---|
| 1 person | $15,960/year | $22,025/year |
| 2 people | $21,640/year | $29,863/year |
| 3 people | $27,320/year | $37,702/year |
| 4 people | $33,000/year | $45,540/year |
| 5 people | $38,680/year | $53,378/year |
| 6 people | $44,360/year | $61,217/year |
Monthly income limits are roughly one-twelfth of those annual figures. For a single adult, that means Medicaid is available if you earn less than about $1,835 per month in an expansion state.
Which States Have Expanded Medicaid?
As of 2026, 40 states plus Washington D.C. have expanded Medicaid under the Affordable Care Act. Expansion states cover most adults under 65 who meet the income threshold, regardless of whether they have children.
Non-expansion states (as of 2026) include Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. In these states, adults without children often cannot qualify for Medicaid regardless of income, unless they are pregnant, have a disability, or meet other specific criteria.
If you live in a non-expansion state, scroll down to the ACA Marketplace section. You may still qualify for heavily subsidized or free private coverage.
Who Qualifies for Medicaid Beyond Income?
Medicaid also covers people who qualify through specific categories, sometimes at higher income levels:
- Pregnant women: Most states cover pregnant women with incomes up to 200% FPL or higher
- Children: Most states cover children up to 138%-300% FPL through Medicaid or CHIP
- People with disabilities: Eligibility rules vary; SSI recipients typically qualify automatically
- Adults 65 and older: Medicare is usually primary, but low-income seniors may qualify for both
- Medically needy "spend down": Some states allow people with high medical expenses to qualify even above the income limit
Income is measured using Modified Adjusted Gross Income (MAGI), which includes wages, self-employment income, and certain other income types.
CHIP: Free Coverage for Children
The Children's Health Insurance Program (CHIP) covers children and some pregnant women in families that earn too much for Medicaid but cannot afford private insurance. In most states, CHIP has no monthly premium, and families pay little or nothing for covered services.
2026 CHIP Income Limits
CHIP income thresholds vary by state, but most fall between 200% and 300% FPL for children. Some states go higher.
| Household Size | 200% FPL | 250% FPL | 300% FPL |
|---|
| 1 person | $31,920/year | $39,900/year | $47,880/year |
| 2 people | $43,280/year | $54,100/year | $64,920/year |
| 3 people | $54,640/year | $68,300/year | $81,960/year |
| 4 people | $66,000/year | $82,500/year | $99,000/year |
New York extends CHIP coverage up to 400% FPL. Always check your specific state's threshold.
Children qualify for CHIP if they:
- Are under age 19
- Are not covered by employer-sponsored insurance or other qualifying coverage
- Meet their state's income limit
- Are a U.S. citizen or meet immigration requirements
You can apply for CHIP at any time of year. There is no enrollment period. If your child qualifies, coverage often starts quickly.
ACA Marketplace: Free or Low-Cost Plans for People Who Earn Too Much for Medicaid
If your income is above the Medicaid threshold, you may still qualify for free or deeply discounted health insurance through the ACA marketplace. Premium tax credits can reduce monthly costs to $0 for people at certain income levels.
2026 ACA Subsidy Income Ranges
ACA subsidies are available to individuals and families with incomes between 100% and 400% FPL. At lower income levels, the subsidies are large enough that many people pay $0 per month.
| Household Size | 100% FPL | 150% FPL | 200% FPL | 400% FPL |
|---|
| 1 person | $15,960/year | $23,940/year | $31,920/year | $63,840/year |
| 2 people | $21,640/year | $32,460/year | $43,280/year | $86,560/year |
| 3 people | $27,320/year | $40,980/year | $54,640/year | $109,280/year |
| 4 people | $33,000/year | $49,500/year | $66,000/year | $132,000/year |
People with incomes between 100% and 150% FPL often qualify for plans with $0 monthly premiums through enhanced subsidies. Between 150% and 200% FPL, premiums are typically very low. Above 400% FPL, subsidies phase out.
Non-Expansion State Exception
If you live in a non-expansion state and your income falls below 100% FPL, you may fall into what is called the coverage gap. Medicaid may not cover you and ACA subsidies do not apply below 100% FPL. Roughly 1-2 million adults are in this situation. Check with your state Medicaid agency or a navigator to see if any options apply.
Open Enrollment for ACA Plans
ACA open enrollment runs from November 1 through January 15 in most states. Outside of open enrollment, you can enroll if you have a qualifying life event (losing job-based coverage, moving, having a baby, getting married, etc.). Some states have extended enrollment windows.
