Medicaid covers people at any age, 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 maximum age. What changes with age is which income and resource limits apply to you, and which programs within Medicaid you may be able to use. A child under 19 has different income thresholds than a working-age adult, who has different thresholds than someone over 65. Your state also sets its own income limits within federal guidelines, so the age-based rules in your state may differ from those in another state.

The most important thing to know is that age itself does not disqualify you. Age determines how much money you can have and still be covered, not whether you can be covered at all.

Key Takeaways

  • Medicaid covers infants, children, working-age adults, and seniors — there is no age cutoff for coverage.
  • Income limits are lower for children than for adults, and different again for people over 65 or blind or disabled.
  • Your state sets its own income thresholds within federal rules, so limits vary by location.
  • If you are over 65, you may also be able to use Medicare, and Medicaid can help pay Medicare premiums and cost-sharing.
  • Pregnant people and parents of young children often have higher income limits than other adults in the same state.

Income limits for children under 19

Every state must cover children under 19 whose household income is at or below 138% of the federal poverty line. Many states cover children at higher income levels — some go up to 200% or 300% of poverty. A child's income limit does not change based on how many siblings are in the household; each child is evaluated separately.

To find your state's exact limit for children, contact your state Medicaid office or use the Medicaid.gov state finder. The limit changes each year when the federal poverty line is updated, usually in January.

Income limits for working-age adults (19 to 64)

Working-age adults have lower income limits than children in most states. The federal minimum is 138% of the poverty line, but your state may set a lower limit. Some states also have different limits for parents versus non-parents, or for pregnant people.

If you are pregnant, you may have a higher income limit than you would as a non-pregnant adult. The same applies if you are the parent or caretaker of a child under 18. These higher limits exist in most states but not all, so check your state's rules directly.

Income limits for people 65 and older

People 65 and older are treated as a separate group for Medicaid purposes. The income limit for seniors is often higher than for working-age adults in the same state, though this varies. Once you turn 65, you become may be able to access for Medicare, and Medicaid can then help pay your Medicare premiums, deductibles, and cost-sharing — a role called "Medicare Savings Programs" or "Medicaid Buy-In."

If you are 65 or older and have limited income, you may be able to use both programs at once. Medicaid will not pay for services Medicare covers, but it covers services Medicare does not, such as long-term care and dental work.

Special income rules for blind or disabled people

If you are blind or disabled at any age, you may have access to Medicaid under rules separate from the age-based limits above. The income limit for blind or disabled people is often higher than for non-disabled working-age adults. You will need to provide medical evidence of blindness or disability; a doctor's statement or Social Security disability information letter usually counts.

Some states also allow people who are blind or disabled to keep more resources (savings, property) than other adults. The rules are complex and vary by state, so speak with your state Medicaid office if you believe you may have access to under this category.

How your state's rules may differ from other states

Medicaid is jointly funded by the federal government and the states, and each state runs its own program within federal guidelines. This means your state's income limits, covered services, and age-related rules may be different from a neighboring state's. For example, one state may cover working-age adults up to 138% of poverty, while another covers them only up to 100%.

The only way to know your state's specific rules is to contact your state Medicaid office or visit your state's Medicaid website. You can find your state office through Medicaid.gov or by calling 211 and asking for your local Medicaid office.

What happens when you turn 19 or 65

If you are covered as a child and turn 19, your income limit will change to the working-age adult limit in your state. This may be lower than the child limit, so you may lose coverage if your household income is now above the adult threshold. Some states have "continuous coverage" rules that let you stay on Medicaid for a few months after you turn 19, giving you time to find other coverage.

When you turn 65, you become may be able to access for Medicare. You do not automatically lose Medicaid, but your coverage may change. You may move into a Medicare Savings Program, or you may stay on Medicaid alone if your income is low enough. Your state will contact you to explain what happens next.

Frequently Asked Questions

Can a newborn be on Medicaid?

Yes. A newborn can be covered from birth if the household income meets your state's limit for children. Many states cover newborns at higher income levels than they cover other family members. You can report the birth to your state Medicaid office, and coverage usually starts on the date of birth.

What if my income is above the limit for my age group?

If your income exceeds your state's limit, you do not may have access to for Medicaid based on income alone. However, you may may have access to under a different category — for example, if you are pregnant, disabled, or caring for a child. You can also look into marketplace insurance through Healthcare.gov, which may have lower costs if your income is moderate.

Do I lose Medicaid when I turn 65?

Not automatically. When you turn 65, you become may be able to access for Medicare, but Medicaid does not end. Your coverage may change — you may move into a Medicare Savings Program, or you may stay on Medicaid alone. Your state will notify you of the change and explain your options.

Can my age group's income limit change during the year?

The federal poverty line, which determines income limits, is updated once a year in January. Your state may adjust its Medicaid income limits at that time. If your income changes during the year, report it to your state Medicaid office — your coverage may change, or you may become newly covered.