Medicaid may be able to access depends on your income, family size, and which state you live in

Medicaid is a joint federal and state program, which means each state sets its own income limits and rules. There is no single national threshold. To find out whether you meet your state's requirements, you need to know three things: your household income, how many people depend on that income, and which state you live in. Most states use a percentage of the federal poverty line to decide who qualifies — for example, one state might cover adults earning up to 138% of the poverty line, while another covers only up to 100%.

Your income is measured as your household's gross monthly income before taxes. If you are self-employed, you report net income (after business expenses). If you receive Social Security, unemployment, child support, or other regular payments, those count too. Your household includes you, your spouse if you are married, and any children under 19 (or up to 22 if they are full-time students in some states).

The fastest way to learn your state's specific rules is to contact your state Medicaid office directly or use your state's online portal. You can also call 211 and ask for a Medicaid referral to a local enrollment counselor who knows your state's current limits.

Key Takeaways

  • Each state sets its own Medicaid income limits, so you must check your specific state's rules — there is no national cutoff that applies everywhere.
  • Your household income is measured as gross monthly income before taxes, and includes all regular payments like Social Security, unemployment, and child support.
  • Your household size includes you, your spouse, and dependent children under 19 (or up to 22 if full-time students in some states).
  • Most states use a percentage of the federal poverty line to set income limits, typically ranging from 100% to 138% of the poverty line.
  • You can find your state's current limits by contacting your state Medicaid office, using your state's online portal, or calling 211 for a local enrollment counselor.

How your state's income limit is calculated

The federal poverty line changes each year. For 2024, the poverty line for a single adult is approximately $15,060 per year, or about $1,255 per month. For a family of four, it is approximately $31,200 per year, or about $2,600 per month. Your state then applies its own percentage to this line. If your state covers people at 138% of the poverty line, a single adult earning up to about $1,733 per month would be within the income range.

Some states have expanded Medicaid to cover adults with no children at income levels up to 138% of the poverty line. Other states have not expanded and cover only certain groups — typically children, pregnant people, parents of dependent children, and people over 65 or with disabilities. If you do not fall into one of those categories and your state has not expanded Medicaid, you may not meet the income requirement no matter how low your earnings are.

Your state's Medicaid office publishes its current income limits each year. These limits are public information and are usually posted on your state's health department or Medicaid agency website. If you cannot find them online, call your state Medicaid office and ask for the current income limit for your household size and category (adult, child, parent, elderly, or disabled).

What counts as income and what does not

Gross income includes wages, self-employment earnings, Social Security, Supplemental Security Income (SSI), unemployment benefits, workers' compensation, child support, alimony, pensions, and rental income. It also includes regular gifts or money from family members if they are counted as part of your household income in your state's rules.

Some income does not count. Student loans, tax refunds, and one-time payments (like a settlement or inheritance) are typically excluded. Food stamps (SNAP) do not count as income. In some states, a portion of your earnings is disregarded — for example, your state might subtract the first $65 of monthly earnings before calculating whether you are over the limit. These disregards vary by state and by whether you are working, disabled, or a student.

When you report your income, be prepared to show recent pay stubs, tax returns, bank statements, or letters from benefit programs. The Medicaid office will ask for documentation to verify what you reported. If your income changes during the year, you may need to report the change within 30 days in most states.

How family size affects your income limit

A larger household has a higher income limit. If you are a single adult, your limit is based on one person's income. If you have a spouse and two children, your limit is higher because the poverty line for a family of four is higher than for one person. Your state counts only people who live with you and depend on your income — not adult children who live elsewhere, not parents who support themselves, and not roommates who are unrelated to you.

If you are pregnant, some states count the unborn child as part of your household size for income purposes. If you are caring for a grandchild or other relative, that person may or may not count depending on your state's rules and whether you are legally responsible for their support. Ask your state Medicaid office whether a specific person in your home counts toward your household size.

