Medicaid and health coverage for SNAP households: 2026-2027 guide

Getting SNAP does not give you health coverage by itself. You still have to apply for Medicaid, the Children’s Health Insurance Program (CHIP) or a Marketplace plan. But a household with SNAP-level income often meets the income rules for one of them, and in many states the same application covers both. In the 43 states and the District of Columbia that cover low-income adults under the Medicaid expansion, an adult with income below about 138% of the poverty line qualifies on income alone. That is about $1,835 a month for one person in 2026, which is higher than the federal SNAP gross income limit of $1,729 for October 2026 to September 2027. You can apply for Medicaid and CHIP at any time of year (HealthCare.gov). Three federal changes matter for 2026-2027. The extra Marketplace tax credits ended after 2025. A Medicaid work requirement starts by January 1, 2027. And a SNAP household member who is subject to SNAP’s work rules is exempt from that Medicaid requirement.

Does SNAP make you eligible for Medicaid?

Not automatically. SNAP and Medicaid are separate programs with separate income rules. SNAP is run by USDA through your state’s SNAP agency. Medicaid and CHIP are run by your state under rules from the Centers for Medicare & Medicaid Services (CMS). There are four links between them.

Many states use one application. In many states the SNAP portal is also the Medicaid portal. Iowa takes Medicaid applications in the same HHS portal as SNAP (Iowa). In Ohio the same Ohio Benefits application covers both (Ohio). Michigan uses MI Bridges and Pennsylvania uses COMPASS (Michigan, Pennsylvania). On a combined application, mark medical coverage for everyone in the household who needs it.

Medicaid agencies must check SNAP records. Federal rules require the state Medicaid agency to request eligibility and enrollment information from SNAP when it helps verify income (42 CFR 435.948(a)(2)). This can mean fewer documents to send in.

Some states enroll children using SNAP findings. A 2009 law created “Express Lane Eligibility.” It lets a state use another program’s findings on income or household size to enroll or renew children in Medicaid or CHIP. SNAP, school lunch, TANF, Head Start and WIC can serve as the “express lane agency.” CMS’s list, last updated August 6, 2021, names seven states (Medicaid.gov):

Renewals can happen without forms. For Medicaid based on modified adjusted gross income (MAGI), which covers most children, parents and adults under 65, the state must first try to renew your coverage with information it already has, such as wage data or your SNAP case, before sending you a form. If it needs a form, you get at least 30 days to return it. If you lose coverage for not returning the form, the state must reconsider you without a new application if you send the form in within 90 days (42 CFR 435.916).

Medicaid and CHIP: who qualifies

Medicaid rules differ by state. In every state you can qualify based on income, household size, disability, family status and other factors (HealthCare.gov). The big difference between states is for adults under 65 who are not parents, pregnant or disabled.

• States that expanded Medicaid. Adults qualify on income alone if household income is below 133% of the federal poverty level, which works out to 138% because of how income is counted. A few states use a different limit (HealthCare.gov: Medicaid expansion). CMS counted 43 states and D.C. covering this adult group in June 2026 (CMS fact sheet, June 1, 2026).
• States that did not expand. If your income is below the poverty line and you do not fit one of your state’s Medicaid groups, you get neither Medicaid nor Marketplace savings. HealthCare.gov still tells you to file an application: children, pregnant women and people with disabilities often qualify, and more detailed income figures can change the result (HealthCare.gov).
• Children and CHIP. CHIP covers children, and in some states pregnant women, in families that earn too much for Medicaid. Your children may qualify for CHIP even if you do not (HealthCare.gov quick guide). The federal Insure Kids Now line, 1-877-543-7669 (1-877-KIDS-NOW), points you to your state’s program (InsureKidsNow.gov).

The table compares the federal SNAP gross income limit with 138% of the 2026 poverty guidelines for the 48 states and D.C. The 138% figures are calculated here as the HHS 2026 guideline × 1.38 ÷ 12. Your state’s Medicaid chart may differ by a few dollars.

