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How does Medicaid vary by state?

Last updated date: September 11, 2025

Medicaid is a health program that helps people with low incomes and special needs get the care they need. Each state runs it a bit differently — with its own rules for who can get it. Here’s how coverage changes from state to state.

Coverage differences

Each state may cover services and provide benefits a little differently.

  • Who qualifies to get it? Each state decides who can get Medicaid and if they can help more people. States usually cover older people, children, pregnant woman and people with disabilities.

  • What’s covered? All states pay for basic health care, like doctor visits and hospital stays. Some states also cover extras, like vision and dental care.

  • Are there rules about working? Some states may have conditions that must be met to maintain Medicaid eligibility for certain population groups.

Care differences

There may also be differences in the way the state delivers and covers care.

  • Paying for care: In some states, people might have to pay a small fee (called a copay) when they go to the doctor. In other states, they don’t pay when they get care.

  • Doctors and clinics: States choose which doctors and hospitals can use Medicaid. This can change how easy it is to find care, depending on where you live.

  • Coverage for long-term care: Some states have special programs for older people that provide care at home. Others use nursing homes. States may also look at what you own, like savings for a house, if you need care for a long time. 

How to find Medicaid information by state

Learn more about who can get Medicaid and what it covers in your state. Choose your state to get started.

How to find Medicaid information by state

Learn more about who can get Medicaid and what it covers in your state. Choose your state to get started.

Why does Medicaid vary by state?

The kind of help that you get can vary by state because each state gets to choose how Medicaid works. That means the rules and services can change from state to state. Let’s take a look.

Medicaid benefits that vary by state

Some states may cover benefits that are considered extra, like:

  • Dental: Some states cover full dental benefits, while others only pay for urgent dental care.
  • Vision: Some states pay for eye exams and glasses, but others don’t cover them.
  • Prescriptions: Each state decides how much it pays for medications.
  • Non-Emergency Medical Transportation (NEMT): Certain states provide rides to medical appointments, while others don’t offer them.
  • Physical therapy: The amount of coverage may vary, depending on your location.

Some people need help for a long time, so states can choose:

  • If care happens at home or in a nursing home
  • Who can get this kind of care

How to qualify:

  • Spend-down programs: In some states, people with higher incomes can lower it by subtracting medical costs to qualify for Medicaid.
  • Private health plans: Some states use private health plans to manage that state’s Medicaid services. This can affect the care you get and which doctors you can see.
  • Income limits: Rules vary by state on how much you can earn and still get Medicaid. Some states let people with higher incomes get Medicaid. Other states only help those with very low incomes. Even if you need to earn more, some states may still offer ways to help you qualify for Medicaid.

How does Medicaid expansion affect coverage in different states?

In January 2010, the Affordable Care Act (ACA) was started as a Medicaid expansion to help more people with low-income get health insurance.

The Affordable Care Act lets states choose to expand Medicaid to cover more low-income adults — especially those without children — by raising the income limit. States can expand Medicaid to adults who earn up to 138% of the poverty level. This is about $20,780 a year per person or $35,630 for a family of 3. 1

What happens when states expand Medicaid?

  • States that expand Medicaid: These states follow the ACA rule. This means more adults can get health care. Because of this, fewer people are left without insurance.
  • States that do not expand Medicaid: These states do not follow the ACA rule. So, fewer adults can get Medicaid. As a result, more people in these states don’t have health insurance. 2

Overall, the plans available to you depend on your state. Some states will have more carriers and options than others.

Signing up for Medicaid

When you’re enrolling in Medicaid, each state might have different steps to take and details to know.

  • How to apply: Each state has its own way to renew or sign up for Medicaid. That means the steps might be a little different, depending on where you live.

  • Health plan options: Some states use private health plans to help you get the medical care you need. These plans help you find doctors and get check-ups. But you might only be able to go to certain doctors that work with the plan.

  • Special rules: Some states ask the government if they can try new ways to run Medicaid. When they do this, it’s called a “waiver.” A waiver is a special way to get health care.

Overall, Medicaid can be a great way to get help with doctor visits, medications and more. But it does vary from state to state. To learn more or check if you can get Medicaid, visit your state’s Medicaid office or web site.

Learn about Medicaid eligibility

Benefits


Disclaimer information

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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

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Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

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