How Medicaid may be able to access works

Medicaid is run by each state, so the rules that determine whether you can enroll depend entirely on where you live. There is no single national income limit, asset limit, or set of conditions that applies everywhere. A person who qualifies in one state may not may have access to in another, even with identical income and circumstances.

Most states use income as the primary measure — they set a threshold, usually expressed as a percentage of the federal poverty line, and anyone below that line can enroll. Some states also look at assets (savings, property, vehicles), family size, age, disability status, or whether you are pregnant or a parent. A few states have added work requirements or other conditions. The only way to know what your state actually requires is to check with your state Medicaid office or use the screening tool on your state's health department website.

Even if you do not think you may have access to, it is worth checking. Many people underestimate their may be able to access because they do not know how their state counts income, or because they assume rules are stricter than they actually are. Medicaid offices can tell you in minutes whether you meet the threshold.

Key Takeaways

  • Medicaid rules are set by each state, so income limits, asset limits, and other conditions vary widely depending on where you live.
  • Most states use income as the main factor, but some also count assets, family size, age, disability, or pregnancy status.
  • Your state Medicaid office or your state health department website can tell you the exact rules that apply to you.
  • Even if you think you do not may have access to, contacting your state office is free and takes only a few minutes to confirm.
  • Some states expanded Medicaid under the Affordable Care Act and others did not, which creates major differences in who can enroll.

Income limits by state and expansion status

States that expanded Medicaid under the Affordable Care Act generally cover adults earning up to 138% of the federal poverty line. In 2024, that is roughly $1,800 per month for a single person, though the exact amount changes each year. These states include California, New York, Illinois, Colorado, and most others — but not all.

States that did not expand Medicaid have much lower income limits. Some cover only parents earning below 50% of the poverty line, or only disabled and elderly people. In these states, a working adult with no disability and no children may not may have access to at any income level. States that have not expanded include Texas, Florida, Georgia, Kansas, and Mississippi.

Your state's Medicaid office website lists the exact income threshold for each category of person (parent, child, elderly, disabled, pregnant). If you are unsure whether your state expanded, search "[your state] Medicaid expansion" or call your state health department directly.

What counts as income for Medicaid

Medicaid counts income differently than the IRS does. Wages and salary count, but so do Social Security, unemployment benefits, child support, and some types of assistance. However, certain income does not count: Supplemental Security Income (SSI) is usually excluded, as are some types of veteran benefits and certain tribal payments.

Self-employment income counts, but Medicaid allows you to deduct business expenses. If you receive cash assistance from family members, Medicaid may or may not count it depending on your state. If you are unsure whether a specific income source counts, ask your state Medicaid office — they can tell you exactly how your income will be calculated.

Medicaid also looks at gross income (before taxes) rather than net income (after taxes). This means if you earn $2,000 per month but pay $300 in taxes, Medicaid counts the full $2,000. Some states allow deductions for work expenses, childcare, or medical costs, which can lower your countable income.

Asset limits and what they mean

Many states have asset limits — a cap on how much money or property you can own and still may have access to. These limits vary sharply. Some states set the limit at $2,000 for a single person; others set it at $3,000 or higher. A few states have no asset limit at all.

Assets usually include savings accounts, checking accounts, stocks, and bonds. A car is often excluded entirely, or excluded up to a certain value. Your primary home is almost always excluded. Some states exclude household goods, personal items, and life insurance policies. Again, your state Medicaid office can tell you exactly what counts as an asset in your state and what the limit is.

If you are close to an asset limit, it may be worth asking whether your state allows you to spend down assets on medical care or other permitted expenses. Some states have programs that let you set aside money for future medical or disability costs without losing Medicaid coverage.

Special categories: children, pregnant people, elderly, and disabled

Children often have higher income limits than adults. Many states cover children in families earning up to 200% or even 300% of the poverty line, even if the state did not expand Medicaid for adults. Pregnant people and new parents also frequently have higher limits than other adults.

Elderly people (usually age 65 and older) and people with disabilities can may have access to through different pathways. Some are covered through SSI, which has its own income and asset limits. Others may have access to through state-specific programs. If you are elderly or disabled, tell the Medicaid office that when you contact them — they may have faster or easier routes to coverage.

Children in foster care, people leaving the foster care system, and people with certain medical conditions (like HIV/AIDS or end-stage renal disease) may also have separate pathways. Your state Medicaid office keeps a list of these special categories and can tell you whether you fit one.

How to find your state's specific rules

Start with your state health department website. Search "[your state] Medicaid income limits" or "[your state] Medicaid may be able to access." Most state sites have a page that lists the current thresholds for each category of person. Some states also have an online screening tool where you can enter your income and family size and get an immediate answer.

If the website is unclear or you cannot find the information, call your state Medicaid office directly. The number is usually on the health department website. You can also call 211 (a free referral service) and ask for your state Medicaid office number. Have your income, family size, and state of residence ready when you call.

If you are applying for Medicaid, you will need to provide proof of income (pay stubs, tax returns, or a letter from your employer), proof of residency, and proof of citizenship or immigration status. Your state office can tell you exactly which documents they need before you apply.

What happens if your income or circumstances change

If you enroll in Medicaid and then your income rises above the limit, you will lose coverage. The timing depends on your state — some end coverage immediately, others give you a grace period of a few months. If your income drops back below the limit, you can re-enroll.

If your family size changes (a child is born, someone moves out, you marry or divorce), tell your Medicaid office. These changes can affect your income limit and your coverage. Some states let you report changes online; others require a phone call or a form.

If you lose Medicaid coverage because your income rose, you may be able to enroll in a marketplace plan instead. You can also check whether you may have access to for subsidies that lower the cost of marketplace coverage. Your state health department or 211 can connect you to a counselor who can explain your options.

Frequently Asked Questions

Does Medicaid count my spouse's income if we are married?

Yes, in most states Medicaid counts both spouses' income together when determining may be able to access. However, some states have different rules for elderly or disabled people. If you are married and unsure, ask your state Medicaid office — they can tell you whether your spouse's income will be counted and how.

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

Medicaid counts self-employment income, but you can deduct business expenses. If your income varies month to month, most states average your income over the past three months or use your expected annual income. Tell your Medicaid office about the variation when you contact them — they can explain how they will calculate your income.

Can I have Medicaid and Medicare at the same time?

Yes. People who may have access to for both are called "dual may be able to access." You can enroll in Medicare (usually at age 65) and keep Medicaid if you still meet your state's income and asset limits. Medicaid can help pay Medicare premiums and cover costs that Medicare does not.

What if I am undocumented or have uncertain immigration status?

Most states do not cover undocumented immigrants through regular Medicaid, but some states cover emergency medical care regardless of immigration status. A few states cover certain groups (like pregnant people or children) without requiring proof of citizenship. Call your state Medicaid office to ask what is available in your state.

How long does it take to learn about I may have access to?

If you call your state Medicaid office with your income and family size, they can often tell you in minutes whether you meet the income limit. A full application and approval can take two to four weeks, depending on how quickly you provide required documents and how busy your state office is.