Medicaid may be able to access depends on your income, family size, and which state you live in

Medicaid is a joint federal and state program, which means each state sets its own income limits and rules. There is no single national threshold. A person with the same income and family size might be covered in one state and not in another. To know whether you meet the requirements, you need to check your specific state's rules — not a national average.

The main factors that matter are: your household income (measured against the federal poverty line), your family size, your age or disability status, and your citizenship. Most states also look at whether you have other insurance available. Some states have expanded Medicaid to cover more people; others have not.

The fastest way to find out is to contact your state Medicaid office directly or use your state's online screening tool. Many states also accept referrals through 211, a free helpline that connects you to local programs. You do not need to complete a full application to get an initial answer — a short phone call or online form can tell you whether you likely meet the basic requirements.

Key Takeaways

  • Income limits vary by state and family size; earning $20,000 per year might make you covered in one state and ineligible in another.
  • Your state Medicaid office or your state's online screening tool can tell you in minutes whether your income and family size meet the threshold.
  • Medicaid covers children, pregnant people, parents, seniors, and people with disabilities, but the income cutoff for each group differs by state.
  • Some states expanded Medicaid to cover adults earning up to 138% of the federal poverty line; others did not, creating a gap for working adults.
  • Citizenship and immigration status matter; most states require U.S. citizenship or certain immigration statuses, though emergency services may be covered regardless.

How income limits work and why they vary by state

Federal poverty guidelines set a baseline, but states can set their own limits higher or lower. For 2024, the federal poverty line for a single person is approximately $15,000 per year; for a family of four, approximately $31,000. However, a state might cover people earning up to 138% of that line, or only 100%, or somewhere in between.

States that expanded Medicaid under the Affordable Care Act generally cover adults earning up to 138% of the federal poverty line. States that did not expand cover far fewer adults — often only parents earning well below the poverty line, or only people over 65 and people with disabilities. This means a 35-year-old earning $25,000 per year might be covered in an expansion state but not in a non-expansion state.

Your state's Medicaid website lists the exact income limit for each category of person (children, parents, seniors, people with disabilities). The limit is usually given as a percentage of the federal poverty line or as a specific dollar amount. If your income is below that number, you meet the income requirement. If it is above, you do not — though some states have exceptions for people with high medical expenses.

Who is covered: age, disability, and family status

Medicaid covers different groups depending on your state. All states must cover children up to age 19 in households earning below a certain threshold — usually higher than the limit for adults. Most states cover pregnant people and new parents. Many states cover seniors (usually age 65 and older) with limited income. People with disabilities can often get Medicaid regardless of age if they meet income and disability requirements.

Working-age adults without children or disabilities are the hardest group to cover. In expansion states, they can get Medicaid if they earn below 138% of the poverty line. In non-expansion states, they typically cannot get Medicaid at all unless they are over 65, have a disability, or are pregnant.

Your category matters because each has its own income limit. A child might be covered at a higher income level than a parent in the same household. A person with a disability might have a higher limit than a working adult. Check your state's rules for your specific situation.

Citizenship and immigration status requirements

Most states require U.S. citizenship or certain immigration statuses to get Medicaid. Lawful permanent residents (green card holders) are usually covered. People with temporary protected status, asylum seekers, and undocumented immigrants are typically not covered by regular Medicaid, though some states have created their own programs to cover undocumented residents.

Emergency services are often an exception. Many states must cover emergency medical care for anyone who needs it, regardless of immigration status. Some states also cover pregnancy-related care and care for children regardless of status. Check your state's rules if immigration status is a factor in your situation.

You will need to provide proof of citizenship or immigration status when you apply. Acceptable documents include a birth certificate, passport, green card, or certain visa documents. If you are unsure whether your status qualifies, ask your state Medicaid office before you apply.

How to check your state's specific rules

Your state Medicaid office maintains a website with income limits, covered groups, and the application process. Search "[your state] Medicaid income limits" or "[your state] Medicaid" to find it. The site usually has a screening tool or a phone number you can call.

Many states also use the federal 211 helpline. Call 211 or visit 211.org, enter your zip code, and ask for Medicaid information. A local specialist can tell you what your state covers and whether you likely meet the requirements based on a short conversation.

Some states use a single application for Medicaid, SNAP (food assistance), and other programs. If you are already receiving SNAP or other benefits, your state may have already verified your income and family size, which can speed up a Medicaid application.

What happens after you learn you might be covered

If your income and family size appear to meet your state's requirements, the next step is to submit an application. Most states accept applications online, by mail, or in person at a local office. The application asks for proof of income (recent pay stubs, tax returns, or a letter from your employer), proof of citizenship or immigration status, and information about your household.

Processing usually takes 30 to 45 days, though some states are faster. Your state will send you a notice saying whether you are covered and when your coverage begins. If you are denied, the notice will explain why and tell you how to appeal.

If you are approved, you will receive a Medicaid card or number. You can use it immediately at doctors, hospitals, and pharmacies that accept Medicaid. Coverage is usually retroactive for up to three months before you applied, so medical bills from that period may be covered even if you applied after receiving them.

Special situations: disability, pregnancy, and changes in income

People with disabilities may have different income limits than working-age adults without disabilities. Some states use a higher threshold; others use the same limit but count income differently (for example, excluding certain work-related expenses). If you receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), you may be automatically covered or have a streamlined application process.

Pregnancy is a covered category in all states. If you are pregnant, you may be covered even if your income is above the limit for other adults. Coverage usually continues for 60 days after the pregnancy ends. If you have a child, that child is usually covered separately under the children's category, which often has a higher income limit than the parent category.

If your income changes — you lose a job, get a raise, or have a change in family size — you can report it to your state Medicaid office. Your coverage may change, or you may become newly covered. Some states allow you to update your information online; others require a phone call or mail.

Frequently Asked Questions

Does having a job disqualify me from Medicaid?

No. Medicaid is based on income, not employment status. If you work but earn below your state's income limit, you can be covered. Some states even have programs that help working people stay on Medicaid when they earn slightly above the limit.

What if I have other insurance through my job?

Having employer insurance does not automatically disqualify you. Your state will look at your income first. If you are below the limit, you may be covered by both Medicaid and your employer plan. Medicaid can pay for services your employer plan does not cover or help with copays and deductibles.

Can I be covered if I am not a U.S. citizen?

It depends on your immigration status. Lawful permanent residents are usually covered. Undocumented immigrants are typically not covered by regular Medicaid, though some states have created separate programs. Emergency care is often covered regardless of status. Contact your state Medicaid office to learn what applies to you.

What if my state did not expand Medicaid?

Non-expansion states cover fewer adults. You may still be covered if you are a parent, senior, or person with a disability earning below your state's limit. If you are a working-age adult without those statuses, you may not be covered by Medicaid but might be covered by a marketplace plan with a tax credit. Check healthcare.gov for other options.

How far back does Medicaid coverage go if I am approved?

Most states cover medical bills from up to three months before you applied, even if you were not yet approved. This is called retroactive coverage. Check your state's rules, as some states cover a shorter period or have exceptions for certain services.