It comes down to three things: your income, your household size, and whether your state expanded Medicaid — 7 of the 23 states we serve didn't, including Florida and Texas. Check your likely path in 60 seconds. If it's Medicaid or CHIP, you can apply today: those programs enroll year-round.
Free guidance on whichever path fits — including help with Medicaid and CHIP applications. No pressure, no obligation.
Rough screening only. This tool compares income against the 2025 federal poverty guidelines and each state's Medicaid expansion status. Actual Medicaid and CHIP eligibility involves many factors this tool cannot see — pregnancy, disability, age, immigration status, assets in some programs, and state-specific income rules and disregards. Only your state Medicaid agency or the Marketplace can determine eligibility. Smooth Health Solutions is not affiliated with or endorsed by any state Medicaid agency, HealthCare.gov, CMS, or HHS.
In expansion states, Medicaid covers nearly all adults up to 138% of the federal poverty level — about $21,600 for a single person, $44,400 for a family of four in 2026. In the 7 non-expansion states we serve — Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, and Texas — able-bodied adults without minor children generally can't get Medicaid at any income, and parents face very low caps.
That creates the coverage gap: adults in those states earning under 100% of poverty can be too "high" for Medicaid but too low for Marketplace subsidies. If that's you, don't give up — pregnancy, disability, and children's coverage run on separate, more generous rules, and your household can mix programs: kids on CHIP, parents on a subsidized Marketplace plan.
Yes — Medicaid and CHIP have no enrollment window. Apply any day of the year through your state agency or HealthCare.gov, and coverage can be retroactive up to three months in many states.
In non-expansion states, adults under 100% of poverty can be ineligible for both Medicaid and Marketplace subsidies. Exceptions that still work: pregnancy coverage, disability pathways, and children's Medicaid/CHIP. Estimating your full-year income honestly matters too — if a new job pushes you over 100% for the year, subsidies come back into play.
Very. Children's limits run far higher than adults' — often 200–300%+ of poverty. Kids on free or low-cost CHIP while parents use a subsidized Marketplace plan is one of the most common household setups we see.
Georgia didn't fully expand, but its Pathways to Coverage program covers some adults up to 100% of poverty who meet work, school, or volunteering requirements. It's narrower than full expansion — worth a call to sort out whether you fit.
Losing Medicaid or CHIP is a qualifying life event: it opens a 60-day Special Enrollment Period for a Marketplace plan, usually with strong subsidies at the income that ended your Medicaid. Check the enrollment checker when it happens.
Estimate a Marketplace credit with the subsidy calculator, confirm an enrollment window with the SEP checker, or read your state's 2026 guide: