Medicaid income guidelines are the dollar amounts your household must stay at or below to receive coverage

Medicaid income limits change based on your state, your family size, and the type of Medicaid program you are looking at. There is no single national limit. A single adult in one state might may have access to at $1,500 per month while the same person in another state qualifies at $2,000 per month. Your state Medicaid office sets its own thresholds, and some programs within a state have different limits than others.

Income limits are usually expressed as a percentage of the federal poverty level. Most states set their main adult Medicaid limit somewhere between 100% and 138% of the federal poverty level, though some go higher or lower. For 2024, 100% of the federal poverty level for a single adult is roughly $1,600 per month; for a family of three, it is roughly $3,400 per month. Your state then multiplies that number by its own percentage to get its limit.

The income threshold that matters to you depends on which Medicaid category you fall into — whether you are applying as a parent, a child, a pregnant person, a disabled adult, or someone over 65. Each category often has its own limit, and some are much higher than others.

Key Takeaways

  • Medicaid income limits vary by state and by family size, so you must check your specific state's numbers rather than relying on national figures.
  • Income limits are usually set as a percentage of the federal poverty level, which changes each year.
  • Different Medicaid categories — such as parent, child, pregnant person, or disabled adult — often have different income thresholds within the same state.
  • Your state Medicaid office publishes its current income limits online, and you can also call them to confirm whether your household income qualifies.
  • Income is counted differently depending on the program; some count only gross income, while others subtract certain expenses or allow deductions.

How states set their own income limits

When the Affordable Care Act expanded Medicaid in 2014, it allowed states to raise their income limits to 138% of the federal poverty level for most adults. Some states took that option; others kept their limits lower. A handful of states have set limits even higher for certain groups. This is why a person earning $2,000 per month might may have access to in one state but not in another.

States can also set different limits for different groups. For example, a state might cover children up to 200% of the federal poverty level but cover parents only up to 100%. Pregnant people often have higher limits than other adults. Seniors and people with disabilities may have separate thresholds. You need to know which category applies to you and what that category's limit is in your state.

What counts as income for Medicaid purposes

Medicaid counts income differently than the IRS does. Wages and salary count. Self-employment income counts. Social Security, unemployment benefits, and child support all count. But not everything that comes into your household is treated the same way.

Some income is excluded entirely. Supplemental Security Income (SSI) is not counted as income for SSI-linked Medicaid programs. Some states exclude certain types of child support or veteran benefits. Food stamps and housing assistance do not count. The rules vary by state and by which Medicaid program you are in, so you cannot assume that money you receive will or will not be counted.

Some states also allow deductions or disregards — amounts you can subtract from your gross income before comparing it to the limit. For example, a state might disregard the first $65 of monthly earnings, or allow you to deduct child care costs. These deductions reduce your countable income and can make the difference between may have access to and not may have access to.

How family size affects your income limit

Medicaid income limits scale with family size. A single adult has one limit; a family of four has a higher limit. The federal poverty level itself changes with family size — it is higher for larger households — and states apply their percentage to that number.

The definition of "family" for Medicaid purposes is not always obvious. In most cases, it includes you, your spouse if you have one, and your children under 19 (or sometimes 21). But stepchildren, grandchildren you are raising, or other relatives in your home may or may not count depending on your state's rules and the specific Medicaid program. If you are unsure whether someone in your household should be counted, ask your state Medicaid office.

Where to find your state's current income limits

Your state Medicaid office publishes its income limits online, usually on the main Medicaid page or in a document titled "Income Limits" or "Financial Standards." You can also call your state Medicaid office directly and ask what the current limit is for your family size and the category you are applying under. The staff can tell you whether your household income falls within the range.

Income limits change each year because the federal poverty level changes. A limit that was correct in January may not be correct in July. If you are checking your own may be able to access or helping someone else, make sure you are looking at the current year's numbers, not an old document.

What happens if your income is just over the limit

If your household income is slightly above your state's Medicaid limit, you may still have other options. Some states have programs for people just above the Medicaid line, such as medically needy programs that let you "spend down" excess income by paying medical bills. Others allow you to set aside income for work-related expenses or child care, which reduces your countable income.

You might also be able to purchase coverage through the health insurance marketplace, where you may be able to get a subsidy (a tax credit that lowers your monthly premium) if your income is between 100% and 400% of the federal poverty level. The marketplace and Medicaid use different income calculations, so being over the Medicaid limit does not mean you cannot get affordable coverage elsewhere.

Income limits for specific Medicaid categories

Medicaid for children often has higher income limits than Medicaid for parents in the same state. A state might cover children up to 200% of the federal poverty level but cover parents only up to 100%. Pregnant people and new mothers usually have higher limits than other adults. Seniors and people with disabilities may have different thresholds, especially if they are receiving SSI.

Some states also run separate programs for specific groups — such as breast and cervical cancer screening for uninsured women, or family planning services — that have their own income limits. If you do not may have access to for regular Medicaid, you might may have access to for one of these narrower programs. Your state Medicaid office can tell you which programs exist and what their limits are.

Frequently Asked Questions

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

Yes, in most cases. Medicaid counts the income of both spouses when determining whether a married couple qualifies. Some states have exceptions for certain programs or situations, so ask your state Medicaid office whether your spouse's income will be counted in your case.

What if my income changes after I am approved for Medicaid?

You are usually required to report income changes to your state Medicaid office. If your income rises above the limit, your coverage may end. If it drops, you may become may be able to access for a higher benefit level. The timing of when changes take effect depends on your state's rules.

Are there income limits for Medicaid for seniors and people with disabilities?

Yes, but they are often higher than limits for working-age adults. Seniors and people receiving SSI may have limits at 100% of the federal poverty level or higher, depending on the state. Some states also allow these groups to keep more assets than other Medicaid applicants.

How do I know if my income is counted correctly?

Ask your state Medicaid office to explain how they counted your income and what deductions or disregards they applied. If you disagree with their calculation, you have the right to request a fair hearing to challenge the decision.

Can I reduce my countable income by claiming dependents or deductions?

Medicaid does not use the same deductions as the IRS. However, some states allow specific deductions like child care costs or work-related expenses. Ask your state Medicaid office what deductions or disregards are available in your situation.