Medicaid requirements depend on your state, income, and household size

Medicaid is run by each state within federal guidelines, so the rules that matter to you are the ones your state sets. Your state decides the income limit, which assets you can own, which family members count toward your household, and whether you fall into a category your state covers. Two people with identical income and family size can have different results in different states.

The core requirement is that your income must fall below your state's limit. Most states also look at your assets — the money and property you own — though the limits are usually high enough that a car, a home, and a modest savings account do not disqualify you. Some states require you to be a U.S. citizen or may have access to immigrant. Age, disability, pregnancy, or caring for children can also affect whether you meet the rules.

The fastest way to learn your state's specific requirements is to contact your state Medicaid office directly or use your state's online screening tool. Many states have a simple form you fill out that tells you within minutes whether you likely meet the requirements.

Key Takeaways

  • Each state sets its own Medicaid income limits, asset limits, and covered categories, so you must check your state's rules, not national averages.
  • Your household income is measured against your state's limit, and household size includes you, your spouse if you have one, and your children under 19 in most cases.
  • Most states allow you to own a home and a car without losing Medicaid, but have limits on cash savings and other liquid assets.
  • Your state Medicaid office or your state's online screening tool can tell you in minutes whether you likely meet the requirements.
  • Pregnancy, disability, age 65 or older, or caring for children can lower the income limit your state uses to determine whether you meet the rules.

How your state measures household income

Your state counts the income of everyone in your household, which typically means you, your spouse if you are married, and your children under 19 (or 20 in some states if they are still in high school). Income includes wages, self-employment earnings, Social Security, unemployment benefits, child support, and some retirement income. Different states count different types of income differently — some exclude the first $65 of monthly earnings, others do not.

Your state compares your total household income to the limit it has set. That limit is usually expressed as a percentage of the federal poverty line. For example, your state might cover anyone whose income is at or below 138% of the federal poverty line. The federal poverty line changes each year, so the income limit your state uses also changes each year.

Some states use gross income (before taxes and deductions), while others use net income (after certain deductions). A few states allow you to deduct medical expenses or work-related costs before they compare your income to the limit. Ask your state Medicaid office which method your state uses, because the difference can matter.

Asset limits and what they mean for your savings

Most states that have asset limits set them high enough that you can own a home, a car, and several thousand dollars in a bank account without losing Medicaid. The exact limit varies by state and by category — someone who is elderly or disabled may have a higher asset limit than someone who is not. Some states have no asset limit at all.

Assets that usually do not count include your primary home, one vehicle, household goods, and personal items. Assets that usually do count include cash, savings accounts, checking accounts, money market accounts, and stocks or bonds. If you are married, your state may count only your assets, only your spouse's assets, or both together — the rule depends on your state and your situation.

If you are close to an asset limit, ask your state Medicaid office what counts and what does not. Some states have special rules for certain situations, such as setting aside money for burial or allowing you to transfer assets to a spouse or child under specific conditions.

Citizenship and immigration status requirements

Most states require you to be a U.S. citizen or a may have access to immigrant to receive Medicaid. may have access to immigrants include lawful permanent residents (green card holders), refugees, asylees, and some other categories defined by federal law. The rules are specific, and immigration status can change how long you must wait before you become may be able to access.

If you are not a citizen, bring your immigration documents when you contact your state Medicaid office. They can tell you whether your status qualifies you. Some states cover certain non-citizens under state-funded programs even if federal Medicaid does not, so it is worth asking even if you are told you do not meet the federal requirement.

Age, disability, and family status categories

Your state may cover you under different rules depending on your age or situation. Children, pregnant people, parents of minor children, elderly people (usually 65 or older), and people who are blind or disabled may each have different income limits. Some states cover pregnant people at a higher income limit than other adults, or cover children at a higher limit than their parents.

If you are disabled, you may need to provide medical evidence of your disability. Your state will have a specific definition of disability for Medicaid purposes, which is different from the Social Security definition. If you receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you are usually automatically may be able to access for Medicaid in most states, though you should confirm this with your state office.

If you are a parent or caregiver for children, your state may cover you at an income level that would not cover you otherwise. Ask your state Medicaid office whether your household composition affects your may be able to access.

Work and income requirements for able-bodied adults

Some states have added work or community engagement requirements for adults without dependent children. These requirements vary widely — some states require 20 hours per week of work, job training, or volunteer service, while others have different rules. Not all states have these requirements, and some states have paused or removed them.

If you are an able-bodied adult without dependent children, ask your state Medicaid office whether work requirements apply to you. If they do, ask what counts as meeting the requirement — work, school, job training, volunteer service, and caregiving may all count depending on your state. Some states allow medical reasons or hardship to exempt you from the requirement.

How to find your state's specific requirements

Your state Medicaid office is the authoritative source for your state's rules. You can find contact information by searching "[your state] Medicaid" online or by calling 211, which connects you to local health and human services information. Many states also have an online screening tool where you enter your income and household information and receive an immediate answer about whether you likely meet the requirements.

When you contact your state office, have ready your household size, your household income for the past month or year (depending on what your state asks for), and your citizenship or immigration status. If you are disabled, have information about your disability available. The office can tell you what documents you will need to provide if you move forward.

Frequently Asked Questions

Does my spouse's income count if we are married?

Yes, in most cases. Your state counts both spouses' income as household income and compares the total to the limit. If you are separated or divorced, only your income counts. If you are married but file taxes separately, ask your state whether it counts both incomes or uses a different method.

What if my income changes after I am approved?

You must report significant income changes to your state Medicaid office. If your income rises above the limit, your coverage may end. If your income drops, you may become may be able to access if you were not before. Your state will tell you how often you must report changes and what counts as a reportable change.

Can I own a home and still get Medicaid?

Yes. Your primary home does not count as an asset in most states, even if it is worth a lot of money. If you own a second home or rental property, that may count. Ask your state Medicaid office about your specific situation.

Do I have to be a citizen to get Medicaid?

Most states require U.S. citizenship or may have access to immigrant status. may have access to immigrants include green card holders and refugees. Some states cover certain non-citizens under state-funded programs. Contact your state Medicaid office with your immigration documents to find out whether you meet the requirement.

What happens if I do not meet the income limit in my state?

You may be able to purchase coverage through the health insurance marketplace, where you may receive a tax credit to lower your monthly cost depending on your income. You can also look into whether your state has other health coverage programs for people who do not meet Medicaid limits.