Medicaid income limits depend on your state and family size, not a single national threshold
There is no single income level at which you stop being able to receive Medicaid. Each state sets its own limits based on a percentage of the federal poverty line, and those limits change year to year. A single person earning $18,000 might may have access to in one state and not in another. Your family size matters as much as your income — a household of four has a higher threshold than a single person.
Most states use the federal poverty line as their starting point, then multiply it by a percentage (often 138% or 100%, depending on whether they expanded Medicaid under the Affordable Care Act). Some states are more generous; others are stricter. A few states have separate income rules for different groups — children, pregnant people, elderly adults, and people with disabilities may each have different thresholds.
The only way to know your state's actual limit is to check with your state Medicaid office or use an online tool that asks for your state, income, and family size. Income limits also shift on January 1 each year when the federal poverty line updates.
Key Takeaways
- Medicaid income limits are set by each state and change every January 1, so a limit that applied last year may not apply now.
- Your family size is as important as your income — the threshold for a family of four is roughly double the threshold for a single person.
- States that expanded Medicaid under the Affordable Care Act generally allow higher incomes than states that did not expand.
- Your state Medicaid office website or a state-specific screening tool can tell you whether your household income falls within your state's current limit.
How states calculate income limits
Most states base their Medicaid income limit on the federal poverty line, which the U.S. Department of Health and Human Services updates each January. For 2024, the federal poverty line for a single person is $14,600 per year; for a family of four, it is $30,000. States then multiply that number by a percentage to set their own threshold.
A state that uses 138% of the poverty line (the standard in Medicaid expansion states) would allow a single person earning up to about $20,140 per year. A state using 100% of the poverty line would cap it at $14,600. Some states go higher — a few allow up to 200% or 300% of the poverty line for certain groups like children or pregnant people.
Non-expansion states, which did not adopt the Medicaid expansion option under the Affordable Care Act, often have much lower limits. Some cap adult Medicaid at 50% of the poverty line or lower, meaning a single adult earning $7,300 per year might already exceed the limit.
Income limits by family size
Medicaid thresholds rise with each additional household member. The exact amounts depend on your state, but the pattern is consistent: a family of three has a higher limit than a family of two, and so on. This is because the federal poverty line itself increases with family size.
For example, in a state using 138% of the poverty line in 2024, the limits would be roughly:
- Single person: $20,140
- Family of two: $27,240
- Family of three: $34,340
- Family of four: $41,440
These are approximate figures for illustration only. Your actual state limit may differ. The key point is that adding a dependent to your household raises the income threshold, sometimes significantly. A parent supporting a child has more room to earn than a single adult.
Medicaid expansion states versus non-expansion states
The biggest divide in Medicaid income limits runs between states that expanded Medicaid and those that did not. Expansion states allow adults earning up to roughly 138% of the poverty line to receive Medicaid. Non-expansion states typically limit Medicaid for working-age adults to much lower thresholds — sometimes 50% of the poverty line or even lower.
As of 2024, about 40 states plus Washington, D.C. have expanded Medicaid. The remaining states have not. This means a single adult earning $20,000 per year might may have access to in an expansion state but fall well above the limit in a non-expansion state.
Some non-expansion states have created their own programs to cover people above their Medicaid limit but below the income threshold for marketplace insurance subsidies. These programs vary widely in scope and generosity. Your state Medicaid office can tell you whether such a program exists where you live.
What counts as income for Medicaid purposes
Medicaid counts most forms of earned and unearned income toward your limit. Wages, self-employment income, Social Security, unemployment benefits, child support, and pension payments all count. Some income sources do not: Supplemental Security Income (SSI) is often excluded, as are certain types of child support and some veteran benefits, depending on your state.
If you receive income irregularly — seasonal work, gig work, or freelance income — Medicaid typically averages your income over the past three months or the past year, depending on your state's rules. A month where you earned nothing does not erase months where you earned more.
Deductions also matter. Some states allow you to deduct work-related expenses, childcare costs, or medical expenses before comparing your income to the limit. Others do not. Ask your state Medicaid office whether deductions apply to your situation.
How to find your state's current income limit
The fastest way is to visit your state Medicaid office website directly. Most states have an income limit chart or a screening tool that asks for your state, family size, and income and tells you whether you may be within the limit. The tool does not determine whether you actually may have access to — that requires a full review of your situation — but it gives you a quick answer.
You can also call your state Medicaid office. The number is usually on your state health department website. Have your family size and approximate monthly or annual income ready when you call.
If you do not know your state's Medicaid office contact information, the Centers for Medicare & Medicaid Services (CMS) maintains a directory at medicaid.gov. You can also dial 211 from any phone to reach a local referral service that can direct you to your state Medicaid office.
Income limits for specific groups
Some groups have different income thresholds than working-age adults. Children often have higher limits — a state might allow a child to earn up to 200% of the poverty line while capping adults at 138%. Pregnant people and new parents may also have higher thresholds. Elderly adults and people with disabilities sometimes have separate rules.
If you fall into one of these groups, your state Medicaid office can tell you which limit applies to you. Do not assume that because you exceed the adult limit, you exceed the limit for your group.
Frequently Asked Questions
Does my income have to be below the poverty line to get Medicaid?
No. Most states allow income above the poverty line. In expansion states, you can earn up to roughly 138% of the poverty line. In non-expansion states, the limit is often lower, but it still may be above the poverty line itself. Your state's specific percentage determines the actual threshold.
If I earn too much this month, do I lose Medicaid?
Not necessarily. Medicaid typically looks at your income over a longer period — often the past three months or the past year — rather than a single month. One high-earning month usually does not disqualify you. Ask your state Medicaid office how they average income in your situation.
Do I have to report income changes to Medicaid?
Yes. If your income changes significantly, you should report it to your state Medicaid office. Some changes may affect your coverage. Reporting changes promptly prevents overpayments or unexpected loss of coverage later.
What if my state did not expand Medicaid?
Your income limit will be lower than in expansion states. You may still may have access to if you are in a category like a child, pregnant person, elderly adult, or person with a disability. If you do not fit those categories and earn above your state's limit, ask about alternative programs your state may offer or whether you may have access to for marketplace insurance subsidies instead.
Can I use an online calculator to check if I may have access to?
Online tools can give you a rough idea based on your state and family size, but they cannot determine actual qualification. Your state Medicaid office will review your full situation — income, resources, citizenship, and other factors — before making a final decision. Use a calculator as a starting point, then contact your state office for a definitive answer.