Medicaid income limits depend on your state, family size, and which Medicaid program you are in
There is no single national income limit for Medicaid. Each state sets its own threshold, and the threshold changes based on how many people live in your household. A family of three might may have access to in one state at an income that would disqualify them in another. Some states also run separate Medicaid programs for specific groups — pregnant people, children, seniors, or people with disabilities — and each program has its own income line.
The federal government sets a floor: states cannot be more restrictive than a baseline amount, which is tied to the Federal Poverty Level (FPL). Most states go higher than that floor. As of 2024, the federal minimum for a single adult is roughly 138% of the Federal Poverty Level, but your state may allow more income and still cover you.
Income limits also change when your circumstances change. If you lose a job, have a baby, or move to a different state, your income situation may shift you into or out of Medicaid coverage. You do not have to wait for an annual renewal to report a change — you can report it anytime.
Key Takeaways
- Your state, not the federal government, decides the income limit, so you must check your specific state's number rather than relying on a national figure.
- Income limits are based on household size, and adding a family member usually raises the threshold you can earn and still may have access to.
- Some states cover adults up to 138% of the Federal Poverty Level; others cover up to 200% or higher, depending on the program.
- You can report a change in income or household size at any time during the year, not just during open enrollment.
- Income is calculated differently depending on whether you are self-employed, receive benefits, or have other sources of money.
How to find your state's specific income limit
The fastest way is to contact your state Medicaid office directly. You can find the phone number and website through the Centers for Medicare & Medicaid Services (CMS) website, which lists every state's Medicaid program. When you call, have your household size ready — the staff member will tell you the exact dollar amount your state allows.
You can also use Healthcare.gov, which has a tool that estimates whether you might be covered based on your income and state. It will not tell you whether you may have access to, but it will show you the income range your state uses and what programs might be available to you. Some states also run their own websites with income calculators.
If you are applying through your state's Medicaid office or through Healthcare.gov during open enrollment, the application itself will ask about your income and tell you whether you meet the threshold. You do not have to figure it out beforehand — the system will do that part.
What counts as income for Medicaid
Medicaid counts most money that comes into your household: wages from a job, self-employment income, Social Security, unemployment benefits, child support, and rental income all count. Some types of income are excluded. For example, Supplemental Security Income (SSI) is usually not counted, and some states exclude certain types of child support or veteran benefits.
The way income is calculated also matters. If you are employed, most programs use your gross income (before taxes). If you are self-employed, they typically use your net income (what you make after business expenses). If you receive benefits, they use the amount the benefit program says you get each month.
Household income means the total earned by everyone living with you who is related to you or claimed as a dependent. If you live with a roommate who is not related to you, their income usually does not count. If you live with a spouse, their income counts even if you file taxes separately.
Income limits by family size (general ranges)
Income limits scale with household size. A single person has a lower threshold than a couple, who have a lower threshold than a family of four. The exact numbers vary by state, but here is how the structure works:
| Household Size | Federal Poverty Level (2024) | 138% of FPL (Federal Minimum) |
|---|---|---|
| 1 person | $14,060 | $19,403 |
| 2 people | $18,870 | $26,041 |
| 3 people | $23,680 | $32,678 |
| 4 people | $28,490 | $39,316 |
| 5 people | $33,300 | $45,954 |
These numbers are the federal floor. Many states allow higher income and still cover you. For example, some states cover adults up to 200% of the Federal Poverty Level, which would be roughly $28,120 for a single person. Your state's limit could be anywhere from 138% to 300% or higher, depending on which Medicaid program you are looking at.
Each time the Federal Poverty Level updates (usually in January), these numbers change slightly. Your state's limit updates at the same time, so the dollar amount you can earn shifts a little each year.
Different income limits for different Medicaid programs
Your state may run more than one Medicaid program, and they do not all have the same income limit. For example, a state might cover children up to 200% of the Federal Poverty Level but cover adults up to only 138%. Pregnant people might have a higher limit than non-pregnant adults. People over 65 or people with disabilities might have different rules altogether.
When you apply, you will be checked against the program that matches your situation. If you do not meet the income limit for one program, you might still meet it for another. For instance, if you are a parent of a child under 19, you might not meet the adult limit but could still be covered under a parent-specific program in your state.
Some states also have waiting lists or enrollment caps for certain programs, which means income alone does not determine coverage — availability does. Your state Medicaid office can tell you which programs are currently open and which have restrictions.
What happens if your income changes
If your income goes down, you can report the change to your state Medicaid office and ask to be re-evaluated. You do not have to wait for your annual renewal. Many people who lose a job or have hours cut can get Medicaid coverage within days of reporting the change.
If your income goes up and you are already on Medicaid, your coverage does not end immediately. You will be asked to report the change at your next renewal, or you can report it sooner if you want. Some states have a grace period where you stay covered even if your income temporarily exceeds the limit. Others end coverage the month after you report an increase.
If you gain a household member — through birth, adoption, or someone moving in — your income limit goes up because household size increases. You should report this change so your new limit is calculated correctly.
How to report income changes
Contact your state Medicaid office by phone, mail, or online portal. Most states now have an online account where you can log in and report changes yourself. The phone number is on your Medicaid card or on your state's Medicaid website. When you call or submit a change, have your case number and the new income information ready.
If you are receiving Medicaid through Healthcare.gov, you can also report changes there. Healthcare.gov will update your information and may adjust your coverage or tell you to contact your state directly. Some changes (like a job loss) may make you may be able to access for a Special Enrollment Period, which lets you change your coverage outside the normal open enrollment window.
Keep records of income changes — pay stubs, termination letters, or benefit statements. If your state asks for proof, you will need to show it. Most programs give you 10 to 30 days to submit documentation after you report a change.
Frequently Asked Questions
Does my spouse's income count if we are married but file taxes separately?
Yes. Medicaid counts household income based on who lives with you, not on how you file taxes. If you are married and living together, your spouse's income counts toward the household total, regardless of tax filing status.
What if I am self-employed? How do they calculate my income?
Most states use your net self-employment income (revenue minus business expenses) from your most recent tax return. If you are newly self-employed and do not have a tax return yet, they may ask for profit-and-loss statements or bank records. Call your state Medicaid office to ask what documents they need.
Can I be on Medicaid if I earn more than the income limit?
Not through regular Medicaid, but you might be covered through a special program. Some states have programs for people with disabilities or chronic conditions that allow higher income. Others have programs for specific groups like pregnant people or children. Your state Medicaid office can tell you whether an alternative program exists for your situation.
If I get a raise, will I lose Medicaid immediately?
No. Your coverage continues until your next renewal or until you report the income increase. Some states have a grace period of a few months. When you do report the raise, your case will be reviewed and you will be told whether you still meet the income limit. You will have time to plan before coverage ends.
How often do income limits change?
Income limits are updated once a year, usually in January, when the Federal Poverty Level is updated. Your state's limits will shift slightly to match the new poverty figures. You do not need to do anything — your state handles the adjustment automatically.