Changes in household size — a new baby, a child turning 19, a spouse moving out — can change your income limit and may affect whether you stay on Medicaid. Report household changes to your Medicaid office as soon as they happen, because your coverage may need to be recalculated.

Special rules for elderly and disabled people

If you are 65 or older, or if you receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you may be on Medicaid under different rules than working-age adults. Many states have higher income limits for elderly and disabled people, or no income limit at all. Some states automatically enroll people on SSI into Medicaid. Others require a separate application.

If you are disabled and working, your state may have a work incentive program that lets you keep some earnings without losing Medicaid. These programs have names like "Medicaid Buy-In" or "Work Incentive Programs." They are designed to help people with disabilities stay employed without losing health coverage. Ask your state Medicaid office or your Social Security work incentive coordinator whether you are on such a program.

If you are receiving SSI, your income limit is usually the same as the SSI payment amount in your state, which is typically around $943 per month for an individual in 2024 (though this varies by state and changes yearly). If you receive SSDI, your state's Medicaid rules for disabled adults apply, which may have a higher limit.

What happens if your income changes

If your income increases above your state's limit, you will lose Medicaid coverage. The timing depends on your state — some end coverage at the end of the month in which you reported the increase, others give you a grace period. If your income decreases, you may become newly on Medicaid or regain coverage you lost. Report income changes within 30 days in most states to avoid gaps in coverage or overpayments.

If you lose your job or have a significant drop in income, contact your Medicaid office immediately. You may be able to restart coverage retroactively — meaning coverage can go back to the date you lost income, not the date you reported it. This is called retroactive coverage and is available in most states for up to 90 days before you apply.

Some states have "continuous enrollment" rules that prevent you from losing Medicaid for a set period even if your income goes up slightly. These rules are common for children and pregnant people. Ask your state Medicaid office whether continuous enrollment applies to you.

How to find your state's specific income limits

Your state Medicaid office is the official source for current income limits. You can find contact information by searching "[your state] Medicaid" online or by calling 211. Most states also have an online tool where you can enter your income and household size to see whether you may be on Medicaid. These tools give you an estimate, not a final decision, but they are a quick way to check.

Some states use a single application for Medicaid and other benefits like SNAP and TANF (Temporary Assistance for Needy Families). If you are applying for any of these programs, one application may cover all of them. Your state's website will tell you whether this is the case.

If you have questions about whether a specific type of income counts, or whether a person in your household should be included, ask your state Medicaid office before you apply. Getting clarity upfront saves time and prevents delays later.

Frequently Asked Questions

Does my spouse's income count if we are married but file taxes separately?

Yes, in most states your spouse's income counts as part of your household income even if you file taxes separately. Medicaid looks at household composition, not tax filing status. Some states have exceptions for people who are legally separated or living apart, so ask your state Medicaid office about your specific situation.

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

Self-employment income is counted as net income after business expenses. If your income varies month to month, most states average your income over the past three months or use your most recent month as a snapshot. Bring tax returns and business records to show how much you typically earn. If your income is very irregular, ask whether your state uses an averaging method that might help you.

Can I be on Medicaid if I have savings or own a home?

Medicaid does not have asset or savings limits in most states — only income limits matter. You can own a home, have a car, and have money in the bank and still be on Medicaid as long as your income is below your state's limit. A few states still have asset limits for certain groups, so check your state's rules if you are concerned.

What if my income is just slightly above the limit?

If you are over the limit, you do not meet your state's Medicaid income requirement. However, some states have programs for people just above the Medicaid limit, such as subsidized marketplace plans through the Affordable Care Act. You may also be on Medicaid for a specific service (like pregnancy) even if you do not meet the general income limit. Ask your state Medicaid office about programs for people near the income cutoff.

Do I have to reapply every year?

Most states require annual renewal, though some have extended the renewal period to every two years. You will receive a notice telling you when to renew. If you do not renew by the deadline, your coverage ends. Some states have "continuous enrollment" for certain groups (like children) that extends coverage without annual renewal. Check your renewal notice or call your state Medicaid office to find out your renewal date.