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

There is no single income limit for Medicaid across the United States. Each state sets its own threshold based on the federal poverty level, and that threshold varies by how many people live in your household. A single adult in one state might earn $1,500 per month and still may have access to, while the same person in another state would not. Your state's Medicaid program will tell you the exact limit that applies to you.

Most states use a percentage of the federal poverty level to set their income limits. The federal poverty level itself changes each year — for 2024, the poverty line for a single person is about $14,600 per year, and for a family of four it is about $30,000 per year. States then decide whether to cover people at 100% of that level, 138%, or some other percentage. A few states use different methods entirely, like looking at your income compared to your state's median income.

The income limit also depends on which Medicaid program you are trying to enter. Standard Medicaid for adults has one limit. Medicaid for children (often called CHIP or Medicaid for Kids) has a higher limit. Medicaid for pregnant people has its own limit. Medicaid for people over 65 or with disabilities follows different rules. You may may have access to for one program but not another.

Key Takeaways

  • Your state, not the federal government, sets the income limit, and it changes based on how many people are in your household.
  • Most states cover people earning between 100% and 138% of the federal poverty level, but some go higher or lower.
  • Children, pregnant people, and seniors often have higher income limits than working-age adults.
  • You can find your state's exact limit by contacting your state Medicaid office or using the federal Medicaid website to locate your state program.
  • Income includes wages, self-employment earnings, Social Security, and some other sources, but the rules for what counts vary by state.

How states calculate the income limit for your household

States use the federal poverty level as a starting point and then multiply it by a percentage. If your state covers people at 138% of the poverty level, and the poverty level for a family of three is $21,960, then your state's limit would be about $30,305 per year. If your state covers at 100%, the limit would be $21,960.

The income limit goes up as your household size increases. A state might set the limit at 138% of poverty for everyone, but a single person's limit will be lower in dollars than a family of four's limit, because the poverty level itself is higher for larger households. When you report your income, you report the total earned by everyone in your household, and the program compares that total to the limit for your household size.

Some states expanded Medicaid in 2014 under the Affordable Care Act and now cover adults earning up to 138% of the poverty level. Other states did not expand and cover adults at a much lower percentage — sometimes as low as 50% of poverty. This is the single biggest difference between states. If you live in a non-expansion state, your income limit as a working-age adult will be significantly lower than in an expansion state, even if you live just across the border.

What counts as income for Medicaid purposes

Medicaid counts most money you receive as income: wages from a job, self-employment earnings, rental income, interest and dividends, Social Security benefits, unemployment benefits, and child support. However, the rules for what counts and how it is counted vary by state and by the type of Medicaid program.

Some income sources are not counted or are only partly counted. Supplemental Security Income (SSI) is usually not counted as income for SSI-linked Medicaid programs. Some states do not count the first $65 of monthly earnings plus half of the rest, a rule called the "earned income exclusion." Food assistance (SNAP) is never counted as income. Tax refunds and one-time payments like stimulus checks are usually not counted.

Your state Medicaid program will ask you to report your income for the past month or the past three months, depending on the program. If your income changes — you get a raise, lose a job, or start receiving benefits — you are supposed to report that change. Some programs have a grace period where small income changes do not affect your coverage right away. Others end your coverage immediately if you report earning over the limit.

Income limits for children and pregnant people

Children's Medicaid (sometimes called Medicaid for Kids or CHIP) has higher income limits than adult Medicaid in most states. A state might cover working-age adults at 100% of poverty but cover children up to 200% or even 300% of poverty. This means a child in your household could may have access to for Medicaid even if you as an adult do not.

Pregnant people also usually have higher income limits than other adults. Many states cover pregnant people up to 185% or 200% of the poverty level, even in states that cover other adults at much lower levels. The coverage for pregnant people typically continues for 60 days after the birth, after which the person would need to meet the regular adult income limit to stay on Medicaid.

