Medicaid income limits depend on your state and family size, not a single national number

There is no single income threshold that determines Medicaid may be able to access across the United States. Each state sets its own limits based on the federal poverty level, and those limits change depending on how many people live in your household. A single person earning $1,500 per month might may have access to in one state and not in another. Your state, your family size, and sometimes your age or disability status all affect whether your income is low enough.

The federal government sets a baseline — the federal poverty level — and states build their Medicaid rules from there. Some states cover people at 100% of the poverty level; others go as high as 200% or more. A few southern states have kept their limits very low. The only way to know your actual threshold is to check your specific state's current rules or start a conversation with your state Medicaid office.

Key Takeaways

  • Medicaid income limits vary by state and household size; there is no single national cutoff.
  • Most states base their limits on a percentage of the federal poverty level, which changes each year.
  • Your state's Medicaid office or a local community health center can tell you the exact limit for your household size in your state.
  • Income is counted differently depending on whether you are applying as an adult, a child, a parent, or a person with a disability.
  • Some states have expanded Medicaid to cover more people; others have not, which creates large differences between neighboring states.

How federal poverty levels set the baseline

The federal government publishes a poverty guideline each year — a dollar amount that depends on family size. In 2024, the poverty guideline for a single person was around $15,000 per year; for a family of four, it was around $31,000. These numbers change annually and are the foundation that states use to calculate their Medicaid limits.

A state might say "we cover people up to 138% of the federal poverty level" or "up to 100% of the poverty level." That percentage is multiplied by the guideline for your household size to get your state's actual income limit. So if your state covers 138% of poverty and you are a single person, the math is roughly $15,000 × 1.38 = $20,700 per year, or about $1,725 per month. But if you live in a state that covers only 100% of poverty, your limit would be $15,000 per year, or $1,250 per month — a difference of $475 every month.

Income limits by state and family size

States fall into rough categories. Medicaid expansion states — those that accepted federal funding to expand Medicaid under the Affordable Care Act — generally cover adults earning up to 138% of the federal poverty level. Non-expansion states have kept their limits much lower, often covering only parents below 50% of poverty or not covering childless adults at all.

The difference is stark. In an expansion state, a single adult earning $1,800 per month might may have access to. In a non-expansion state, that same person earning the same amount would not. A parent in one state might may have access to at $2,500 per month while a parent in a neighboring state qualifies only at $1,200 per month. Children often have higher income limits than adults in the same state, sometimes reaching 200% or 300% of poverty.

Your state Medicaid office publishes its current income limits, usually on its website. You can also call your state's Medicaid hotline or visit a local community health center, and staff there can tell you the exact limit for your household size and situation. Because these limits change each year and occasionally change mid-year, calling is more reliable than relying on information you find online from previous years.

How income is counted and what counts as income

Not all money counts the same way. Medicaid looks at gross income — what you earn before taxes — not what you take home. If you earn $2,000 per month but taxes take out $300, Medicaid counts the full $2,000. Wages from a job, self-employment income, Social Security, unemployment benefits, and child support all count. Gifts and one-time payments usually do not.

Some income is excluded entirely. The first $65 per month of earned income is often not counted, and some states exclude a portion of child support. If you receive Supplemental Security Income (SSI), your state may have different rules than for regular Medicaid. If you are over 65 or have a disability, your state might count income differently than it does for working-age adults without disabilities.

The rules are complex enough that if you are close to the limit, it is worth asking your state Medicaid office exactly how they will count your specific income sources. A caseworker can walk through your situation and tell you whether you are over or under the threshold.

Expansion versus non-expansion states

In 2012, the Supreme Court made Medicaid expansion optional for states. Expansion states used federal funding to extend Medicaid to more people, usually all adults earning up to 138% of poverty. Non-expansion states declined the funding and kept their old, much lower limits. This created a coverage gap: in some states, a person earning too much for Medicaid but too little for marketplace insurance subsidies has no path to coverage.

As of 2024, about 40 states have expanded Medicaid, but 10 have not. The non-expansion states are concentrated in the South and include Texas, Florida, Georgia, and others. If you live in a non-expansion state and do not have children or a disability, your Medicaid options may be very limited even if you have low income. Knowing whether your state expanded is the first step to understanding what coverage might be available to you.

Special rules for children, parents, and people with disabilities

Medicaid often has different income limits depending on who you are. Children usually have the highest limits — sometimes 200% or 300% of poverty — because states want to cover more children than adults. Parents typically have lower limits than children in the same state. Childless adults have the lowest limits, or no coverage at all in non-expansion states.

If you are 65 or older or have a disability, your state may use different income rules or allow more deductions. Some states count income differently for people receiving SSI. Pregnant people sometimes have higher limits than other adults. The category you fall into matters as much as your actual income.

What to do if your income is close to the limit

If you earn just above your state's Medicaid limit, you may still have options. Some states allow deductions for work expenses, childcare, or medical costs that can lower your countable income. If you are self-employed, certain business expenses reduce your income for Medicaid purposes. If you have high medical bills, some states let you "spend down" — use medical expenses to lower your countable income below the limit.

You may also be able to get coverage through the health insurance marketplace, where you might receive a subsidy to lower your monthly premium. The marketplace uses a different income calculation than Medicaid and sometimes covers people Medicaid does not. Contact your state Medicaid office or visit healthcare.gov to explore both options.

Frequently Asked Questions

Does my income limit change if I get a raise?

Yes. If your income rises above your state's Medicaid limit, you will lose coverage. Medicaid rechecks your income periodically — sometimes monthly, sometimes annually depending on your state. If you earn more, you should report it so your coverage can be adjusted. You may then be able to get marketplace insurance instead.

What if I am self-employed or have irregular income?

Medicaid usually counts your expected income for the next 12 months, not just last month's earnings. If you are self-employed, you report your net income (revenue minus business expenses). If your income varies, your state may average it over several months or ask you to estimate what you expect to earn. Tell your caseworker about the variation so they can count it correctly.

Do I have to report income changes right away?

Yes. Most states require you to report changes within 10 days. If you get a job, lose a job, or your income changes significantly, contact your state Medicaid office. Failing to report can result in overpayments you may have to repay later. Some states have online portals where you can report changes; others require a phone call or a form.

Can I get Medicaid if I am unemployed?

It depends on your state and your situation. In expansion states, unemployed adults with very low or no income usually may have access to. In non-expansion states, you may may have access to only if you are a parent, pregnant, elderly, or disabled. Unemployment benefits count as income, so if you receive them, that amount affects your may be able to access.

How do I find my state's exact income limit?

Call your state Medicaid office directly — the number is on your state's Medicaid website. You can also visit a local community health center or dial 211 to be connected to local resources. Have your household size and state ready, and ask for the current income limit for your situation. Written limits are published online but can become outdated, so a phone call is most reliable.