Medicaid does not stop at a specific age, but your coverage type and income limits change at key points

Medicaid continues from birth through old age for people who meet income and other requirements. However, the program you are on shifts at certain ages, and the rules about what counts as income change. A child on Medicaid does not automatically lose coverage on their 18th or 19th birthday — but the program they are on may change, and their parent's income no longer counts toward their own may be able to access.

The most common transition points are age 18 (when you move from child Medicaid to adult Medicaid) and age 65 (when you become may be able to access for Medicare, which usually becomes your primary insurance). Between those ages, Medicaid continues as long as your income and household size stay within your state's limits. Each state sets its own income thresholds, so the point at which you lose coverage depends on where you live and which category of Medicaid you are on.

Key Takeaways

  • Medicaid does not end at 18, but the rules change — your parent's income no longer counts, and you are evaluated as your own household.
  • At 65, you become may be able to access for Medicare, which becomes your primary insurance, though Medicaid may continue to cover costs Medicare does not.
  • You can lose Medicaid at any age if your income rises above your state's limit, you move to a state with different rules, or you no longer meet other requirements like citizenship or residency.
  • Some states expanded Medicaid to cover adults earning up to 138% of the federal poverty level; others have lower limits, so your coverage depends on your state and income category.
  • If you turn 18 and your parent's income was the reason you had Medicaid, you may need to reapply as an adult, because your own income is now what matters.

What happens to child Medicaid when you turn 18

When you turn 18, you are no longer considered a dependent, so your parent's or guardian's income stops counting toward your Medicaid may be able to access. This is the biggest change at that age. If you were on Medicaid because your family's income was low, you will need to report your own income when you turn 18. If you earn little or nothing, you will likely stay on Medicaid. If you earn enough that your income alone exceeds your state's adult limit, your coverage will end.

You do not automatically lose coverage on your 18th birthday. Your state's Medicaid program should send you a notice before your 18th birthday explaining what will happen and asking you to provide your own income information. Some states call this a "redetermination" or "renewal." You must respond with your current income and household information. If you do not respond, your coverage may be terminated, though most states give you a grace period to submit the paperwork.

If you are still in high school or enrolled in college, your status as a student does not affect Medicaid may be able to access — only your income and your state's rules matter. Some states have separate programs for young adults aged 18 to 26, but these are still based on your own income, not your parent's.

Medicaid and Medicare at age 65

At 65, you become may be able to access for Medicare, the federal insurance program for older adults. This does not automatically end your Medicaid, but it changes how the two programs work together. Medicare becomes your primary insurance, meaning it pays first. Medicaid then covers some of the costs that Medicare does not — such as copayments, coinsurance, and deductibles. This combination is sometimes called "dual coverage."

You must enroll in Medicare Part A (hospital insurance) and Part B (medical insurance) when you turn 65, or you will face penalties if you sign up later. You can enroll starting three months before your 65th birthday. If you are already on Medicaid, you should contact your state Medicaid office to let them know you have enrolled in Medicare, so they can update their records and coordinate benefits correctly.

Medicaid does not end at 65 if you continue to meet your state's income and resource limits. However, Medicare's income limits are different from Medicaid's, and some people who may have access to for Medicaid before 65 may no longer may have access to after 65 because Medicare counts as income in some states. Check with your state Medicaid program to understand how your coverage will change.

Income limits and when you lose coverage

You can lose Medicaid at any age if your income rises above your state's limit. Each state sets its own income threshold for Medicaid. Some states that expanded Medicaid cover adults earning up to 138% of the federal poverty level (about $1,967 per month for a single person in 2024, though this amount changes yearly). Other states have much lower limits — some cover only adults earning up to 100% of the poverty level, or only parents with children, or only people over 65 or with disabilities.

When your income changes, you are usually required to report it to your state Medicaid program within 30 days. If your income exceeds the limit, your coverage will end, typically at the end of the month in which you reported the change. Some states allow a grace period or phase-out, but most do not. If you lose Medicaid because of income, you may be able to purchase insurance through the health insurance marketplace, and you may be may be able to access for subsidies if your income is between 100% and 400% of the poverty level.

