Looking for information about Medicaid? We're here to help. Find answers to common questions about Medicaid — from who is eligible to how to apply and more.
Medicaid is a federal and state program that provides health care coverage to people who qualify. Each state runs its own Medicaid program, but the federal government has rules that all states must follow. The federal government also provides at least half of the funding for their Medicaid requirements. Learn more about Medicaid and what it covers.
In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states, Medicaid covers all low-income adults below a certain income level.
The exact requirements to qualify for Medicaid depend on where you live. To find out if you're eligible for Medicaid in your state, visit the website for Medicaid in your state. Then check the eligibility requirements.
You'll find a link to the website for your state Medicaid agency on the "Plan Details" page for each health plan UnitedHealthcare Community Plan offers. To see plans available in your area, please use the search box at the bottom of this page.
Yes, as long as you meet the qualifications for Medicaid in your state. Whether or not you get Social Security Disability Insurance (SSDI) doesn't change your Medicaid eligibility. Getting SSDI automatically qualifies you for Medicare, but there's a waiting period. You’ll likely need to wait 2 years after you qualify for the Social Security disability benefit before you can get Medicare.
When you apply for Medicaid, you'll need to fill out an application form. Different states have different requirements for Medicaid. You'll likely need to have various documents, such as:
Personal information
Financial information
Medical information
You'll need to apply through the state agency that manages the Medicaid program in your state. To see plans available in your area, please use the search box at the bottom of this page.
You can apply for Medicaid or CHIP (the Children's Health Insurance Program) at any time throughout the year.
The Medicaid program in each state is run by the state government for that state. While certain states may offer different types of Medicaid plans, each plan is typically for a certain type of person (such as children, families or low-income adults). It’s not likely you can change your Medicaid plan or switch to a different Medicaid plan unless your life situation changes. (If you get married or become pregnant, for example). You can apply for Medicaid at any time throughout the year.
You'll find a link to the website for your state Medicaid agency on the "Plan Details" page for each health plan UnitedHealthcare Community Plan offers. To see plans available in your area, please use the search box at the bottom of this page.
UnitedHealthcare Community Plan serves members who qualify for Medicaid or for both Medicaid and Medicare in 42 states and the District of Columbia.*
UnitedHealthcare offers Medicaid plans in these states:
Arizona, Colorado, Florida, Hawaii, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Mississippi, North Carolina, Nebraska, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, Washington, Wisconsin
*As of September 2023
Each state manages its own Medicaid program so what’s covered by Medicaid can change from state to state. But there are some services that every state must cover in their Medicaid program by federal law. These are called mandatory benefits. States can also choose to offer other benefits under Medicaid. These are called optional benefits.
Mandatory Medicaid benefits include:
Optional benefits offered by some states may include:
Medicaid is a health care program that's managed at the state level by each state government. However, state governments do not actually provide health insurance. State governments contract with private insurance companies like UnitedHealthcare to provide health coverage for beneficiaries of Medicaid and other government health care programs. Our government-sponsored health plans operate under the name UnitedHealthcare Community Plan.
In most cases, Medicaid is the payer of last resort. That means that Medicaid will pay after any other payer has paid its share of the services provided. For example, if you have Medicare or any type of private health care coverage, Medicaid will always be the secondary payer. Health care providers will bill the primary payer first, and Medicaid will pay what's left over. That's why Medicaid enrollees must say if they have other sources of coverage.
In most cases, Medicaid pays the full cost for covered services, so people with Medicaid do not have to pay a monthly premium or any deductibles. But there are some exceptions and rules vary by state. In certain cases, if someone has Social Security benefits, a small amount may be taken from those benefits to help cover the cost of Medicaid coverage.
Medicare is a national health insurance program run by the federal government. It’s for people age 65 and older, and also some people under age 65 with certain disabilities. Learn more about Medicare.
The Affordable Care Act (ACA) expands access to quality and affordable health coverage for millions of Americans. Signed into federal law by President Barak Obama in 2010, the ACA guarantees health coverage regardless of income level, work situation, or previous health conditions.
DDD stands for Division of Developmental Disabilities – a division of the Department of Economic Security (DES). DES works with families, community organizations, advocates and state and federal partners to realize our collective vision that every child, adult, and family will be safe and economically secure.
A state-specific health plan for certain Medicaid recipients. It's for physically disabled adults and children.
Supplemental Security Income (SSI) is a monthly cash benefit paid by the federal Social Security Administration (SSA) and state Department of Health and Services (DHS) to low-income elderly, blind, and disabled residents. SSI benefits are not the same as Social Security benefits.
CHIP, which stands for Children’s Health Insurance Program, provides low-cost insurance for children whose families do not meet the income eligibility requirements for Medicaid. CHIP may also provide coverage for pregnant women in some states, but does not cover adults caring for children who qualify for CHIP.
Answer a few quick questions to see what type of plan may be a good fit for you.
Medicaid or dual-eligible plan benefits can change depending on where you live. Search using your ZIP code to find the right plan to meet your health care needs.
Disclaimer information (scroll within this box to view)Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.
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.
Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).
Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.
This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.
UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees.
UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.
UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees.
This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook.
UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.
Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.
The choice is yours
We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.
The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.
Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.
Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.
In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.
Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.
Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.
To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.
If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.
If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.