How the Homeless Can Enroll for Medicaid Coverage

May 7th 2016

Community Health Centers

Approximately 1,150 community health centers across the United States specialize in Medicaid services. Some of these centers receive grants, known as Health Care for the Homeless grants, specifically to help homeless citizens enroll in Medicaid. These health centers exist specifically to assist people to gain affordable health insurance coverage. The U.S. Department of Health and Human Services has an online map to locate nearby facilities.


Special government employees known as navigators assist people with enrollment. These employees work with state-regulated insurance marketplaces to find the right insurance coverage for low-income people, including homeless citizens, looking to enroll.

Local Agencies

Local government agencies and nonprofit organizations are crucial to the success of Medicaid expansion for homeless people. Organizations such as food pantries, churches, homeless shelters, halfway houses and law enforcement agencies all serve homeless people on a regular basis. These groups could provide assistance to health center personnel if a homeless person needs medical assistance. Federal, state and local agencies may have tip sheets that help staffers engage with homeless citizens to try to reduce barriers to enrolling in Medicaid.

Barriers to Coverage

Several barriers, some of which represent unique challenges faced by homeless people, may prevent these low-income citizens from enrolling in Medicaid. Homeless people rarely have easy ways to maintain contact, since they may not have a permanent address, a regular phone number or a mailing address. Sometimes, homeless citizens mistrust outsiders and refuse offers of help. Homeless people may not have any documentation with them, such as valid identification or Social Security card.

Since Medicaid enrollment became more streamlined and easier in January 2014, low-income people simply have to get to an appropriate government office to seek help. Agencies and organizations can provide transportation to people who cannot afford mass transit fares. The hard part remains trying to convince homeless citizens that affordable health care could help them get out of poverty. One of the largest barriers involves trying to find ways to engage with homeless people and start a conversation.


Before implementation of the Affordable Care Act of 2010, low-income citizens could enroll in Medicaid after proving they had a disability, were elderly or had children. Beginning in January 2014, states had the option to expand Medicaid to include anyone below 133 percent of the federal poverty level, regardless of other factors. For 2015, that means individuals who make less than $15,654 per year or $32,253 for a family of four. Homeless people may apply for Medicaid health insurance under this new initiative, but barriers to enrollment still exist.

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