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

Medicaid is run by states, not the federal government, so the rules that determine who gets coverage change depending on where you live. Every state must cover certain groups — children, pregnant people, parents of dependent children, elderly people, and people with disabilities — but the income limits and asset rules vary widely. Some states have expanded Medicaid to cover more working-age adults; others have not. Before you look at your own situation, you need to know what your state's rules are, because two people with identical income and family size might may have access to in one state and not in another.

The three main factors that determine whether you meet your state's rules are income, assets, and which category you fall into. Income is measured as gross monthly earnings before taxes. Assets include money in the bank, vehicles, and property. Your category — whether you are a child, parent, elderly person, person with a disability, or working-age adult — determines which income and asset limits apply to you in your state.

Key Takeaways

  • Medicaid income limits vary by state and by which group you fall into (children, parents, elderly, disabled, or working-age adults), so you must check your specific state's rules.
  • Income is usually counted as gross monthly income before taxes, and household size includes everyone you live with and claim as a dependent, not just your immediate family.
  • Most states have asset limits — money in the bank, vehicles, and property — though the limits differ by state and by which category you may have access to under.
  • You can find out whether you likely meet your state's rules by using your state's Medicaid website or calling your state's Medicaid office directly.

How income limits work and what counts as income

Medicaid measures income as your gross monthly income, which means the money you earn before taxes are taken out. This includes wages from a job, self-employment income, Social Security, unemployment benefits, child support, and some types of assistance. The income limit depends on which category you fall into and which state you live in. For example, a parent in one state might have an income limit of 138% of the federal poverty line, while a parent in another state might have a limit of 100% or even lower.

Your household size matters because the income limit is higher for larger households. A single person has a different threshold than a family of four. Household size includes you, your spouse if you have one, and any children or other dependents you claim on your tax return — not just people who live with you, though living arrangements do matter in some cases. If you have a child who lives with you but you do not claim them as a dependent, the rules for counting them vary by state.

Some income does not count toward the limit. For instance, many states exclude the first $65 to $90 of monthly earnings, or they count only a portion of self-employment income after expenses. A few states have special rules for students, people over 65, or people with disabilities. Your state's Medicaid office can tell you exactly what counts and what does not.

Asset limits and what they cover

Most states have asset limits — a cap on how much money and property you can own and still may have access to. These limits are often $2,000 for an individual and $3,000 for a couple, though some states have higher limits and a few have none. Assets include cash in the bank, money market accounts, stocks, bonds, and vehicles. A car is usually not counted if you use it for transportation, and your primary home is typically not counted either.

Some assets are excluded entirely. Retirement accounts like 401(k)s and IRAs are usually not counted. Household goods, personal items, and tools you use for work are generally excluded. The rules for what counts as an asset and what does not vary by state, and they can be complicated — for instance, some states count a second vehicle but not a first, or they count life insurance with a cash value above a certain amount.

If you are over 65 or have a disability, different asset rules may apply. Some states use higher limits for elderly or disabled people, or they use different rules altogether for long-term care coverage versus regular Medicaid. Check your state's rules before assuming you are over the limit.

Medicaid expansion and working-age adults

In 2014, states were given the option to expand Medicaid to cover working-age adults with income up to 138% of the federal poverty line. As of now, most but not all states have done so. If your state has expanded Medicaid, you may may have access to even if you are not in a traditionally covered group like parents, elderly people, or people with disabilities. If your state has not expanded, you will need to fall into one of those groups to may have access to.

You can find out whether your state has expanded Medicaid by visiting your state's Medicaid website or calling the state Medicaid office. The difference matters: in an expansion state, a single adult with income around $1,500 per month might may have access to; in a non-expansion state, that same person would not.

Citizenship and immigration status requirements

You must be a U.S. citizen or a may have access to immigrant to get Medicaid in most cases. may have access to immigrants include people with a green card, people granted asylum, refugees, and people with certain other immigration statuses. Undocumented immigrants are not may be able to access for regular Medicaid in most states, though some states offer limited coverage for emergency services or pregnancy-related care regardless of status.

You will need to provide proof of citizenship or immigration status when you apply. This can be a birth certificate, passport, green card, or other documents depending on your situation. If you are unsure whether your immigration status qualifies you, ask your state's Medicaid office — they can tell you whether you meet this requirement.

How to find your state's specific rules

The fastest way to learn whether you meet your state's rules is to contact your state's Medicaid office directly. You can find the phone number and website through Medicaid.gov, which has links to every state's program. Many states also have online tools where you can enter your income and household size and get an immediate answer about whether you likely meet the income limit.

You can also call 211, a free helpline, and ask for a referral to your state's Medicaid office or a local organization that can help you understand the rules. Some community health centers and legal aid organizations also offer free help understanding Medicaid rules in your state.

What happens after you meet the basic rules

Meeting the income and asset limits is only the first step. When you apply, you will need to provide documents to prove your income, household size, citizenship, and residency. This usually means recent pay stubs, tax returns, a lease or mortgage statement, and proof of citizenship. The application process itself takes time — usually two to four weeks — and the state may ask for more information before making a decision.

If you are approved, your coverage usually starts on the first day of the month you applied or the first day of the following month, depending on your state. If you are denied, you have the right to ask for a hearing to challenge the decision. Your state's Medicaid office will tell you how to request a hearing and what documents to bring.

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 toward the household income limit even if you file separately. Some states have exceptions for certain situations, but the general rule is that married couples are treated as one household for Medicaid purposes. Check your state's rules to be sure.

What if my income changes after I get Medicaid?

You must report changes in income to your state's Medicaid office. If your income goes above the limit, your coverage may end. If your income drops, you may become may be able to access if you were not before. The timing of when changes take effect depends on your state, so report changes as soon as they happen.

Can I have a savings account and still may have access to?

Yes, as long as your total savings are below your state's asset limit. Most states allow individuals to have up to $2,000 in the bank. Money in a savings account counts as an asset, so you need to know your state's exact limit before you assume you are over it.

Do I lose Medicaid if I get a job?

Not automatically. If your new job income stays below your state's limit, you keep coverage. If your income goes above the limit, your coverage ends. Some states have work incentives that let you keep Medicaid for a few months even if your income exceeds the limit, so ask your state's office about this when you report the job.

What if I am homeless — can I still get Medicaid?

Yes. You do not need a permanent address to apply for Medicaid. You can use a shelter address, a mailing address where mail can reach you, or a social worker's address. Contact your state's Medicaid office or a local homeless services organization to find out how to apply without a home address.