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Home > About Us > Policy Areas > Child Health > Medicaid

Medicaid

Medicaid is a federal-state partnership that helps states provide medical services to low-income individuals. The federal and state governments jointly fund Medicaid. 

Medicaid is the largest source of funding for health services for low-income people in the United States. Medicaid covers all services that a doctor or other health care professional identifies as being "medically necessary." 

Who's eligible for Medicaid?

Eligibility varies from state to state.  At a minimum, all states must provide Medicaid coverage for children in the following categories:

• Children younger than six years of age and pregnant women whose family income is at or below 133 percent of the federal poverty level (FPL) ($26,600 for a family of four).
• Children between 6 and 19 years of age whose family income is at or below 100 percent of FPL ($20,000 for a family of four).
• Many states cover children in families whose income is above these income limits.  For example, some states cover children under age one and pregnant women whose family income is at or below 185 percent of FPL (or $37,000 for a family of four).  Please contact your state’s Medicaid office to find more information about whether you qualify.

To learn more about Medicaid eligibility guidelines, go to the Centers for Medicare & Medicaid Services website.

What do children receive once they are enrolled in Medicaid?

• Health services vary from state to state but states are required to provide the following services through Medicaid: 
• Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services for children
• Immunizations
• Prescription drug coverage
• Physician services
• Hospital care (inpatient and outpatient)

Visit the Centers for Medicare & Medicaid Services website to learn more about Medicaid.

Children's Defense Fund
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