If you applied for Medicaid or the Children’s Health Insurance Program (CHIP), and your state said you weren’t eligible, you should complete a Marketplace application for private insurance. Most people will get a notice from the Marketplace.
When completing your application, you may be asked if anyone on your application was recently turned down for state Medicaid or CHIP coverage. You may also be asked to select the name of anyone on your application who applied for coverage through their state or the Marketplace during a specific period of time.
Medicaid and CHIP programs may also be called different names, like “Medical Assistance,” “All Kids,” or “Family Care.”
Here’s more information about how to answer these questions
Were any of these people found not eligible for Medicaid and Children’s Health Insurance Program (CHIP) in the past 90 days? Or, were any of them found not eligible for Medicaid or CHIP due to their immigration status since October 1, 2013?
There will be a box next to each person’s name.
Do check the box for any person who:
- Had their Medicaid or CHIP end in the past 90 days because of a change in state rules made them ineligible for Medicaid or CHIP
- Was told by the state that their current Medicaid or CHIP coverage will end within the next month
- Was denied Medicaid or CHIP by the state in the past 90 days because their income is too high
- Was denied Medicaid or CHIP by the state since October 1, 2013, because their immigration status doesn’t qualify for Medicaid or CHIP
- Was denied Medicaid or CHIP by the state because their state doesn’t cover people with their household type (for example, some states don’t cover adults who aren’t taking care of children)
Don’t check the box for any person who:
- Was denied Medicaid or CHIP in the past 90 days but had changes in income or family size since the denial (unless they were denied based on immigration status)
- Was denied Medicaid or CHIP by the state more than 90 days ago (unless that denial was based on immigration status)
- Applied for Medicaid or CHIP, but hasn't received a response yet
- Was denied Medicaid or CHIP because of the results of a disability determination or because of having too many assets
- Was denied Medicaid or CHIP coverage because the applicant didn't turn in paperwork that the state asked for
Recent income changes If your household income has decreased since the time the Medicaid and CHIP agency(s) sent the denial, you should select “None of these people.” For example, if anyone in your household lost their job, had their hours or wages cut at work, or stopped getting unemployment benefits or another taxable income source, select “None of these people.”
Recent family size changes If your household size has increased since you were denied Medicaid or CHIP by your state, you should select “None of these people.” For example, if you or another household member got married, had a baby, adopted a child, became pregnant, or started claiming someone new as a dependent on your tax return, you should select “None of these people.”
Did any of these people apply for coverage between these dates?
Check the box if anyone on your application applied for coverage through their state or the Marketplace during the specific dates.
Select "None of these people" if no one on your application applied for coverage during these dates.
Are you a full-time student?
If you aren’t sure whether you’re a full-time student, check with your school.
Do you have a parent living in the same state where you go to school?
You may be asked this if you’re a full-time student. A parent can be a birth, adoptive, step, or foster parent.
Why are we asking this question? We want to make sure people get health coverage in the right state. Sometimes full-time students get health coverage in the state where their parents live instead of the state where they go to school.
Are you American Indian or Alaska Native?
American Indians and Alaska Natives can still get services from the Indian Health Services, tribal health programs, or urban Indian health programs, and the results of this application won’t change that.
For more information on questions asked to American Indians and Alaska Natives, click here.
Why are we asking this question? American Indians and Alaska Natives may get extra help—they may not have to pay cost sharing and may get monthly Special Enrollment Periods.
Are you pregnant?
Some pregnant women get extra help paying for health coverage, depending on the family’s income.
If any of the women on your application are pregnant, telling us here will help the whole household get the most help possible paying for health coverage.
How many babies are you expecting during this pregnancy?
If you’re pregnant, telling us how many babies you’re expecting during this pregnancy will help the whole household get the most help possible paying for health coverage.
Were you ever in foster care?
Why are we asking this? Sometimes young adults who were in foster care can get extra help paying for health coverage.
Were you getting health care through your state Medicaid program?
Why are we asking this? Sometimes young adults who were in foster care can get extra help paying for health coverage, but only if they were enrolled in Medicaid while they were in foster care.