Infants and young children often have the highest limits of all. Some states cover children under age 1 or under age 6 at 300% of poverty or higher. If you have a young child, it is worth checking the specific limit for that age group in your state, because it may be much higher than you expect.

Income limits for seniors and people with disabilities

Medicaid for people over 65 or with disabilities works differently from Medicaid for working-age adults. These programs are often linked to Supplemental Security Income (SSI), which has its own income limit. In 2024, the SSI income limit is $943 per month for an individual and $1,415 for a couple, though these amounts change each year.

If you receive SSI, you automatically may have access to for Medicaid in most states. If you do not receive SSI but are over 65 or have a disability, your state may have a separate Medicaid program with a higher income limit. Some states use the SSI limit; others allow people to earn more. A few states have special programs for people with disabilities that allow higher income but require you to work or participate in a work incentive program.

People over 65 who need nursing home care or long-term care services can have higher income limits for Medicaid coverage of those services, even if they would not may have access to for regular Medicaid. The rules are complex and vary significantly by state.

How to find your state's specific income limit

The fastest way to find your state's income limit is to contact your state Medicaid office directly. You can locate it through the federal Medicaid website (medicaid.gov), which has a link to each state's program. You can also call 211, a free referral service, and ask for your state's Medicaid income limits for your household size and situation.

When you contact your state program, have your household size ready and be specific about which program you are asking about — adult Medicaid, children's Medicaid, Medicaid for pregnant people, or Medicaid for seniors and people with disabilities. The income limit will be different for each. Your state program can also tell you whether your state expanded Medicaid and what that means for your income limit.

Many state Medicaid websites publish their income limits in a table or chart. Look for a document called "Income Limits" or "Financial Standards." If you cannot find it online, call the number on your state's Medicaid website and ask them to mail or email you the current limits. Income limits change once per year, usually in January, so make sure you are looking at the current year's limits.

What happens if your income changes after you get Medicaid

If you are on Medicaid and your income increases above the limit, your coverage will end. The timing depends on your state and program. Some programs end coverage at the end of the month in which you report the income increase. Others give you a grace period of 30 or 60 days. A few programs have a "continuous may be able to access" period where your coverage does not end for a set time, even if your income goes over the limit.

You are responsible for reporting income changes to your state Medicaid program. If you do not report and your income is later discovered to be over the limit, your state may ask you to repay benefits you received while ineligible. However, if the increase was small or temporary, some states have rules that allow you to keep coverage. Always report changes as soon as they happen rather than waiting.

If your income drops below the limit again, you can report that change and ask to be reinstated. Some states will reinstate you immediately. Others will treat it as a new application and require you to go through the process again. Ask your state program what their policy is.

Frequently Asked Questions

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

Yes, in most Medicaid programs, your spouse's income counts toward your household income, even if you file taxes separately. Some programs for seniors or people with disabilities have different rules. Contact your state Medicaid office to confirm how they count spousal income in your situation.

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

Self-employment income is usually counted as your net income after business expenses. You will need to provide tax returns or profit-and-loss statements to prove what you earned. Some states count self-employment income differently than wages, so ask your state program how they handle it.

If I get a raise, will I lose Medicaid immediately?

Not necessarily. Most states give you a month or more to report the change, and some have grace periods where small increases do not end your coverage right away. Report the change as soon as you know about it and ask your state program when your coverage would end if the new income is over the limit.

Can I have Medicaid if I also have a job with health insurance?

Yes. Having other health insurance does not disqualify you from Medicaid. Medicaid can work alongside employer insurance or marketplace insurance. Your income is what matters, not whether you have other coverage.

Do I have to report every small income change, or only big ones?

You are supposed to report all income changes, but the impact depends on your state. Some states only act on changes that push you significantly over the limit. Others end coverage for any amount over. Ask your state program what their reporting requirements are and whether there is a threshold below which small changes do not affect your coverage.