Medicaid income limits depend on your state and family size

There is no single Medicaid income limit that applies everywhere. Each state sets its own threshold, and the amount you can earn and still be covered varies by where you live, how many people are in your household, and whether you are applying as an individual, a parent, a child, or a senior. Some states use the federal poverty line as their benchmark; others set limits higher or lower.

The fastest way to find your state's actual limit is to contact your state Medicaid office directly or use the Medicaid.gov state finder to locate your local agency. They can tell you the exact income threshold for your household size in minutes. Online income calculators exist, but they often lag behind current rules, so a phone call to your state office is more reliable.

Key Takeaways

  • Income limits vary by state and household size; there is no national threshold that applies to everyone.
  • Most states use a percentage of the federal poverty line (usually 100% to 200%) to set their limits, but some use different methods.
  • Your state Medicaid office can tell you the exact limit for your household in one phone call.
  • Income includes wages, self-employment earnings, Social Security, unemployment benefits, and child support, but not all income counts the same way.
  • Some states have expanded Medicaid to cover adults earning up to 138% of the federal poverty line; others have not.

How states calculate income limits

Most states base their Medicaid income limits on the federal poverty line, which the U.S. Department of Health and Human Services updates each year. A state might say "we cover individuals earning up to 138% of the federal poverty line" or "families earning up to 200% of the poverty line." The percentage varies by state and by the category of person applying (child, parent, senior, person with a disability).

For 2024, the federal poverty line for a single person is approximately $15,060 per year; for a family of four, it is approximately $31,200 per year. If your state covers people at 138% of the poverty line, a single person could earn roughly $20,783 per year. But this changes every January when the poverty line is updated, and your state may use a different percentage or a different calculation method altogether.

A handful of states use income limits that are not tied to the poverty line at all. They may use a flat dollar amount, a percentage of the state median income, or other formulas. This is why calling your state office is the only way to know for certain whether you fall within the limit.

Medicaid expansion and higher income thresholds

In 2014, states had the option to expand Medicaid to cover more low-income adults. States that expanded Medicaid generally cover individuals earning up to 138% of the federal poverty line (roughly $20,783 for a single person in 2024). States that did not expand Medicaid often have much lower income limits for adults without children or disabilities — sometimes as low as 50% of the poverty line.

Whether your state expanded Medicaid is one of the biggest factors in whether you will be covered. If you live in a non-expansion state and earn slightly above your state's limit, you may have no Medicaid option, even though you would be covered in an expansion state. Your state Medicaid office can tell you immediately whether expansion applies to you.

What counts as income for Medicaid

Medicaid counts most money you receive as income: wages, self-employment earnings, Social Security benefits, unemployment insurance, workers' compensation, child support, and retirement pensions all count. However, not all income is counted the same way, and some income is excluded entirely.

For example, the first $65 per month of earned income (wages or self-employment) is often disregarded, meaning it does not count toward the limit. Some states disregard a portion of child support received. Supplemental Security Income (SSI) recipients may have different rules. Gifts and one-time payments usually do not count. The rules are complex and vary by state, so ask your state Medicaid office which income sources apply to your situation.

How to find your state's specific income limit

Go to Medicaid.gov and use the "Find Care" or state finder tool to locate your state Medicaid office phone number and website. Call and tell them your household size and ask for the current income limit for the category you fall into (child, parent, senior, person with a disability, pregnant person, or adult without dependents). They will give you a dollar amount.

You can also visit your state Medicaid website directly — most states publish their income limits in a table organized by household size and category. Some states have online income screening tools that give you an estimate, though these should be confirmed by calling the office. If you are applying through a community health center or hospital, their staff can often look up your state's limits for you as well.

What happens if your income is just above the limit

If you earn slightly more than your state's Medicaid limit, you may still have other options. Some states have separate programs for people just above the Medicaid threshold, or you may be able to purchase coverage through the health insurance marketplace (Healthcare.gov) and receive a tax credit to lower your premium. Your state Medicaid office can tell you what programs exist in your state for people in your income range.

If you have a child, that child may still be covered by Medicaid or the Children's Health Insurance Program (CHIP) even if your household income is above the adult limit. Children's income thresholds are often higher than adult thresholds in the same state. Ask your state office about coverage for each household member separately.

Income changes and reporting requirements

If you are already on Medicaid and your income changes, you must report the change to your state Medicaid office. The timing and method vary by state — some require reports within 10 days, others within 30 days. If your income rises above the limit, your coverage will end, usually at the end of the month in which you reported the change. If your income drops, you may become newly covered or have your coverage reinstated.

Many states now use continuous enrollment, meaning your Medicaid coverage will not end just because your income temporarily exceeds the limit by a small amount. Check with your state office about their specific rules for income changes and when you must report them.

Frequently Asked Questions

Does my spouse's income count toward the Medicaid limit?

It depends on your state and your situation. If you are applying as an individual, only your income counts. If you are applying as a parent with children, your spouse's income usually counts as household income. If you are applying as a senior or person with a disability, spousal income rules vary. Ask your state Medicaid office how they count household income for your specific category.

What if I am self-employed — how do they count my income?

Self-employment income is counted, but the calculation can be complex. Most states count your net self-employment income (revenue minus business expenses). Some states allow deductions for taxes you pay on that income. Keep records of your business income and expenses, and bring them when you apply. Your state office can walk you through how they calculate self-employment income.

Does child support I receive count as income?

Yes, child support counts as income in most states. However, some states disregard a portion of child support — for example, the first $50 per month may not count. Ask your state Medicaid office whether they disregard any portion of child support in your state.

Can I be on Medicaid if I work part-time?

Yes. Medicaid does not require you to be unemployed. If your total household income is at or below your state's limit, you can work part-time or full-time and still be covered. Some states have special programs for working people with disabilities that allow higher income limits.

What if my income varies month to month?

Most states average your income over a period of time — often the past three months or the past year — rather than looking at a single month. If you have irregular income, bring documentation of your average earnings when you apply. Your state office can explain how they handle variable income.