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

There is no single income threshold that determines Medicaid may be able to access across the United States. Each state sets its own limits based on the federal poverty level, and those limits vary significantly. A household that qualifies in one state may not may have access to in another, even with identical income and family composition.

Most states use a percentage of the federal poverty level to set their threshold. Some cover people at 100% of the poverty line; others go as high as 400% or higher, particularly for children and pregnant people. A few states have chosen not to expand Medicaid at all under the Affordable Care Act, which affects who can enroll regardless of income.

Your state's Medicaid program is the only source that can tell you whether your household income falls within the range they cover. Income limits also change annually, usually on January 1st, when the federal poverty guidelines update.

Key Takeaways

  • Each state sets its own Medicaid income limit as a percentage of the federal poverty level, so the threshold in your state may differ from a neighboring state.
  • Federal poverty guidelines, which determine most state limits, change every January 1st, so your may be able to access status can shift even if your income stays the same.
  • Your state's Medicaid office or website will show the exact income limit for your household size and family type.
  • Some household members may have different income limits than others — for example, children often have higher limits than adults in the same state.
  • Income is calculated as gross monthly or annual income before taxes, and some types of income are excluded from the calculation.

How states calculate the income limit

States express their Medicaid income limit as a percentage of the federal poverty level. The federal government publishes poverty guidelines each year; for 2024, the poverty line for a single person is around $15,000 annually, and it increases with each additional family member.

A state that covers people at 138% of the poverty level (the standard in many states that expanded Medicaid) would cover a single person with annual income up to roughly $20,700. A state covering at 100% would stop at roughly $15,000. A state covering at 200% would extend coverage to roughly $30,000. The exact figures shift each January when the federal guidelines update.

Some states have different limits for different groups. A state might cover adults at 138% of poverty but children at 200% or 250%, and pregnant people at yet another threshold. This means your 8-year-old child might may have access to for Medicaid while you do not, or vice versa.

What counts as income for Medicaid

Medicaid counts gross income — what you earn before taxes, deductions, or withholdings. If you earn $3,000 per month before taxes, that $3,000 is what the program counts, not your take-home pay.

Income includes wages, salary, self-employment earnings, Social Security benefits, unemployment benefits, child support, and most other regular payments. However, some income is excluded. Supplemental Security Income (SSI) is typically not counted. Some states exclude a portion of child support or other specific payments.

If you are self-employed, Medicaid counts your net business income (revenue minus business expenses). If you receive irregular income — a bonus, a one-time payment, or seasonal work — the program may average it over the year or count only the months you received it, depending on your state's rules.

How to find your state's specific limit

Your state Medicaid office publishes income limits for each family size and group. You can find this information on your state health department website or your state's Medicaid program page. Search "[your state] Medicaid income limits" to reach the official table.

The table will show limits for different household sizes — usually from one person through six or more. It will also show whether limits differ for children, pregnant people, parents, or other groups. Some states post the limits as monthly income; others use annual figures.

If you cannot locate the table online or the information is unclear, call your state Medicaid office directly. They can tell you in minutes whether your household income falls within the range for your state and family size. Many states also operate a 211 helpline that can provide this information and direct you to local enrollment assistance.

Income limits for specific groups

Children often have higher income limits than adults in the same state. A state might cover children up to 200% of poverty while covering adults only at 138%. This is because federal law allows states to cover children more broadly than they cover adults.

Pregnant people and new parents typically have their own income threshold, often higher than the general adult limit. Elderly people and people with disabilities may also have separate limits, sometimes higher and sometimes lower depending on the state.

If you are applying for someone other than yourself — a child, parent, or spouse — confirm which group's income limit applies to them. A household with multiple people may have some members who may have access to and others who do not.

What happens if your income changes

If your income rises above your state's limit after you enroll, you will lose Medicaid coverage. Most states give you a grace period to report the change, usually 30 to 90 days. If you do not report it and the program discovers the overage later, you may be asked to repay benefits you received while ineligible.

If your income drops below the limit, you can enroll or re-enroll at any time. You do not have to wait for an open enrollment period. Medicaid is available year-round for people who meet the income requirement.

Your state's Medicaid office can explain how income changes affect your coverage and what you need to do to report them. Some states allow you to report changes online; others require a phone call or a form submission.

States that did not expand Medicaid

Twelve states have not expanded Medicaid under the Affordable Care Act. In these states, the income limit for adults remains at or near the federal poverty level — typically around $15,000 annually for a single person — even though federal law would allow higher limits.

If you live in a non-expansion state and your income exceeds the state's narrow limit, you may not may have access to for Medicaid even if you have no other insurance. You might be able to purchase coverage through the federal health insurance marketplace instead, and you may may have access to for a tax credit to reduce the premium.

The non-expansion states are: Florida, Georgia, Idaho, Kansas, Mississippi, Missouri, North Carolina, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. If you live in one of these states and your income is above the limit, ask about marketplace coverage as an alternative.

Frequently Asked Questions

Does my household income include my spouse's income?

Yes, in most cases. Medicaid counts the income of your spouse and any dependent children in your household. If you are married but file taxes separately or live apart, ask your state Medicaid office how they treat your spouse's income — the rules vary by state.

If I work part-time, does Medicaid count all my earnings?

Yes, Medicaid counts all earned income, including part-time wages. It counts gross pay before taxes. If your income fluctuates, the program may average it over several months or use your most recent pay stub, depending on your state's method.

What if my income is just barely over the limit?

If your income exceeds your state's limit, you do not may have access to for Medicaid through the income pathway. However, some states have other programs or pathways — for example, coverage for people with disabilities or certain medical conditions — that may have different rules. Contact your state Medicaid office to ask about other options.

Do I have to report my income every month?

No. You report your income when you first apply, and then you report changes if your income rises or falls significantly. Most states ask you to report changes within 30 to 90 days of when they occur. You do not need to send pay stubs every month unless your state specifically asks for them.

Can I get Medicaid if I am unemployed?

Yes, if your household income (including unemployment benefits, if you receive them) falls within your state's limit. Unemployment benefits count as income for Medicaid purposes. If you have no income at all, you likely may have access to, as zero income is below any state's threshold.