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

There is no single income level that makes you "poor enough" for Medicaid. Each state sets its own limits, and those limits change based on how many people live in your household. A family of three in one state might may have access to at an income that disqualifies them in another state. The federal government sets a floor — states cannot go below it — but most states have raised their limits above that floor.

Your income is measured against the federal poverty line, which the U.S. Department of Health and Human Services updates every year. In 2024, the poverty line for a single person was about $15,000 per year; for a family of four, about $31,000. Most states use a percentage of that line — often 138% or 200% — to decide who qualifies. That means a state might cover everyone earning up to 138% of the poverty line, or up to 200%, depending on what that state chose.

Your state's Medicaid office publishes its exact income limits. You can find them by searching "[your state] Medicaid income limits" or by calling your state's Medicaid hotline. The limits are usually listed by family size and sometimes by category — parent, child, pregnant person, disabled adult — because different groups may have different thresholds in the same state.

Key Takeaways

  • Each state sets its own Medicaid income limit; there is no national cutoff that applies everywhere.
  • Income limits are expressed as a percentage of the federal poverty line and change each year.
  • Your household size matters — the same income qualifies a single person in one state but not a family of four in another.
  • You can find your state's exact limits by contacting your state Medicaid office or searching online for "[state name] Medicaid income limits."
  • Some states have expanded Medicaid to cover adults earning up to 138% of poverty; others have not expanded and use lower limits.

How states calculate income and what counts

When Medicaid checks your income, they count wages, self-employment earnings, Social Security, unemployment benefits, and child support. They do not count food stamps, housing assistance, or most other benefit programs. Some states exclude the first $65 of monthly earnings or allow you to keep a small amount of unearned income before it counts against you — the rules vary.

Income is usually measured over the past month or the month you are applying in. If you were recently laid off or had a sudden drop in hours, that recent income is what counts, not your average over the year. If you are self-employed, states typically average your income over the past three months or use your most recent tax return.

Some states count only the income of people in your household who are applying for Medicaid. Others count the income of a spouse or parent even if that person is not applying. A few states use "deeming" rules that count part of a spouse's or parent's income as yours for Medicaid purposes. Ask your state Medicaid office whether household members' income affects your case.

Medicaid expansion and why your state's limit matters

In 2014, the Affordable Care Act allowed states to expand Medicaid to cover adults earning up to 138% of the federal poverty line. As of 2024, about 40 states have done so. The remaining states have not expanded and use lower income limits — often 50% to 100% of the poverty line for adults without children.

If you live in a non-expansion state, you may not may have access to for Medicaid even if your income is quite low, unless you are a child, pregnant, disabled, or over 65. In an expansion state, a single adult earning under about $20,000 per year (138% of 2024 poverty) would likely may have access to. In a non-expansion state, that same person might not may have access to at all.

This matters because it means your state of residence is one of the biggest factors in whether you can get Medicaid. If you are moving or considering moving, check whether your destination state has expanded Medicaid. Some people in non-expansion states turn to the Affordable Care Act marketplace for coverage instead, where you may receive a tax credit to lower your premium if your income is between 100% and 400% of poverty.

Special income rules for children, pregnant people, and seniors

Children often have higher income limits than adults in the same state. Many states cover children in families earning up to 200% or even 300% of the poverty line, even if the state's adult limit is much lower. Pregnant people and new parents typically have higher limits than other adults. Seniors (age 65 and older) and people receiving Supplemental Security Income (SSI) for disability may have different thresholds.

Some states have separate programs for children and pregnant people with higher income limits than the main Medicaid program. These programs go by different names in different states — sometimes called CHIP (Children's Health Insurance Program) or a state-specific name. If your income is too high for regular Medicaid but you have children or are pregnant, ask your state Medicaid office whether a separate program covers your family.

What happens if your income changes

If you are on Medicaid and your income rises above the limit, your coverage will end. Most states give you a grace period — usually one or two months — before they terminate your case. If your income drops back below the limit during that period, you can report the change and keep your coverage.

If your income rises above the limit and stays there, you lose Medicaid. You may then be able to buy coverage through the Affordable Care Act marketplace. If your income is between 100% and 400% of poverty, you may receive a tax credit that lowers your monthly premium. If your income is above 400% of poverty, you do not may have access to for a tax credit, but you can still buy a plan on the marketplace.

Report income changes to your state Medicaid office as soon as they happen. Some states allow you to report online, by phone, or by mail. Waiting to report can result in overpayment — Medicaid may pay for services you were no longer supposed to receive, and you could be asked to repay the difference.

How to find your state's exact income limit

The fastest way is to call your state Medicaid office directly. They can tell you the exact limit for your household size and situation. You can find the phone number by searching "[your state] Medicaid" or by visiting the Centers for Medicare & Medicaid Services (CMS) website, which lists all state Medicaid offices.

You can also search online for "[your state] Medicaid income limits" — most states publish a table showing the limit for each family size. Some states include the limit in their online application. If you are not sure whether you may have access to, you can start an application; most states will tell you whether your income is within the limit before you finish.

If you are unemployed or your income is very low and unstable, bring recent pay stubs, a letter from your employer, or tax returns when you contact Medicaid. Having documentation ready speeds up the process and makes it easier for the caseworker to understand your situation.

Frequently Asked Questions

Does my spouse's income count if we are married but file taxes separately?

In most states, yes — Medicaid counts a spouse's income even if you file taxes separately. A few states have different rules for legally separated people. Call your state Medicaid office to ask whether your spouse's income will be counted in your case.

What if I am self-employed and my income varies month to month?

Most states average your self-employment income over the past three months or use your most recent tax return. If you are newly self-employed and do not have a tax return yet, some states will look at your recent bank deposits or a signed statement of expected income. Ask your state Medicaid office what documents they need.

Can I get Medicaid if I am working but earning very little?

Yes, if your total household income is below your state's limit. Some states exclude the first $65 of your monthly earnings before counting income, which can help. In expansion states, a single adult working part-time and earning under about $20,000 per year would likely may have access to.

Do I lose Medicaid immediately if my income goes over the limit?

No. Most states give you a one- or two-month grace period after your income rises above the limit. If your income drops back down during that time, you can report the change and keep your coverage. After the grace period ends, your coverage stops.

What if my state has not expanded Medicaid and I do not may have access to?

You may be able to buy coverage through the Affordable Care Act marketplace. If your income is between 100% and 400% of the poverty line, you may receive a tax credit to lower your premium. You can compare plans and enroll at healthcare.gov or your state's marketplace website.