Why don't I qualify for Medicaid or health insurance savings?

If you have a low income and don't qualify for Medicaid or savings on a Marketplace plan, your eligibility may depend on your household income, household size, state, immigration status, and other factors.

What is the Medicaid coverage gap?

In most states, adults with low incomes may qualify for Medicaid, while people with higher incomes may qualify for savings on a Marketplace plan.

However, some states have not expanded Medicaid to all low-income adults. In these states, some people can fall into the Medicaid coverage gap because:

• Their income is too high to qualify for Medicaid under their state's rules, but
• Their income is too low to qualify for a Marketplace premium tax credit.

Medicaid rules vary by state, so not everyone with a low income will fall into the coverage gap.

What if I don't qualify for savings?

Marketplace financial assistance is generally based on your expected annual household income.

If you don't qualify for Medicaid or a premium tax credit, you can still enroll in a full-price Marketplace plan through Stride.

You can also:

• Update your Marketplace application if your income changes. You may become eligible for financial assistance later in the year.
• Look for low-cost care at a community health center or other local provider.

Don't increase or decrease your reported income just to qualify for savings. Your application should reflect your best estimate of your actual household income for the year.