Do I Qualify for Free or Low-Cost Health Coverage?
More than half of uninsured Americans actually qualify for a free or low-cost program and just are not enrolled, usually because the paperwork is confusing. Answer a few questions and see which programs may cover you, and what to do next.
See what you may qualify for
A few questions, no signup, and nothing is saved. This is a guide, not an official decision.
1. Who needs coverage?
A rough number is fine. Based on the 2025 federal poverty guidelines (Alaska and Hawaii have higher limits).
5. Any of these? (optional)
The programs, in plain English
Medicaid
Free or very low-cost coverage for people with low income. Who qualifies depends on your state, your income, and your situation (child, parent, pregnant, disabled, or, in states that expanded Medicaid, any adult up to about 138% of the poverty line).
CHIP
Low-cost coverage for children in families that earn a bit too much for Medicaid. Income limits are much higher than for adults, so many working families qualify.
Marketplace subsidies (ACA)
Tax credits that lower the cost of a private health plan bought on HealthCare.gov. They generally start at 100% of the poverty line. Subsidy rules are changing, so check current amounts when you apply.
Medicare Savings Programs + Extra Help
For people on Medicare with limited income and assets: programs that pay your Medicare premiums and cost-sharing, plus Extra Help for prescriptions. See our QMB guide.
Hospital charity care
Nonprofit hospitals must offer free or discounted care to lower-income patients, often up to 200 to 400% of the poverty line, whether or not you have insurance. Find a program near you.
County and local programs
Many counties run their own indigent-care or hospital-district programs (for example the Harris Health Gold Card in the Houston area). These are a real backstop where Medicaid does not reach.
If you are in the coverage gap (states like Texas)
We will be straight with you: in the states that did not expand Medicaid, many adults fall into a coverage gap. Childless adults generally do not qualify for Medicaid at all, parents lose it at very low income (in Texas, well under $400 a month for a family of three), and Marketplace subsidies do not start until you reach the poverty line. If that is you, regular Medicaid may not be an option right now.
Already have a hospital bill? Coverage might erase it
Here is something most people never hear: in most states, Medicaid can pay for care you received up to 3 months before you applied (called retroactive eligibility). So if you got a big hospital bill while uninsured and it turns out you were Medicaid-eligible, enrolling can make Medicaid cover the bill you already have. Hospitals often have a presumptive-eligibility process, and Emergency Medicaid can cover emergency care.
Send us the bill, we check for coverage and fight the rest
CareRoute Bill Defense reviews a bill you already have, checks whether retroactive Medicaid, charity care, or another program can cover it, and negotiates down whatever is left. We do not charge you to apply for coverage. Bill Defense is free to submit, and you only pay if we save you money.
Send us the billFree to submit. You only pay if we save you money.
Frequently asked questions
Is this an official eligibility decision?
No. This is a quick, private guide that points you to the programs you may qualify for and how to apply. It is not an official determination, only your state Medicaid agency or the Marketplace can decide. Eligibility rules and income limits vary by state and change every year, so always confirm with the official source before relying on a result.
What programs does it check?
Based on a few answers, it points you toward Medicaid, CHIP (for children), subsidized ACA Marketplace coverage, Medicare Savings Programs and Extra Help (for people on Medicare), and, if none of those fit, hospital charity care and county programs. It also flags when an existing hospital bill might be covered by Medicaid retroactively.
I live in Texas (or another state that did not expand Medicaid). Do I still qualify?
Maybe not for regular Medicaid, and it is important to be honest about that. In states that did not expand Medicaid, childless adults are generally not eligible, and parents lose coverage at very low incomes. If your income is also below where Marketplace subsidies begin (100% of the poverty line), you may fall in the "coverage gap." If so, the tool points you to your real backstops: hospital charity care, county indigent-care programs, and Emergency Medicaid.
I already have a hospital bill. Can getting Medicaid help?
Possibly, and this is often missed. Medicaid can pay for care you received up to 3 months before you applied (retroactive eligibility) in most states. So if you get a big bill and then qualify for Medicaid, it may cover the bill you already have. If you send us the bill, we check for coverage like this and negotiate down whatever is left.
Is there free help to actually apply?
Yes. Free, trained "navigators" and enrollment assisters can help you apply at no cost, find one at LocalHelp.HealthCare.gov, or ask your local hospital or community health center. Funding for this help has been cut recently, so it can be harder to reach, but it is still worth using.
Does CareRoute charge for this?
The screener and the guides are free. CareRoute makes money on Bill Defense, where we review and negotiate medical bills you already have, and you only pay if we save you money. We do not charge you to apply for coverage.
Related
Sources & references
This is general information and a directional guide, not an official eligibility determination, and not legal, medical, or insurance advice. Only your state Medicaid agency or the Marketplace can decide eligibility. Program rules, income limits, and state Medicaid-expansion status vary by state and change every year, always confirm with the official source before relying on a result. Last updated: August 2026.