So in an expansion state, an adult who passes SNAP’s 130% gross test is usually under Medicaid’s limit too. Many states let SNAP households have income up to 165%, 185% or 200% of poverty (see SNAP income limits). Those households can be over Medicaid’s adult limit and should look at the Marketplace instead. The two programs also count income differently. Medicaid for most adults uses modified adjusted gross income (MAGI), the tax-based figure. SNAP counts gross monthly income. For the Marketplace, MAGI does not include SSI (IRS FS-2025-10, Q8).

Medicaid changes in 2026-2027, by date

Public Law 119-21, signed July 4, 2025, changed Medicaid as well as SNAP. CMS calls it the “Working Families Tax Cut” legislation. These are the dates that affect households, from the law and CMS’s informational bulletin of November 18, 2025 (P.L. 119-21; CMCS bulletin):

The retroactive coverage change matters if you have a hospital bill. From January 1, 2027, Medicaid can pay older bills for only one or two months before the month you apply. Apply in the month of the bill if you can.

How SNAP’s work rules connect to Medicaid’s

From January 1, 2027 (or earlier if a state chooses), expansion adults aged 19 to 64 must show 80 hours a month of work, community service, a work program or half-time school, or a combination. Monthly income of at least 80 times the federal minimum wage also counts; CMS gives that as $580 a month in 2026. New applicants may have to show this for one to three months before they apply, depending on the state. People already enrolled show it between renewals. If the state cannot verify it, you get a notice and 30 days to respond (CMS fact sheet).

The law exempts anyone who “is a member of a household that receives supplemental nutrition assistance program benefits … and is not exempt from a work requirement” under the SNAP law (P.L. 119-21, sec. 71119). In plain terms: if you get SNAP and SNAP’s work rules apply to you, Medicaid does not add a second work requirement. If SNAP exempts you, Medicaid may still apply its own rule unless you fit another exemption. Other exemptions include:

• parents and caretakers of a child 13 or younger or of a disabled person;
• people who are medically frail;
• veterans with a total disability rating;
• former foster youth;
• American Indians and Alaska Natives;
• people who are pregnant or postpartum;
• people meeting TANF work requirements; and
• people in drug or alcohol treatment.

Your state decides how it checks these exemptions. The SNAP rules themselves are in SNAP work requirements in 2026.

The Marketplace and premium tax credits for 2027

If you do not qualify for Medicaid or CHIP, you can buy a private plan through the Health Insurance Marketplace. That is HealthCare.gov or your state’s own marketplace (second table below). The premium tax credit lowers the monthly premium.

The enhanced credits ended after 2025. For tax years 2021 through 2025, Congress removed the rule that blocked the credit for household income above 400% of the poverty line. From 2026 that limit applies again: generally, the credit goes to household income from 100% to 400% of poverty (IRS FS-2025-10, Q7). HealthCare.gov describes the same 100%-400% range in its pages for 2027 coverage (HealthCare.gov).

There is no cap on paying back extra credit. For tax years after 2025, if the credit paid to your insurer during the year is more than you qualify for, you repay the whole difference at tax time. Before 2026, caps limited that repayment (IRS FS-2025-10, Q1 and Q31). Report income changes to the Marketplace during the year. You can also choose to take less of the credit in advance (HealthCare.gov).

Fewer immigrants qualify from 2027. Starting January 1, 2027, Marketplace savings go only to lawful permanent residents (green card holders), Cuban and Haitian entrants, and Compact of Free Association migrants. Other lawfully present immigrants can still buy a plan, but without savings (HealthCare.gov). For SNAP’s own immigrant rules, see SNAP eligibility for immigrants.

