Medicaid income limits are set by your state, not by the federal government, and they change based on family size and composition
Medicaid does not have a single national income limit. Each state sets its own threshold for who can receive coverage, which means a household that qualifies in one state may not may have access to in another. The limit depends on your household size, your state of residence, and sometimes your age or disability status. Most states use the federal poverty level as a starting point and then set their own percentage above it — some states cover people at 100% of poverty, others at 138%, and a few go higher or lower.
Your income is counted as gross monthly income before taxes. This includes wages, self-employment income, Social Security, unemployment benefits, child support, and most other regular payments. Some income sources are excluded — for example, the first $65 per month of earned income and the first $20 per month of unearned income are often not counted, though rules vary by state and by category of Medicaid (children, adults, elderly, disabled).
Because states set their own limits and update them annually, the exact number for your household is not something you can look up in a general guide. You need to check your specific state's current limits or use your state's Medicaid office to find out whether your income falls within the range.
Key Takeaways
- Medicaid income limits vary by state and are usually expressed as a percentage of the federal poverty level, ranging from 100% to 138% or higher depending on where you live.
- Income is counted as gross monthly income before taxes, and includes wages, benefits, and support payments, though some income sources are partially or fully excluded.
- Your state's Medicaid office or your state health department website will show the current income limits for your household size and category.
- Even if your income is above the limit, you may still be covered under special rules for pregnant people, children, elderly people, or people with disabilities.
- Income limits are updated each year, usually in January, so you should check your state's current limits rather than relying on information from previous years.
How states set their income thresholds
The federal government sets the poverty level each year — for 2024, the federal poverty level for a family of four is approximately $31,200 per year, or about $2,600 per month. States then decide what percentage of that level to use as their Medicaid cutoff. A state that covers people at 138% of poverty would cover that same family of four if their gross monthly income is roughly $3,586 or less.
Some states are more generous than others. States that expanded Medicaid under the Affordable Care Act typically cover adults up to 138% of poverty. States that did not expand Medicaid often have much lower limits — some cover only people at or below 100% of poverty, and a few cover only people with disabilities, elderly people, or children, with little or no coverage for working-age adults without dependents.
Your state's Medicaid program publishes its current income limits on its website, usually under a section called "Income Guidelines" or "may be able to access." You can also call your state Medicaid office or use the 211 helpline to ask what the limit is for your household size.
Income limits by household size and category
Medicaid programs often have different income limits for different groups. A state might cover children up to 200% of poverty, pregnant people up to 185%, elderly people up to 100%, and working-age adults without disabilities up to 138%. This means your income might make you ineligible for one category but may be able to access for another.
Household size matters because the poverty level increases with each additional person. A single person has a lower poverty threshold than a family of three. When you report your income, you will need to list everyone in your household — usually anyone who lives with you and shares income or expenses, though the exact definition varies by state.
| Household Size | 2024 Federal Poverty Level (Annual) | 2024 Federal Poverty Level (Monthly) |
|---|---|---|
| 1 person | $14,600 | $1,217 |
| 2 people | $19,720 | $1,643 |
| 3 people | $24,860 | $2,072 |
| 4 people | $31,200 | $2,600 |
| 5 people | $37,540 | $3,128 |
These are the federal poverty levels that states use as a baseline. A state covering at 138% of poverty would multiply these numbers by 1.38. Your state may use a different percentage, so check your state's specific limits rather than calculating from these figures.
What counts as income and what does not
Gross income includes almost any regular money coming into your household: wages from a job, self-employment income, Social Security, Supplemental Security Income (SSI), unemployment benefits, workers' compensation, child support, alimony, pensions, and rental income. It is counted before taxes are taken out.
Some income is excluded or partially excluded. Most states do not count the first $65 per month of earned income (money from work) and the first $20 per month of unearned income (money from benefits or support). Some states exclude child support entirely. Medicaid for the elderly and disabled may have different exclusions than Medicaid for working-age adults and children.
Money that is not counted as income includes gifts, loans, tax refunds, and one-time payments. If you receive a lump sum — for example, from a settlement or inheritance — it may affect your resources (savings) but not your monthly income count.
How to find your state's current income limits
Your state Medicaid office publishes income limits on its website. Search for "[Your State] Medicaid income limits" or "[Your State] Medicaid may be able to access." Most state sites have a page that lists the limits by household size and category, updated annually.
You can also contact your state Medicaid office directly by phone or through its website. Many states have online tools where you can enter your household size and income to see whether you may be covered. These tools are informational only — they do not determine your actual coverage, but they can give you a quick answer about whether it is worth pursuing further.
The 211 helpline (dial 211 from any phone) can also tell you your state's income limits and connect you to your local Medicaid office. Staff there can answer questions about your specific situation and tell you what documents you will need to bring when you apply.
What happens if your income is above the limit
If your income exceeds your state's Medicaid limit, you may still have other options. Some people are covered under special rules: pregnant people, children, elderly people, and people with disabilities often have higher income limits or separate programs. Some states also cover people through work-related programs or medically needy categories, which allow higher income if you have significant medical expenses.
If you do not may have access to for Medicaid, you may be able to purchase coverage through the Health Insurance Marketplace (healthcare.gov) and may be may be able to access for tax credits or cost-sharing reductions based on your income. You can also check whether you may have access to for other assistance programs like the Low Income Home Energy Assistance Program (LIHEAP) or food assistance, which have their own income limits.
Income limits change every year
The federal poverty level is updated each year, usually in January. When it changes, state Medicaid income limits change as well. This means that even if you were ineligible last year, you might be may be able to access this year, or vice versa. It is worth checking your state's limits annually, especially if your income has not changed — the threshold may have moved.
Some states also change their Medicaid program rules or coverage categories from year to year. If you were denied Medicaid in the past, it is worth applying again to see whether the rules have changed or whether your circumstances now fit a different category.
Frequently Asked Questions
Does Medicaid count my spouse's income if we are married?
Yes, in most cases. Medicaid counts the income of your spouse as part of your household income, even if you file taxes separately. Some states have different rules for elderly or disabled people, so check your state's policy. If you are applying for Medicaid for a child, only the parents' income is usually counted, not a grandparent's or other relative's.
What if my income varies month to month because I work irregular hours?
Medicaid usually uses your average income over the past three months or your expected income for the next month, depending on your state. If you are self-employed or have seasonal work, bring documentation showing your typical monthly earnings. If your income is genuinely unpredictable, ask your Medicaid office how they handle variable income in your state.
If I get a raise, will I lose Medicaid?
Not automatically. Most states have a process called "continuous may be able to access" that keeps you covered for a set period even if your income changes. After that period ends, your coverage will be reviewed. Some states also have a small income buffer — you can earn slightly above the limit without losing coverage. Ask your state Medicaid office about their rules on income changes and how long you have before your case is reviewed.
Are there income limits for Medicaid for children?
Yes, but they are usually higher than the limits for adults. Most states cover children up to 200% of poverty or higher. Some states cover all children in a household up to a certain age regardless of income. Check your state's limits for children specifically, as they often differ from adult limits.
How do I know if my state expanded Medicaid?
States that expanded Medicaid under the Affordable Care Act typically cover working-age adults up to 138% of poverty. States that did not expand usually have much lower limits for adults. You can search "[Your State] Medicaid expansion" or call your state Medicaid office to find out whether your state expanded and what that means for your income limit.