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How Health Benefits Work

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    How Health Benefits Work

    Income-Based Medicaid

    Look at income-based Medicaid-short if:

    • You are less than 65 years old

    • You don’t qualify for Medicare

    • You don’t qualify for APA

    • You are a U.S. citizen or eligible immigrant, and

    • Your household has low to moderate income.

    Is Income-Based Medicaid-short Right for You?

    Gloss-Medicaid is government-funded health coverage for people in certain situations. You may qualify if you:

    Answer the questions on this page to see if you might qualify for income-based Medicaid. If so, it’s probably your best health coverage option because it doesn’t usually have a premium, the copayments for services are generally lower than copayments required by private plans, and Medicaid-short covers more services than most private plans. Also, if you qualify for Medicaid-short, you cannot get government help paying for an individual plan on Health-Insurance-Marketplace.

    Note: Income-based Medicaid-short is sometimes called MAGI-Category Medicaid-short, Adult Medicaid-short, or Medicaid-short Expansion.

    Do You Meet Income-Based Medicaid-short’s Basic Requirements?

    To qualify for income-based Medicaid, you must:

    • Be under 65 years old
      • You can be 65 or older if you are the parent or caretaker of a child
    • Not qualify for Medicare
      • You can be on Medicare if you are the parent or caretaker of a child or are pregnant
    • Be a U.S. citizen or meet specific noncitizen requirements

    If you are under 65, do not qualify for Medicare, and are either a U.S. citizen or a noncitizen who qualifies, income-based Medicaid-short might cover you.

    Medicaid-short’s rules for immigrants:

    <2026-ACA-immigrants>Most immigrants who have been lawfully present for less than five years do not qualify for full Medicaid-short coverage. However, they may qualify for private coverage subsidized by the government.[GM 12/23/2025: Subsidies below 100% FPG for this group end on 1/1/26. Subsidies for almost this entire group at any income level end on 1/1/27. Removing bullet in this context because for purposes of Medicaid info, the remaining subsidies aren't really a substitute for Medicaid anymore.]

    Note: You can get Medicaid-short coverage if you are a Native American born in Canada or Mexico who has rights to cross the border.

    Do You Qualify for Adult Public Assistance (APA)?

    If you have a disability, low income, and low Gloss-Assets, you may qualify for APA. If you already get APA benefits, you automatically get APA-related Medicaid-short coverage and do not need to apply separately.

    If you do not get APA benefits, income-based Medicaid-short might cover you.

    Is Your Income Low Enough for Income-Based Medicaid-short?

    These are the main income rules for income-based Medicaid-short:

    • If your family’s income is at or under 138% of the Federal Poverty Guidelines (FPG) (FPL-138%-individual-monthly per month for an individual; FPL-138%-family-4-monthly for a family of four), you may qualify.
    • If you are 18 or younger and your family’s income is at or under Medicaid-SCHIP-FPG-percent% of FPG (Medicaid-SCHIP-limit-family-4-monthly per month for a family of four), you may qualify. Income-based Medicaid-short for children is also called Denali KidCare (DKC).
    • If you are pregnant or gave birth within the last 12 months and your family’s income is at or under Medicaid-pregnant-FPG-percent% of FPG (Medicaid-pregnant-limit-family-4-monthly per month for a family of four), you may qualify. The unborn baby is counted as a family member.

    Income-based Medicaid-short counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based Medicaid-short eligibility.

    Note: There are no limits to how much money or other Assets you can have for income-based Medicaid-short.

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    If your income is low enough and you meet all other requirements, you should sign up for Medicaid-short.

    Is income-based Medicaid-short’s income limit 133% or 138% of FPG?

    You may see the income limit for income-based Medicaid-short listed as 133% of FPG in some places. However, when Medicaid-short counts your income, they’ll knock 5% of FPG off your income if you make more than 133% of FPG. That's why we say that you can make up to 138% of FPG, because it more accurately shows how much income you could have and still get Medicaid-short. For children, this means we show Medicaid-SCHIP-FPG-percent% of FPG as the limit, instead of =[Medicaid-SCHIP-FPG-percent]-5% and for pregnant women, we show Medicaid-pregnant-FPG-percent% instead of =[Medicaid-pregnant-FPG-percent]-5%.

    More Ways to Qualify for Medicaid-short if You Have a Disability

    There are other ways to qualify for Medicaid-short if you have a disability. You might qualify for APA-related Medicaid-short if:

    • Get Adult Public Assistance (APA) benefits. If you get APA, you also get APA-related Medicaid-short automatically.
    • You make more money at work than income-based Medicaid-short allows. In that case, you could also apply for the Gloss-Medicaid-buy-in program.
    • You also get Medicare. Usually, Medicaid-short doesn’t cover people getting Medicare, but APA-related Medicaid-short does. It may even help pay your monthly Medicare premiums and other Medicare expenses like deductibles and coinsurance.
    • You are 65 years old or older.

    You might qualify for income-based Medicaid, even though you have a disability, if:

    • Your disability does not meet Social Security’s definition of disability. APA-related Medicaid-short is only for people who have disabilities meeting this standard and for seniors.
    • You have more Assets than are allowed by APA-related Medicaid-short.
    • You make enough money that you would have to pay a monthly premium for the Medicaid-buy-in-short program.

    Learn more about APA-related Medicaid-short and the Medicaid-buy-in-short.

    How to Sign Up

    You can apply for Medicaid-short:

    If you use an application form, you can also apply for other benefits at the same time, such as Adult Public Assistance (APA), Gloss-Food-Stamps, and Gloss-TANF. If you apply for Medicaid-short online, you have to apply for other benefits separately.

    Staying on Medicaid-short

    Usually, once you are approved for Medicaid-short, you will continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, you need to report within 10 days of when you know about the change. You can report these changes to the Division of Public Assistance (DPA) by calling 1-800-478-7778, by fax to 1-888-269-6520, by email to hss.dpa.offices@alaska.gov, or in person at any Link-county-human-services-agency.

    When you report your changes, the DPA will tell you whether you will continue getting Medicaid-short or if you have new health coverage options, like individual coverage with subsidies or the Medicaid-buy-in-short program.

    Learn more

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    Supplemental Security Income (SSI)

    SSI and Adult Public Assistance (APA) give cash benefits to people with disabilities and seniors who have low income and low resources.