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

There is no single income cutoff for Medicaid across the United States. Each state sets its own limit based on the federal poverty level, and that limit changes depending on how many people live in your household. A single person might may have access to in one state at an income that would disqualify them in another. Your state's Medicaid program publishes its current limits, and you can find yours by contacting your state Medicaid office or checking its website.

Most states use a percentage of the federal poverty level to set their income limit — commonly 138%, 100%, or 48%, depending on the state and which Medicaid category you fall into. For 2024, the federal poverty level for a single person is $14,060 per year; for a family of four, it is $28,870. A state that uses 138% of poverty would allow a single person to earn up to roughly $19,403 per year. But another state using a lower percentage would set a tighter limit.

Your actual income calculation also matters. Most programs count gross income (before taxes), but some deduct certain expenses or allow a small monthly buffer. Self-employment income, child support, and Social Security are all counted, though the rules vary by state.

Key Takeaways

  • Each state sets its own Medicaid income limit based on a percentage of the federal poverty level, so the threshold where you live determines whether you may have access to.
  • Income limits vary by family size — a household of three has a higher dollar limit than a single person, but the percentage of poverty is the same.
  • Most states count gross income before taxes, and include earnings from work, self-employment, Social Security, and child support.
  • Your state Medicaid office or website shows the exact current limit for your household size and can tell you whether your income falls within it.
  • Some states have expanded Medicaid to cover more people; others have not, which creates large differences in who qualifies between neighboring states.

How states calculate the income limit

States choose a percentage of the federal poverty level and apply it to your household size. The federal government publishes poverty guidelines each year, and states use those numbers as their starting point. If your state uses 138% of poverty (the most common threshold after Medicaid expansion), a family of four earning $39,840 per year would be at the limit. A family of five would have a higher limit because the poverty guideline for five people is higher.

Some states have not expanded Medicaid and use much lower percentages — as low as 48% of poverty for parents or 75% for children. This means two neighboring states can have vastly different income limits. A parent in a non-expansion state might earn $10,000 per year and still be over the limit, while a parent in an expansion state earning $27,000 per year would may have access to.

The income limit applies to your household as a whole. If you are married and both working, both incomes count. If you have dependent children, their income (from work or other sources) is usually counted too. Some states allow you to exclude a small amount of earned income or subtract certain expenses, but this varies widely.

What income counts and what does not

Medicaid counts most money coming into your household. Wages from employment, self-employment income, Social Security, Supplemental Security Income (SSI), unemployment benefits, and child support all count toward the limit. If you receive rental income or interest from savings, that counts as well.

Some income does not count. Gifts and one-time payments usually do not. Some states exclude a small amount of unearned income (like interest) or allow you to keep a small monthly work incentive. If you receive TANF (Temporary Assistance for Needy Families) or SNAP (food assistance), those benefits themselves do not count as income, but the cash or resources you have do. The rules are specific to your state, so ask your Medicaid office which deductions or exclusions apply to you.

Self-employed people should know that most states count net self-employment income (after business expenses) rather than gross revenue. Keep records of your business expenses to show what you actually earned.

Medicaid expansion states versus non-expansion states

In 2014, the Affordable Care Act allowed states to expand Medicaid to cover more people. States that expanded Medicaid generally cover adults earning up to 138% of the federal poverty level. States that did not expand have much lower limits, often covering only parents earning 48% of poverty or children earning 75% of poverty.

This creates a significant gap. In an expansion state, a single adult earning $19,403 per year might may have access to. In a non-expansion state, that same person would likely earn too much. Some states have expanded Medicaid since 2014, and a few have rolled back coverage, so the landscape continues to shift. Your state's current status determines your actual income limit.

If you live in a non-expansion state and earn too much for Medicaid, you may be able to purchase coverage through the Health Insurance Marketplace, where you might receive a tax credit to lower your premium. Your state Medicaid office or a local navigator can explain what options are available to you.

How to find your state's exact income limit

Your state Medicaid program publishes its income limits for each household size and updates them yearly. You can find this information by visiting your state's Medicaid website (usually part of the state health department) or calling your state Medicaid office. Many states also have online screening tools where you enter your income and household size to see whether you may be within the limit.

When you contact your state, have your household size and monthly or annual income ready. Be clear about whether you are asking about yourself, a child, a parent, or a pregnant person, because limits can differ by category. If you are self-employed, bring documentation of your business income and expenses so the worker can calculate your net income correctly.

If your income is close to the limit, ask whether your state allows any deductions or work incentives that might bring you under it. Some states have special rules for people with disabilities or for certain types of income. A few minutes on the phone with your state office can clarify exactly where you stand.

What happens if your income changes

If you are on Medicaid and your income increases above the limit, your coverage will end. Most states give you a grace period (often one month) to report the change, and some allow you to keep coverage through the end of the month in which you became ineligible. After that, you lose Medicaid coverage.

If your income drops below the limit, you can reapply for Medicaid at any time. You do not have to wait for an annual renewal. Many states allow you to report a change online, by phone, or by mail, and coverage can start the month after you report the change.

If you lose Medicaid because your income increased, you may be able to buy coverage through the Health Insurance Marketplace. A job loss or income drop may also may have access to you for a special enrollment period, allowing you to sign up outside the normal open enrollment window.

Income limits for specific Medicaid categories

Medicaid covers different groups of people, and income limits can vary by category. Parents and caretakers, children, pregnant people, elderly people, and people with disabilities may each have different thresholds. In some states, a child qualifies at a higher income level than a parent. In others, a person over 65 has a different limit than a working-age adult.

If you are applying for Medicaid for a child, ask your state what the child's specific limit is — it is often higher than the adult limit. If you are elderly or have a disability, your state may have a separate income limit or may count income differently (for example, by excluding certain resources or allowing a higher work incentive).

Your state Medicaid office can tell you which category you fall into and what the income limit is for that category. Do not assume that because you are over the limit for one category, you are over the limit for all of them.

Frequently Asked Questions

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

Yes. Medicaid counts the income of your spouse regardless of how you file taxes. Both incomes are added together to determine whether your household is within the limit. Some states may have exceptions for legally separated spouses, so ask your state office about your specific situation.

If I earn money under the table, does it count toward the Medicaid limit?

Yes. Medicaid counts all income, whether reported to the IRS or not. You are required to report all earnings honestly when you apply for or renew Medicaid. Underreporting income can result in overpayment recovery or program termination.

What if my income fluctuates month to month because I am self-employed?

Most states average your income over a period (often the past three months or the past year) to determine whether you may have access to. If your average falls below the limit, you may may have access to even if some individual months are higher. Bring documentation of your actual earnings to show the Medicaid office.

Can I reduce my income to may have access to for Medicaid?

You cannot intentionally reduce your income to become may be able to access. However, some states have work incentive programs that allow you to exclude a portion of earned income if you have a disability. Ask your state Medicaid office whether any work incentives apply to your situation.

If I am denied because my income is too high, can I appeal?

Yes. Every state has an appeal process. If you believe your income was calculated incorrectly or if you have deductions or exclusions the worker did not consider, you can request a hearing. Your state Medicaid office will explain how to file an appeal and what documentation to bring.