Dates for 2027 coverage on HealthCare.gov. Open enrollment runs November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage that starts January 1, or by January 15 for coverage that starts February 1 (HealthCare.gov dates and deadlines). State-run marketplaces may set different dates. Outside open enrollment you need a qualifying life event. You can apply for Medicaid and CHIP at any time of year. HealthCare.gov said it would post 2027 savings estimates on November 1, 2026 (HealthCare.gov).

The credit for a year uses the poverty guidelines in effect on the first day of that year’s open enrollment (IRS FS-2025-10, Q7). For 2027 coverage those are the 2026 guidelines. Yearly household income in the 48 states and D.C.:

Alaska and Hawaii have higher guidelines. If you live in a state that did not expand Medicaid, your income later rises above 100% of poverty, and you were turned down for both Medicaid and tax credits, HealthCare.gov says to call the Marketplace Call Center at 1-800-318-2596 within 60 days of the change (HealthCare.gov).

Seniors and people with disabilities: Medicare Savings Programs

If someone in your household has Medicare, look at the state-run Medicare Savings Programs. They pay Medicare costs for people with limited income. The federal limits for 2026 are below; Alaska and Hawaii are slightly higher, and some states allow more (Medicare.gov):

The 2026 resource limit for all three is $9,950 for one person and $14,910 for a couple. Qualifying also gives you Extra Help with Part D drugs, so you pay no more than $12.65 in 2026 for each covered drug. You apply through your state Medicaid agency (Medicare.gov). The standard Part B premium in 2026 is $202.90 a month (Medicare.gov costs).

How SNAP treats health coverage and medical bills

Medicaid pays doctors and hospitals directly. It is not money paid to your household, so SNAP does not count it as income (7 CFR 273.9(c)(1)).

If a household member is 60 or older or disabled, that member’s out-of-pocket medical costs above $35 a month are deducted from income. The deductible costs include health insurance premiums, Medicare premiums, Medicaid cost sharing or spend-down, prescriptions, dental care, glasses, hearing aids and travel to medical care (7 CFR 273.9(d)(3)). Other households get no medical deduction. Report these costs to your SNAP office with proof. See SNAP for seniors and people with disabilities.

Worked examples with 2026-2027 figures

These use the FY2027 federal SNAP figures for the 48 states and D.C. and the 2026 poverty guidelines. Your state’s rounding or utility rules can change the SNAP result by a few dollars.

1. A single adult in a state that expanded Medicaid

Dana is 35, has no children, and earns $15 an hour for 25 hours a week. Monthly pay: $15 × 25 × 52 ÷ 12 = $1,625.

• SNAP: $1,625 is under the $1,729 gross limit for one person, so Dana can pass the gross test.
• Medicaid: $1,625 is under about $1,835 (138% of poverty), so Dana qualifies for expansion Medicaid on income.
• Work requirement from January 1, 2027: Dana works about 25 × 52 ÷ 12 = 108 hours a month, and $1,625 is more than $580. Either one meets the requirement. If Dana gets SNAP, SNAP’s work rules apply to Dana, which is itself an exemption from the Medicaid rule.
• Renewal: as an expansion adult, Dana’s Medicaid is renewed every 6 months from 2027.

2. A parent of two in a state that did not expand Medicaid

Marcus earns $3,000 a month and has children aged 8 and 12. His state did not expand Medicaid and lets SNAP households have gross income up to 200% of poverty. For three people, 200% is $4,554 a month in most such charts for FY2027; the Florida chart is one example of a 200% chart.

• SNAP: $3,000 is under $4,554, so the household passes the gross test and goes on to the net test and benefit calculation.
• The children: apply for Medicaid or CHIP for them. Children can qualify for CHIP even when a parent does not (HealthCare.gov quick guide).
• Marcus: his yearly income is $3,000 × 12 = $36,000. That is $36,000 ÷ $27,320 = 132% of poverty for three. Without expansion, a parent qualifies only under the state’s own limit for parents, so the Medicaid application will show whether he does. If he does not, he falls within the 100%-400% range for a 2027 premium tax credit, so he should apply on HealthCare.gov between November 1, 2026 and January 15, 2027.
• In an expansion state, 132% is under 138%, so Marcus would qualify for Medicaid. As the parent of a child under 14, he would be exempt from the work requirement.

