Medicaid, Medicare, CHIP or a Marketplace plan: which is for you?

People mix these programs up all the time, and the names don't help. The quickest way to tell them apart is to ask who each one is for.

Medicaid

Medicaid is for people with low income. In most states that includes adults under 65 with no children, as well as children, pregnant women, parents, older adults and people with disabilities. Your state looks at your income and your situation. You can apply any time of year.

Medicare

Medicare is federal health insurance for people 65 and older, and for younger people who have received Social Security disability benefits for two years or have certain conditions such as kidney failure. Income doesn't matter. Most people pay a monthly premium for Part B.

You can have both. People with Medicare and low income may also qualify for Medicaid, or for a Medicare Savings Program that pays their Medicare premiums. Lesson 14 covers that help.

CHIP

The Children's Health Insurance Program covers children, and in some states pregnant women, whose families earn too much for Medicaid but not enough to buy private coverage easily. Costs are low, and some states charge a small monthly fee. You apply the same way you apply for Medicaid.

Marketplace plans

The Health Insurance Marketplace (HealthCare.gov or your state's own site) sells private plans to people who don't get coverage another way. Depending on income, you may get help with the monthly cost. Most people can only sign up during open enrollment in the fall, unless something like losing other coverage gives them a special enrollment period.

When you apply on HealthCare.gov, one application checks all of these at once. If it looks like someone in your household qualifies for Medicaid or CHIP, the Marketplace sends your information to your state.

Sources: Medicaid & CHIP coverage, HealthCare.gov; Children's Health Insurance Program, HealthCare.gov; Medicare Savings Programs, Medicare.gov.