How Medicaid Offices Work Across the United States

Medicaid is the joint federal and state health coverage program for low-income children, parents, pregnant women, older adults and people with disabilities. Across the United States, tens of millions of people rely on it for doctor visits, hospital care, prescriptions and long-term care. Yet there is no single national Medicaid counter. Each state runs its own program, and the office you visit depends on where you live.

Our directory lists 240 Medicaid office locations in 40 states. Some are state agency regional offices. Others are county social services or human services branches that take applications for the state. This page explains the difference so you can pick the right door before you spend a morning in line.

The program dates to 1965, when Congress added Title XIX to the Social Security Act. The federal Centers for Medicare & Medicaid Services (CMS) sets baseline rules and approves each state plan. States decide much of the rest: who qualifies above the federal minimums, which optional benefits to cover, and how applications are processed.

Federal money follows a formula. Washington pays each state a share of its Medicaid costs, known as the federal medical assistance percentage. States with lower per-capita income receive a higher share, and the statutory floor is 50 percent. That funding structure helps explain why programs in Mississippi and New York look quite different.

Do not confuse Medicaid with Medicare. Medicare is a federal program, mainly for people 65 and older, and you enroll through the Social Security Administration. Medicaid is need-based and administered by the states. Some people, called dual eligibles, qualify for both, and a Medicaid office can often help them with premiums and cost sharing.

Who Runs Your Local Office: State, County or City

In most states, one designated state Medicaid agency is legally responsible for the program. The name varies. Mississippi uses its Division of Medicaid, Alabama has the Alabama Medicaid Agency, Texas operates through the Health and Human Services Commission, and Tennessee runs TennCare. Florida splits the work: the Agency for Health Care Administration oversees the program, while the Department of Children and Families determines eligibility for most applicants.

County involvement is the second common pattern. New York, New Jersey and North Carolina rely heavily on county offices. In New York, a county department of social services handles many applications, while the state Department of Health sets policy. In New Jersey, county boards of social services work with the state Division of Medical Assistance and Health Services. North Carolina counties determine eligibility through their departments of social services.

City-run Medicaid offices are rare. When a city name appears in a listing, it usually tells you where the office is, not which government staffs it. Listings such as Auburn in Lee County, Alabama or Alexandria in Rapides County, Louisiana give you the town and the county, so you can confirm who actually runs the desk.

One practical rule: the agency that decides your eligibility is not always the one that pays your claims. Most states use managed care plans for much of their Medicaid population, and those plans handle provider networks and bills. The Medicaid office handles your application, annual renewal, and changes in income or address.

How Rules, Services and Fees Differ From State to State

The biggest divide is expansion. Under the Affordable Care Act, states may cover adults with incomes up to 138 percent of the federal poverty level. A 2012 Supreme Court decision made that expansion optional. Kentucky, Louisiana and North Carolina have expanded. Texas, Mississippi, Alabama, South Carolina and Florida had not when we last reviewed them, and Georgia offers only a limited program with work requirements. Policies change, so confirm the current status on your state page.

In non-expansion states, a childless adult with a very low income often does not qualify at all. Parents may qualify only at extremely low income levels. Children usually have much higher limits through Medicaid or the Children's Health Insurance Program, and pregnancy coverage also uses higher thresholds.

Names differ too, which confuses newcomers. California calls its program Medi-Cal, Massachusetts uses MassHealth, Tennessee uses TennCare, and Washington uses Apple Health. If you search for Medicaid in those states, you may be sent to a differently branded website, but it is the same federal-state program.

Applying costs nothing. No Medicaid office charges a fee to file an application, and you do not need a lawyer or paid helper. Once enrolled, most people pay little or nothing. Federal rules cap copayments for people with low incomes, and children and pregnant women are largely exempt.

Long-term care is where states diverge most. Nursing home and home-care coverage involves asset limits and look-back rules for past transfers of property. Many states can also cover medical bills from up to three months before your application, though some have waivers that limit this. Ask a caseworker how your state handles both.

What to Bring and Which Mistakes Slow Down an Application

Caseworkers must verify who you are, where you live and what you earn. Bring originals or clear copies of the following:

  • A photo ID, such as a driver's license or state ID card
  • Social Security numbers for everyone applying, or proof that you have applied for them
  • Proof of citizenship or eligible immigration status, such as a birth certificate, passport or permanent resident card
  • Proof of residency, such as a lease or a utility bill with your name and address
  • Recent pay stubs, a tax return, or award letters for Social Security, unemployment or other income
  • For older adults and people with disabilities, bank statements and details on property or vehicles, since some categories have resource limits

The most common mistake is going to the wrong office. If your state processes applications by county, an office one town over may not be able to open your case. The second is ignoring mail. Coverage is normally renewed every 12 months, and a missed notice can end it even when you still qualify. Third, people forget to report changes in income, household size or address, which can trigger a denial or a repayment demand later.

Finally, remember that Medicaid is not the only option. If your income is above your state's limit, a Marketplace plan with subsidies may cost far less than you expect. A caseworker can often tell you which route fits.