Medicare for Low-Income Seniors and People with Disabilities
Medicare is the federal health program for adults 65 and older and certain younger adults with disabilities. While Medicare itself is not income-based, low-income Medicare enrollees can access extra help through:
- Medicare Savings Programs (MSPs): State programs that pay Medicare premiums, deductibles, and copays for people with limited income and assets
- Extra Help / Low Income Subsidy (LIS): Federal program that lowers prescription drug costs for low-income Medicare enrollees
- Dual eligibility: People who qualify for both Medicare and Medicaid get comprehensive free coverage
Income limits for Medicare Savings Programs vary by state but are generally between 100% and 135% FPL for individuals.
For full Medicare eligibility details, see our Medicare eligibility guide.
How to Apply for Free Health Insurance
Step 1: Check Your Eligibility
Use the free screener at CoveredUSA. Answer about 10 questions. You will see which programs you likely qualify for in about 2 minutes.
Step 2: Gather Documents
Before you apply, have these ready:
- Proof of identity (driver's license, passport, or birth certificate)
- Proof of income (recent pay stubs, tax return, or employer letter)
- Social Security numbers for all household members applying
- Proof of citizenship or immigration status
- Current health insurance information (if any)
Step 3: Apply
You have several options:
For Medicaid and CHIP:
- Apply through your state Medicaid agency directly
- Apply through HealthCare.gov (which routes Medicaid applications to your state)
- Apply in person at your local Department of Social Services or Medicaid office
- Call 1-800-318-2596 (Medicaid/marketplace helpline)
For ACA Marketplace plans:
- Apply at HealthCare.gov (or your state's marketplace if it has one)
- Work with a free enrollment navigator or licensed broker
- Apply by phone: 1-800-318-2596
For Medicare:
- Enroll through the Social Security Administration (ssa.gov)
- Call 1-800-772-1213
Step 4: Confirm Coverage
After submitting, you will receive a decision letter. Medicaid decisions often come within a few days to a few weeks. Keep the letter and any ID cards sent to you. Contact the agency if you do not hear back within 45 days.
What Does Medicaid Cover?
Medicaid covers a broad range of services at no or very low cost:
- Doctor visits and preventive care
- Emergency room and hospital stays
- Prescription drugs
- Mental health and substance use disorder treatment
- Maternity and newborn care
- Vision and dental (for adults, in most states)
- Home health and long-term care services
Specific covered services vary by state.
Income Limits Reference
For a quick comparison of how major programs stack up by income level, see our Medicaid income limits reference page for state-by-state tables.
Frequently Asked Questions
Can I get free health insurance if I am unemployed?
Yes. Losing a job is a qualifying life event for ACA enrollment. If your income is low enough, you may qualify for Medicaid immediately. If your income is between 100% and 150% FPL, ACA subsidies can bring your premium to $0. Apply as soon as possible after losing coverage to avoid gaps.
What if I am self-employed? Can I still qualify?
Self-employed individuals qualify for the same programs as everyone else. Income is based on your net self-employment earnings after business expenses. If your net income is below 138% FPL in an expansion state, you likely qualify for Medicaid. If higher, check ACA marketplace subsidies.
Do I have to be a U.S. citizen to get free health insurance?
Medicaid and CHIP require U.S. citizenship or qualifying immigration status. Lawful permanent residents, refugees, and certain other documented immigrants may qualify, though some must wait five years after gaining lawful status. Undocumented immigrants generally do not qualify for federal Medicaid except for emergency services. Some states use state-only funds to cover broader groups.
What is the income limit for free health insurance for a family of 4?
In Medicaid expansion states, a family of four with annual income up to about $45,540 qualifies for free Medicaid in 2026. For CHIP, coverage may extend to $66,000-$99,000 depending on the state. ACA subsidies extend well above $100,000 for families of four, though the coverage becomes subsidized rather than free at higher incomes.
How long does it take to get approved?
Medicaid decisions typically take 1 to 45 days. CHIP decisions are similar. ACA marketplace enrollments are effective on the first of the month following enrollment (or the 15th of the month in some cases). Emergency Medicaid can be approved same day in life-threatening situations.
What if my income changes during the year?
Report income changes promptly to your Medicaid or marketplace plan. Changes that drop your income may make you eligible for Medicaid mid-year. Changes that increase income may affect your subsidy amount. You have 30 days to report changes on healthcare.gov.
Can I have Medicaid and marketplace coverage at the same time?
Generally no. If you are enrolled in Medicaid, you are not eligible for ACA marketplace premium tax credits. If you lose Medicaid eligibility, you can enroll in a marketplace plan with a special enrollment period.
Next Steps
Free health insurance is available to a large share of Americans in 2026. The main barrier is not knowing where to start.
Check your eligibility now at CoveredUSA. It takes 2 minutes. The screener covers Medicaid, CHIP, ACA marketplace plans, and Medicare at coveredusa.org/screener.
If you qualify, a licensed agent can help you enroll at no cost to you. Brokers are paid by insurance companies, not by you.
