Medicaid covers people of all ages, but the rules for who qualifies depend on your age group and your state

There is no minimum age to be on Medicaid — newborns can be covered from birth. There is also no upper age limit; Medicaid covers people into their 90s and beyond. What changes with age is which rules your state uses to decide whether you may have access to, and what services the program will pay for.

A newborn whose parent has low income may may have access to automatically. A teenager might may have access to through a separate children's program. A working adult qualifies based on income and household size. An older adult might may have access to through a different income threshold or by spending down assets. The age you are determines which category your state looks at first.

Key Takeaways

  • Newborns and children under 19 have their own income limits, which are usually higher than limits for adults, so a child might may have access to when a parent does not.
  • Pregnant people may have access to under pregnancy-related rules in most states, regardless of age, and coverage can continue for 60 days after the pregnancy ends.
  • Working-age adults (19 to 64) may have access to based on income and household size, and the income limit varies by state and whether your state expanded Medicaid.
  • People 65 and older may may have access to for Medicaid even with higher income if they have high medical or long-term care costs, through a process called spend-down.
  • Your state's specific rules determine your path to coverage, so you need to check with your state Medicaid office, not a national number.

Children and teenagers under 19

States must cover children under 19 whose household income is at or below 133 percent of the federal poverty line. Many states set the limit higher — some at 200 percent or more. This means a child in a household that earns too much for a parent to may have access to might still may have access to themselves.

Newborns born to a Medicaid-covered parent are usually covered automatically for the first month of life. After that, your state will check the baby's household income to decide if coverage continues. You do not have to reapply; your state handles this.

Teenagers who age out of foster care (usually at 18 or 21, depending on your state) have extended Medicaid coverage in most states until age 26, even if their income rises. This is called extended foster care Medicaid. The rules vary by state, so check with your state's child welfare office if this applies to you.

Pregnant people of any age

Pregnancy is a separate category in every state. You can may have access to for Medicaid based on pregnancy alone, regardless of your age or how much you earn, in most states. Some states have income limits even for pregnancy, but they are usually higher than the limit for other adults.

Coverage for pregnancy-related care begins as soon as your state confirms you are pregnant — you do not have to wait for a due date or a certain month of pregnancy. Coverage continues for 60 days after the pregnancy ends, whether the pregnancy resulted in a birth, miscarriage, or abortion. After 60 days, your coverage ends unless you may have access to under a different category (such as being a parent with low income).

Working-age adults (19 to 64)

Income limits for working-age adults depend on whether your state expanded Medicaid under the Affordable Care Act. In expansion states, the limit is usually 138 percent of the federal poverty line. In non-expansion states, the limit is often much lower — sometimes 50 percent of the poverty line or even lower — or there is no adult category at all outside of parents or people with disabilities.

Your household size and income are what matter, not your age within this range. A 25-year-old and a 60-year-old with the same household income and size face the same income test. Some states also have work requirements or other conditions for adults in this age group, so check your state's rules.

If you are self-employed or have variable income, your state will usually average your income over the past three months or use your most recent tax return. Keep records of what you earn so you can show your state if your income changes.

People 65 and older

Age 65 is when Medicare becomes available, but Medicaid does not stop at 65. You can be on both programs at the same time — this is called being dual may be able to access. Medicaid covers costs that Medicare does not, such as long-term care in a nursing home.

Income limits for people 65 and older are usually the same as for working-age adults in your state, but older adults have an additional path to coverage through spend-down. If your income is too high to may have access to, you can become may be able to access by spending money on medical or long-term care costs until your remaining income falls below the limit. This is how many people pay for nursing home care — Medicaid covers it after the person's assets are spent down.

Asset limits (how much money or property you can own) apply to people 65 and older in most states. The limit is often $2,000 for an individual, though some states set it higher. Your home, one car, and certain other items do not count toward this limit. Check your state's rules on what counts as an asset.

People with disabilities of any age

Medicaid covers people under 65 who receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). The income and asset limits for SSI are very low — $943 per month for an individual in 2024, though this amount changes yearly. SSDI has no asset limit, but income limits vary by state.

You do not have to be 65 to use spend-down if you have a disability. If your income is above your state's limit but you have high medical costs, you can spend down to become may be able to access, just as older adults do. This is common for people with chronic conditions who need ongoing care.

How to find your state's specific age rules

Your state Medicaid office is the only source that can tell you the exact income limits, asset limits, and rules for your age group. You can find your state office through the Centers for Medicare & Medicaid Services website, or call 211 and ask for your state Medicaid number.

When you contact your state, have ready: your date of birth, your household size, your household income for the past month or most recent tax year, and information about anyone else in your household who might need coverage. If you are pregnant, say so — your state will route you to the pregnancy category. If you are 65 or older, mention any medical costs you are paying out of pocket.

Frequently Asked Questions

Can a newborn be on Medicaid if the parents do not may have access to?

Yes. Newborns have their own income limit, which is higher than the limit for parents in most states. A newborn born to a Medicaid-covered parent is automatically covered for the first month. After that, your state checks the baby's household income. If the household income is too high for a parent, it may still be low enough for the baby.

What happens to Medicaid coverage when someone turns 19?

Coverage does not stop automatically. Your state will check whether you still may have access to under the adult rules for your state. If your income is now too high, coverage ends. If you are still within the income limit, coverage continues. You may need to recertify your income, so watch for mail from your state.

Can someone on Medicare also have Medicaid?

Yes. People 65 and older can be on both programs at the same time. Medicaid covers costs Medicare does not, such as nursing home care, and can pay your Medicare premiums. You must meet your state's income and asset limits to may have access to for Medicaid, even if you are on Medicare.

Do asset limits apply to people under 65?

Asset limits usually apply only to people 65 and older and to people receiving SSI. Working-age adults without disabilities typically have no asset limit — only an income limit. Check your state's rules if you are on SSI or SSDI, as asset rules are stricter for SSI recipients.

What if someone's age or birth date is unclear?

Your state will ask for a birth certificate, passport, or other document showing your date of birth. If you do not have one, ask your state Medicaid office what documents they will accept. Some states accept a signed statement from someone who knows your age if official documents are not available.