Who Medicaid Covers

Medicaid covers people based on income, family size, disability status, age, or pregnancy — not on employment or insurance history. Each state sets its own income limits and decides which groups to cover, so the threshold in one state may not match another's. The federal government sets a floor; states can go higher.

You do not need to be a U.S. citizen to get Medicaid in most states, though you do need to be a legal resident. Undocumented immigrants are generally excluded except in a few states that cover emergency services or pregnancy care regardless of status.

The main groups Medicaid covers are children under 19, pregnant people, parents and caretakers of dependent children, people over 65, people who are blind or disabled, and in some states, childless adults earning below a certain threshold. If you fall into one of these categories, your income and assets determine whether you meet your state's specific limits.

Key Takeaways

  • Medicaid income limits vary by state and family size, and you can find your state's exact threshold on your state health department website or at Healthcare.gov.
  • You must be a U.S. citizen or legal resident, though a few states cover emergency care for undocumented immigrants.
  • Medicaid covers children, pregnant people, parents with dependent children, seniors, and people with disabilities; some states also cover childless adults below the income line.
  • Your household income is counted differently depending on your state and which Medicaid program you are seeking — some count only your own income, others count a spouse's or parent's income too.
  • You can check whether you may be covered and find your state's contact information through Healthcare.gov or by calling 211.

Income Limits and How Your State Calculates Them

Your state publishes its Medicaid income limit as a percentage of the federal poverty line. For 2024, the federal poverty line for a single person is around $14,600 per year, and for a family of four around $30,000 — but your state may set its limit at 130 percent, 200 percent, or another percentage of that line. Some states are more generous than others.

Income is usually counted as gross monthly earnings before taxes. Self-employment income, child support, and some other sources count too. However, certain income does not count — Social Security benefits may be excluded in some programs, and some states disregard a portion of work income for people with disabilities.

Your state also counts household size. A single person has one threshold; a family of four has a higher one. If you are unsure whether your income falls within your state's limit, your state Medicaid office can tell you the exact number and explain how they count your household.

Asset Limits and What They Mean

Some Medicaid programs have asset limits — a cap on how much money, property, or other resources you can own and still be covered. Traditional Medicaid for seniors and people with disabilities often has a limit of $2,000 for a single person or $3,000 for a couple, though this varies by state and program.

Medicaid for children, pregnant people, and parents usually has no asset limit at all. Your home and one car do not count toward the limit in most states. Bank accounts, stocks, and other liquid assets do count.

If you are close to an asset limit, ask your state Medicaid office which assets count and which do not. Some states allow you to spend down assets on medical care or set them aside in a trust before you apply.

Citizenship and Residency Requirements

You must be a U.S. citizen or a may have access to non-citizen to get Medicaid. may have access to non-citizens include lawful permanent residents (green card holders), refugees, asylees, and some other immigration statuses. You will need to provide proof — usually a birth certificate for citizens, or immigration documents for non-citizens.

You must also live in the state where you are applying. Most states do not require you to have lived there for a certain length of time, but a few do. If you recently moved, ask your new state's Medicaid office whether there is a waiting period.

A small number of states — California, Illinois, New York, and a few others — cover emergency services for undocumented immigrants. If you are undocumented and need care, contact your state Medicaid office to learn what is available where you live.

How Family Size and Household Composition Affect Coverage

Medicaid counts your household differently depending on which program you are seeking. For children and pregnant people, the household usually includes only the child or pregnant person and their parents or guardians. For parents seeking coverage, it includes the parent and their dependent children.

A spouse's income and assets count toward your household total in most cases. If you are married, your spouse's earnings will be included even if they do not apply for Medicaid themselves. For children, a non-custodial parent's income usually does not count.

If you live with someone who is not related to you, they are not part of your household for Medicaid purposes. Roommates, partners, and other unrelated adults do not affect your application.

Special Circumstances: Disability, Pregnancy, and Age

If you are pregnant, most states cover you regardless of income — this is called emergency Medicaid for pregnancy. You will need to show proof of pregnancy, usually a letter from a doctor or midwife. Coverage typically lasts through the end of the month after you give birth.

If you are disabled or blind, you may be covered under a separate Medicaid program with different income and asset rules than regular Medicaid. You will need medical documentation of your disability from a doctor. The Social Security Administration's definition of disability is often used, but some states have their own standards.

If you are over 65, you are covered under Medicare first if you have worked long enough to earn it. Medicaid can cover your Medicare premiums and out-of-pocket costs if your income is low enough — this is called Medicare Savings Programs or Medicaid for seniors.

How to Find Your State's Specific Requirements

Your state Medicaid office publishes its income limits, asset limits, and covered groups on its website. You can also find this information on Healthcare.gov by entering your state and income. The site will tell you whether you may be covered and provide your state's contact information.

You can also call 211 — a free helpline available in most areas — and ask about Medicaid in your state. The representative can tell you your state's limits and help you understand whether your situation may may have access to.

If you are applying, your state will ask for proof of income (pay stubs, tax returns, or a letter from your employer), proof of citizenship or residency, and proof of your household composition (birth certificates, marriage license, or custody documents). Having these ready speeds up the process.

Frequently Asked Questions

Does my income have to be below the poverty line to get Medicaid?

No. Most states set their Medicaid income limit higher than the poverty line — often at 130 to 200 percent of it. Your state's specific limit depends on which Medicaid program you are seeking and which group you fall into. Check your state's website or call 211 to learn your state's exact threshold.

What counts as income for Medicaid?

Gross monthly earnings from a job, self-employment income, child support, and some other sources count. Social Security benefits may or may not count depending on your state and program. Ask your state Medicaid office which types of income they count and whether they disregard any portion of your earnings.

Can I get Medicaid if I am not a citizen?

You can if you are a lawful permanent resident, refugee, asylee, or certain other immigration statuses. Undocumented immigrants are generally not covered except for emergency services in a few states. Contact your state Medicaid office to learn what is available based on your immigration status.

Do I have to report my assets when I apply for Medicaid?

It depends on your state and which Medicaid program you are seeking. Medicaid for children and pregnant people usually has no asset limit. Medicaid for seniors and people with disabilities often does. Your state will tell you whether assets are counted and what the limit is.

What happens if my income changes after I get Medicaid?

You must report the change to your state Medicaid office. If your income rises above the limit, your coverage may end. If it drops, you may become covered or move to a different Medicaid program. Report changes as soon as they happen to avoid losing coverage or owing money back.