3. A senior on Medicare: what a Medicare Savings Program does to SNAP

Ruth is 68 and lives alone. She gets $1,150 a month from Social Security, and the $202.90 Part B premium is taken out of it. Her rent is $700 with utilities included. Her drugs cost $30 a month.

Without help. Her medical costs are $202.90 + $30 = $232.90.

With QMB and Extra Help. Her $1,150 is under the 2026 QMB limit of $1,350, so she may qualify; the state decides. QMB pays her Part B premium, and her Social Security payment goes up by $202.90. Say her two drugs then cost $12.65 each, or $25.30 a month. That is under $35, so there is no medical deduction.

Her SNAP falls by $185 − $96 = $89. But she keeps $202.90 a month that was going to the premium and saves $30 − $25.30 = $4.70 on drugs. Each month she is ahead by $202.90 + $4.70 − $89 = $118.60. Report the change to SNAP when the premium stops. The benefit formula is in How SNAP benefits are calculated.

If you do not qualify for any coverage

At a community health center, what you pay depends on your income. They provide primary care, prenatal care, baby shots and referrals to specialized care, including for mental health and substance abuse treatment (HealthCare.gov). Find one with HRSA’s Find a Health Center tool. HealthCare.gov’s general help line is 1-800-318-2596 (HealthCare.gov).

Where to apply in your state

You can apply for Medicaid and CHIP directly with your state, or through the Marketplace. If you apply through the Marketplace and look eligible for Medicaid, it sends your information to the state (HealthCare.gov). Each state’s Medicaid program, from our state pages:

Each state’s health insurance marketplace. States that run their own use their own site, deadlines and phone line:

Guam has no marketplace in the table. The U.S. Virgin Islands row shows that HealthCare.gov does not serve Virgin Islands residents. The Guam and U.S. Virgin Islands pages list the territories’ Medicaid offices and other health programs.

Sources

• Medicaid & CHIP: getting coverage, HealthCare.gov (CMS), checked 2026-10-17
• Medicaid expansion and what it means for you, HealthCare.gov, checked 2026-10-17
• A quick guide to the Health Insurance Marketplace and Dates and deadlines, HealthCare.gov, checked 2026-10-17
• Health coverage for lawfully present immigrants, HealthCare.gov, checked 2026-10-17
• Income levels and savings and The premium tax credit, HealthCare.gov, checked 2026-10-17
• How to find low-cost health care in your community, HealthCare.gov, and Find a Health Center, HRSA, checked 2026-10-17
• FS-2025-10, Updates to Questions and Answers about the Premium Tax Credit, Internal Revenue Service, December 2025, checked 2026-10-17
• Public Law 119-21, sections 71107, 71109, 71112, 71119, 71120, congress.gov, checked 2026-10-17
• CMCS Informational Bulletin, November 18, 2025, Centers for Medicare & Medicaid Services, checked 2026-10-17
• Medicaid Community Engagement Requirement Interim Final Rule fact sheet, CMS, June 1, 2026, checked 2026-10-17
• Express Lane Eligibility for Medicaid and CHIP Coverage, Medicaid.gov, checked 2026-10-17
• 42 CFR 435.916 and 42 CFR 435.948, eCFR, checked 2026-10-17
• 7 CFR 273.9, eCFR, checked 2026-10-17
• Medicare Savings Programs and Medicare costs, Medicare.gov, checked 2026-10-17
• InsureKidsNow.gov, CMS, checked 2026-10-17
• SNAP Fiscal Year 2027 Cost-of-Living Adjustments, USDA, August 21, 2026, and HHS Poverty Guidelines for 2026, ASPE