Examples From Our Listings and How to Choose Your State Page

Mississippi has the most listings in our database. One is the Brookhaven Mississippi Medicaid Office at 1372 Johnny Johnson Dr in Lincoln County, phone 601-835-2020. For statewide detail, see Medicaid Office in Mississippi.

New York is close behind. The Bath New York Medicaid Office at 3 Pulteney Square East serves Steuben County and lists 607-664-2087. Browse the rest on Medicaid Office in New York.

In Alabama, the Auburn Alabama Medicaid Office is at 1716 Catherine Court in Lee County, phone 334-502-5446, and more are on Medicaid Office in Alabama. Florida's Brooksville listing is at 1122 Ponce De Leon Boulevard in Hernando County, phone 352-799-5177, with others on Medicaid Office in Florida. In Texas, the Austin Texas Medicaid Office at 724 Eberhart Lane in Travis County lists 512-445-0022; see Medicaid Office in Texas. In New Jersey, the Camden listing is at 2 Riverside Drive in Camden County.

To choose the right state page, use the state where you live and where you would receive care, not where you work or where a relative lives. Then match your county, call to confirm hours and ask whether you need an appointment.

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Reading Medicaid Office Listings Across the United States

Listing names in our database follow the town where an office is best known, which is not always the mailing town. The Fairfax South Carolina Medicaid Office sits at 3657 Allendale-Fairfax Highway in Allendale, in Allendale County. The Norristown Pennsylvania Medicaid Office uses an Audubon address in Montgomery County. Match the street address and county, not just the title, before you travel.

Rural counties often have one office covering a wide area. Examples include Dublin in Laurens County, Georgia, Halifax in Halifax County, North Carolina, and Falmouth in Pendleton County, Kentucky. Urban listings such as Austin and Honolulu may be busier. Louisiana residents can start with Medicaid Office in Louisiana, where Alexandria in Rapides County is one listed location, then call to confirm hours.

Phone numbers in listings are a starting point. Offices move and reorganize, so verify details with your state Medicaid agency's main line.

Medicaid Office Questions Across the United States

Both share the job. The federal Centers for Medicare & Medicaid Services sets national requirements, approves each state plan and pays a share of costs. Each state then operates its program through a designated agency, such as the Alabama Medicaid Agency, the Mississippi Division of Medicaid or TennCare in Tennessee. Some states give eligibility work to counties, as New York, New Jersey and North Carolina do. In practice, your application is decided at the state or county level, and federal staff rarely deal with individual enrollees. Start with your own state's agency website or phone line.

It depends on the state. Where counties process applications, as in New York or North Carolina, you generally apply with the county where you live, and your case stays there. Some states route applications through a central online system or call center, so any regional office can help you start. If you walk into the wrong office, staff may still accept your paperwork or redirect you, but that can cost days. Check your address, confirm the county, and call the number in the listing before you travel, especially for rural offices with limited hours.

Federal rules generally require states to decide within 45 days of an application, or 90 days when the decision depends on a disability determination. Many straightforward cases for children or pregnant women finish faster. Delays usually come from missing documents, unanswered caseworker letters or unreported income. Answer every request by the deadline printed on the notice, and keep copies of what you submit. If you have an urgent medical need, tell the caseworker, and ask whether expedited processing or presumptive eligibility for children or pregnancy is available in your state.

Yes, mainly in who qualifies. Kentucky expanded Medicaid to adults with incomes up to 138 percent of the federal poverty level, so many low-wage workers without children can enroll. Texas has not expanded, so adults without dependent children are generally excluded, and parents qualify only at very low incomes. Once enrolled, covered services follow federal minimums, including hospital care, physician visits and lab tests, while optional benefits such as adult dental or vision vary by state. Check your state agency for current rules, since expansion decisions and waivers change.

Medicaid does not transfer between states. If you move, report your new address to your old state, then apply in your new state as soon as possible. Your previous coverage normally ends once you are no longer a resident, and the new state decides eligibility under its own rules. That matters if you move from an expansion state like North Carolina to a non-expansion state like Georgia, where you might no longer qualify. Gather proof of your new residency, such as a lease, and ask whether the new state can cover bills from before your application date.

Every denial or reduction notice must explain the reason and your right to a fair hearing. The deadline to request one is printed on the notice and differs by state, so act quickly. First, call the office and ask whether a missing document caused the denial, since a quick fix may be possible. If not, file the hearing request in writing or by phone as the notice directs. Bring pay stubs, medical records or letters that support your case. Legal aid organizations in many counties help low-income applicants at no cost, and a Marketplace plan may also be an option.

No. Filing a Medicaid application is free in every state, and caseworkers do not charge for help completing forms. Once you are enrolled, most people pay little or nothing. Federal rules limit copayments for people with low incomes, and children and pregnant women are largely exempt from them. A few states charge small premiums to certain groups. Be wary of anyone who asks for money to guarantee approval or to sign you up. Legitimate help comes at no charge from the state agency, the county office, community health centers and trained Marketplace navigators.