Medicaid income limits depend on your state and family size, not a single national number

There is no single income threshold for Medicaid across the United States. Each state sets its own limits based on the federal poverty level, and those limits vary widely — a single person might may have access to in one state at $1,500 per month but not in another at $1,200. Your state, your family size, and sometimes your age or disability status all determine whether your income falls within the range.

Most states use the federal poverty level as a starting point and then set their own percentage of it. Some states cover people at 100% of the federal poverty level; others go as high as 400% or more. A few states have not expanded Medicaid at all under the Affordable Care Act, which means their income limits are much lower and apply mainly to children, pregnant people, and those with disabilities.

The fastest way to find your state's actual number is to contact your state Medicaid office directly or use the Medicaid.gov website to look up your state. Income limits also change once per year, usually on January 1st, so the number that applied last year may not apply now.

Key Takeaways

  • Medicaid income limits are set by each state and based on the federal poverty level, which changes every year.
  • Your state's limit depends on family size — a single person has a different threshold than a family of four.
  • Some states have expanded Medicaid to cover people earning up to 138% of the federal poverty level; others have not expanded at all.
  • You can find your state's current income limit by calling your state Medicaid office or visiting Medicaid.gov and selecting your state.
  • Income counts differently depending on what kind of Medicaid program you are looking at — regular Medicaid, emergency Medicaid, or Medicaid for people over 65.

How states set their own income limits

Federal law sets a floor, not a ceiling. The Affordable Care Act allows states to expand Medicaid to cover people earning up to 138% of the federal poverty level. As of now, most states have chosen to expand, but some have not. If your state has expanded Medicaid, the income limit is higher. If it has not, the limit is lower and usually applies only to specific groups like children under 19, pregnant people, parents of young children, or people with disabilities.

Even among states that have expanded, the limits are not identical. Some states cover people at exactly 138% of the federal poverty level. Others cover people at 100%, 150%, or even higher percentages. A few states have their own additional programs that cover people above the Medicaid limit but below a higher threshold.

The federal poverty level itself changes each year. In 2024, the federal poverty level for a single person was around $15,060 per year, and for a family of four it was around $31,200 per year. These numbers increase slightly each January. Your state's Medicaid limit will be a percentage of that number, so it also increases each year.

What counts as income for Medicaid

Not all money you receive counts as income for Medicaid purposes. Wages and salary count. Self-employment income counts. Social Security benefits count. Unemployment benefits count. Child support and alimony count. Rental income counts.

Some money does not count. Supplemental Security Income (SSI) does not count toward the limit if you are applying for SSI-related Medicaid. Certain tax credits and refunds do not count. Some states do not count child support received. Food assistance (SNAP) does not count. Gifts from family members generally do not count, though this varies by state.

The way income is calculated also depends on which Medicaid program you are applying for. Regular Medicaid usually counts gross income (before taxes). Some programs count net income (after taxes and work expenses). If you are self-employed, you may be able to deduct business expenses. If you receive irregular income, some states average it over a period of time.

Income limits for different family sizes

Medicaid income limits scale with family size. A single person has a lower limit than a couple, who have a lower limit than a family of four. The exact numbers depend on your state, but the pattern is consistent: each additional family member raises the income threshold.

Family size usually includes you, your spouse if you are married, and any children under 19 (or sometimes 21) who live with you. Some states count stepchildren or foster children. Some do not count adult children even if they live in your home. The definition of "family" for Medicaid purposes is not the same as the definition used for taxes or other programs, so ask your state Medicaid office if you are unsure whether someone in your household counts.

How to find your state's current income limit

Visit Medicaid.gov and select your state from the map or list. The site will show you the current income limit for your family size and tell you whether your state has expanded Medicaid. You can also call your state Medicaid office directly — the phone number is on your state's Medicaid website.

When you call or visit, have your family size ready and ask for the income limit that applies to you. If you are applying for a specific type of Medicaid (such as Medicaid for people over 65, or Medicaid for people with disabilities), mention that, because the limit may be different. Ask whether the limit includes or excludes certain types of income, especially if you are self-employed or receive irregular income.

Many states also have online screening tools that let you enter your income and family size and see whether you may be within the limit. These tools are not official determinations, but they can give you a quick answer before you apply formally.

What happens if your income is slightly above the limit

If your income is above your state's Medicaid limit, you may still have other options. Some states have programs that cover people above the Medicaid limit but below a higher threshold. Some states allow you to "spend down" income by paying medical bills, which can bring your countable income below the limit. Some people are covered under special rules for people with disabilities or people over 65, which sometimes have higher income limits than regular Medicaid.

You may also be able to purchase coverage through the health insurance marketplace. If your income is between 100% and 400% of the federal poverty level, you may be able to get a tax credit that reduces your monthly premium. Visit Healthcare.gov to see what plans and subsidies are available in your area.

Income limits for Medicaid expansion versus non-expansion states

States that have expanded Medicaid under the Affordable Care Act generally cover people earning up to 138% of the federal poverty level. In 2024, that meant roughly $21,483 per year for a single person and $44,235 per year for a family of four in an expansion state.

States that have not expanded Medicaid have much lower limits. In those states, Medicaid is usually available only to children, pregnant people, parents of young children, people over 65, and people with disabilities. The income limit for those groups varies by state and by category, but it is often well below the poverty level.

If you live in a non-expansion state and your income is above the limit for your category, you cannot get regular Medicaid, but you may be able to get coverage through the marketplace with a tax credit, or you may be covered under a state-specific program. Contact your state Medicaid office to learn what programs exist in your state.

Frequently Asked Questions

Does my income limit change if I get a raise or lose a job?

Yes. Medicaid rechecks your income periodically, usually once per year, but some states check more often. If your income increases above the limit, you may lose coverage. If your income decreases below the limit, you may become newly covered. Report major income changes to your state Medicaid office as soon as they happen, because the rules about when you must report vary by state.

What if I am self-employed or have irregular income?

Self-employment income counts toward the limit, but you may be able to deduct business expenses. Irregular income is often averaged over a period of time — usually three months or a year, depending on your state. Contact your state Medicaid office to learn how they calculate self-employment or irregular income, because the rules vary.

Do I have to report my spouse's income if we are married?

Yes, in most cases. Medicaid counts household income, which includes your spouse's income even if you file taxes separately. Some states have exceptions for people over 65 or people with disabilities. Ask your state Medicaid office whether your situation qualifies for an exception.

Can I still get Medicaid if I am over the income limit but have high medical bills?

In some states, yes. Some states allow you to "spend down" by paying medical bills, which reduces your countable income. Other states do not allow spend-down. A few states have separate Medicaid programs for people with disabilities or people over 65 that have higher income limits. Contact your state Medicaid office to ask whether spend-down or a higher-limit program is available to you.

What if my state has not expanded Medicaid?

If your state has not expanded Medicaid and your income is above the limit for your category (such as parent, child, or person with a disability), you cannot get regular Medicaid. You may be able to purchase coverage through the health insurance marketplace at Healthcare.gov, and if your income is between 100% and 400% of the federal poverty level, you may be able to get a tax credit to reduce your premium.