Other reasons you can lose Medicaid at any age include moving to another state (you must reapply in your new state), no longer meeting citizenship or residency requirements, or failing to respond to a renewal notice. Most states require you to renew your Medicaid every 12 months by submitting updated income and household information.

Special rules for pregnant people and new parents

Pregnant people and new parents have different Medicaid rules that can extend coverage beyond the normal income limits. Many states cover pregnant people and postpartum people at higher income levels than they cover other adults. Some states cover pregnant people earning up to 200% or 300% of the federal poverty level, even though they would not may have access to for regular adult Medicaid at that income.

Postpartum coverage typically lasts 60 days after the end of pregnancy in most states, though some states have extended this to 12 months. After the postpartum period ends, you will be evaluated for regular adult Medicaid based on your income and your state's standard rules. If your income is too high, your coverage will end, even if you have a newborn. Some states have separate programs for children or parents that may help you stay covered.

What to do if your Medicaid is ending or has ended

If you receive a notice that your Medicaid will end, read it carefully and note the end date. You have the right to request a hearing if you believe the decision is wrong. Contact your state Medicaid program to ask how to file an appeal — you usually have 30 to 60 days from the notice date.

If your coverage ends because your income is too high, you can look for insurance through the health insurance marketplace at healthcare.gov (or your state's marketplace). You may be able to enroll outside the normal open enrollment period if you lost Medicaid, which counts as a "may have access to life event." You may also be may be able to access for premium tax credits or cost-sharing reductions if your income is between 100% and 400% of the federal poverty level.

If your coverage ends for another reason — such as failure to renew or moving to a new state — you can reapply at any time. Contact your state Medicaid program or use the online application portal to start the process. If you are experiencing a hardship, some states have expedited processing or emergency Medicaid programs.

Medicaid in different states and territories

Medicaid rules vary significantly by state. Some states expanded Medicaid to cover more adults; others have not. Some states cover people earning up to 138% of the poverty level; others cover only people earning up to 100% or less. Some states have separate programs for young adults, parents, or people with disabilities that may keep you covered even if you do not may have access to for standard adult Medicaid.

To find out your state's specific income limits and rules, contact your state Medicaid program directly or visit its website. You can also call 211 to be connected to local resources that can explain your state's Medicaid rules and help you understand when your coverage might end. If you live in a U.S. territory such as Puerto Rico or the U.S. Virgin Islands, Medicaid rules are different and are set by the territory's government.

Frequently Asked Questions

Does my child automatically lose Medicaid when they turn 18?

No, but the rules change. Your child's own income becomes the measure of may be able to access instead of your family's income. Your state will send a notice asking for your child's current income information. If your child earns little or nothing, they will likely stay covered. If their income exceeds your state's adult limit, coverage will end.

What is the income limit for adult Medicaid in my state?

Income limits vary by state and by category (parent, pregnant person, adult without children, person with disability). Contact your state Medicaid program or visit its website to find the exact limit. You can also call 211 for help understanding your state's rules.

Can I keep Medicaid after I turn 65 if I enroll in Medicare?

Yes. Medicare becomes your primary insurance at 65, and Medicaid can continue to cover costs Medicare does not pay. You must enroll in Medicare Part A and Part B, and you must meet your state's Medicaid income and resource limits. Contact your state Medicaid program when you turn 65 to update your information.

What happens if I move to a different state?

Medicaid does not transfer between states. You must apply for Medicaid in your new state using that state's rules and income limits. Your old state's coverage will end on the date you move. Apply in your new state as soon as you arrive to avoid a gap in coverage.

Can I appeal if my Medicaid ends?

Yes. You have the right to request a hearing if you believe your coverage ended incorrectly. Contact your state Medicaid program within 30 to 60 days of receiving the notice to ask how to file an appeal. You can also ask for an expedited hearing in some cases.