How Medicaid income limits work

Medicaid income limits depend on which state you live in and which category of coverage you are trying to enter. There is no single national income cutoff. The federal government sets a baseline — currently 138% of the federal poverty level for most adults under the Affordable Care Act expansion — but states can set their own limits higher or lower, and many do.

Income is measured as your household's gross monthly or annual earnings before taxes. For a single person in 2024, the federal poverty level is roughly $1,550 per month; for a family of three, roughly $3,200 per month. A state using the 138% federal baseline would cover individuals earning up to about $2,140 per month. But a state that has not expanded Medicaid, or that uses a different category, might have a limit of $900 per month or might not cover working-age adults at all.

The state you live in determines your actual limit. You need to check your specific state's Medicaid program, not a national figure.

Key Takeaways

  • Medicaid income limits vary by state and by category — there is no single national cutoff, and your state's limit may be higher or lower than neighboring states.
  • Most states that have expanded Medicaid cover adults earning up to roughly 138% of the federal poverty level, which is around $2,140 per month for a single person in 2024.
  • Income is counted as gross household earnings before taxes, and household size matters — a family of four has a higher limit than a single person.
  • Some states have not expanded Medicaid and cover only children, pregnant people, seniors, and people with disabilities, regardless of income limits for working-age adults.
  • Your state's Medicaid office or a 211 referral can tell you the exact income limit for your household size and situation in your state.

Income limits by state and category

States fall into three broad groups. States that have expanded Medicaid under the Affordable Care Act generally cover adults earning up to 138% of the federal poverty level. States that have not expanded Medicaid typically cover only specific groups — children, pregnant people, seniors, and people with disabilities — and may have much lower income limits for those groups. A handful of states have expanded Medicaid but set their own limits, which may be higher or lower than 138%.

Within each state, different categories have different limits. A child may have a higher income limit than an adult. A senior or person with a disability may have a different limit than a working-age adult. Pregnancy-related coverage may have its own threshold. You need to know both your state and which category applies to you.

The easiest way to find your state's limits is to contact your state Medicaid office directly or call 211 and ask for Medicaid income limits in your state for your household size and situation. Both can give you the exact figure in minutes. Your state's Medicaid website usually publishes the limits as well, though the pages can be hard to navigate.

How household size affects your income limit

Medicaid counts your household, not just you alone. Household usually means people living with you who file taxes together or depend on your income — typically a spouse and children, but sometimes parents or other relatives. The larger your household, the higher your income limit.

For example, in a state using the 138% federal baseline, a single person might have a limit of $2,140 per month, but a family of three might have a limit of $4,550 per month. A family of four might have a limit of $5,800 per month. The exact figures vary by state and change yearly as the federal poverty level adjusts.

When you contact your state Medicaid office or 211, tell them your household size. They will give you the limit that applies to you, not to someone living alone.

What counts as income for Medicaid

Medicaid counts gross income — what you earn before taxes, deductions, or expenses. This includes wages from a job, self-employment income, Social Security, unemployment benefits, child support, and some types of rental income. It does not include food stamps, housing vouchers, or certain other government benefits.

Income is usually averaged over a month. If you work irregular hours or have seasonal income, Medicaid may average your earnings over the past three months or the past year to get a typical monthly figure. If you just started a job or lost one, tell your state Medicaid office — they may use a different method to calculate your current income.

Deductions and expenses do not reduce your income for Medicaid purposes. If you have high medical bills, childcare costs, or business expenses, those do not lower the income figure Medicaid uses to decide whether you may have access to. Some states have small deductions for things like work expenses or child support paid out, but these are rare and vary by state.

Income limits for specific groups

Children often have higher income limits than adults in the same state. A state might cover adults up to 138% of poverty but cover children up to 200% or 300% of poverty. Pregnant people usually have their own limit, often higher than working-age adults. Seniors and people with disabilities may have different limits depending on whether they receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI).

If you are applying for coverage for a child, pregnant person, senior, or person with a disability, ask your state Medicaid office which income limit applies to that person's category. Do not assume the limit for one group applies to another.

What to do if your income is above the limit

If your income exceeds your state's Medicaid limit, you may still have other options. Many states offer Medicaid programs for people with higher incomes if they have significant medical expenses or disabilities. Some people with income above the limit can "spend down" — use medical bills to reduce their countable income — and become covered. This is most common for seniors and people with disabilities.

If you do not may have access to for Medicaid, you may be able to purchase coverage through the health insurance marketplace, where you might receive a tax credit to lower your monthly premium. You can also ask 211 or your state Medicaid office whether any other programs in your state might help with medical costs.

How to find your state's exact income limit

Contact your state Medicaid office directly. You can find the phone number on your state's Medicaid website, which usually appears in a search for "[your state] Medicaid." Tell them your household size and which category applies to you — adult, child, pregnant person, senior, or person with a disability. They will give you the current income limit and tell you whether you fall within it.

You can also call 211 (dial 2-1-1 from any phone) and ask for your state's Medicaid income limits. 211 is a free referral service that knows local and state programs. They can also tell you whether your state has expanded Medicaid and what other coverage options might be available to you.

If you are already receiving Social Security, Supplemental Security Income, or unemployment benefits, your state Medicaid office can often look up your income directly from those agencies and tell you on the spot whether you may have access to.

Frequently Asked Questions

Does my income limit change if I get married or have a child?

Yes. Your household size changes, so your income limit changes. If you marry or have a child, contact your state Medicaid office to report the change. Your new household size may raise your limit, which could mean you now may have access to or that your coverage continues. If your household size shrinks, your limit may lower.

If I earn just over the limit, can I still get Medicaid?

Not usually, unless your state has a spend-down program or you fall into a category with a higher limit. Some states allow people with disabilities or seniors to deduct medical expenses from their income. Ask your state Medicaid office whether spend-down is available in your state and whether you might may have access to under a different category.

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

Yes. Medicaid counts the income of your spouse and any dependents living in your household. If you are married, your household income includes both your earnings and your spouse's earnings. If your spouse has no income, that does not lower your household income — it just means the household income is yours alone.

What if my income varies month to month?

Medicaid usually averages your income over the past three months or the past year to get a typical monthly figure. If you are self-employed, work seasonal jobs, or have irregular hours, tell your state Medicaid office. They may use a different calculation method. If you just lost a job or started a new one, report that too — they may use your current income instead of an average.

Do I have to report income changes to Medicaid?

Yes. If your income changes significantly — you get a raise, lose a job, or start a new job — contact your state Medicaid office. Some changes may affect your coverage. Many states allow you to report changes online, by phone, or by mail. Ask your state office how to report changes and whether your change affects your coverage.