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

There is no single income limit for Medicaid across the United States. Each state sets its own threshold based on the federal poverty level, and that threshold changes depending on how many people live in your household. A single person in one state might earn $1,500 per month and still may have access to, while someone in another state earning $1,200 per month would not.

Most states use a percentage of the federal poverty level to determine who qualifies. The federal poverty level itself changes every year — the Department of Health and Human Services publishes new figures each January. Your state then applies its own percentage to that number. Some states cover people at 100% of the poverty level; others go as high as 400% or as low as 50%, depending on the program and the state.

The income limit also depends on which Medicaid program you are looking at. Traditional Medicaid for adults has different limits than Medicaid for children, pregnant people, seniors, or people with disabilities. Some states have expanded Medicaid under the Affordable Care Act, which raised income limits significantly; others have not.

Key Takeaways

  • Your state, not the federal government, sets the income limit, and it varies by family size and the type of Medicaid program you are seeking.
  • Income limits are based on a percentage of the federal poverty level, which is recalculated every January and differs for individuals, couples, and families.
  • States that expanded Medicaid under the Affordable Care Act typically allow higher incomes than states that did not expand.
  • Your actual income for Medicaid purposes may not equal your gross pay — some income sources are excluded, and some states count only part of what you earn.

How your state calculates the income limit

Start by finding your state's specific limit. Your state Medicaid agency publishes income guidelines every year, usually in a table organized by family size. For example, if your state covers adults at 138% of the federal poverty level (the standard in Medicaid expansion states), and the 2024 federal poverty level for a single person is $14,580, then the income limit would be roughly $20,120 per year, or about $1,677 per month.

The federal poverty level is higher for each additional family member. A family of three has a higher poverty threshold than a family of two. Your state applies the same percentage to each family size. This means a family of four might have an income limit of $3,000 per month in one state and $2,000 per month in another, depending on what percentage that state uses.

You can find your state's current income limits on your state Medicaid agency website, or by calling their customer service line. Many states also list limits on Healthcare.gov. The limits change once per year, usually in April, when states update their guidelines to match the new federal poverty level.

What counts as income and what does not

Medicaid counts most money you receive as income, but not everything. Wages from a job count. Self-employment income counts. Social Security, unemployment benefits, and child support all count. However, some sources do not: Supplemental Security Income (SSI) is often excluded, as are certain types of assistance like TANF (Temporary Assistance for Needy Families) in some states.

Many states also allow you to exclude a portion of your earned income — typically the first $65 to $90 per month of wages, plus a percentage of the rest. This is called an earned income exclusion, and it exists to encourage people to work without immediately losing Medicaid. If you earn $1,500 per month and your state excludes the first $65, Medicaid counts only $1,435 toward your income limit.

Some income is counted differently depending on how often you receive it. If you get paid weekly, your state may average your income over a month. If you get paid irregularly or seasonally, the calculation can be more complex. When you apply, you will need to provide recent pay stubs, tax returns, or other proof of income. The Medicaid office will tell you exactly what documents they need and how they will count your specific situation.

Medicaid expansion states versus non-expansion states

In 2014, the Affordable Care Act allowed states to expand Medicaid to cover more adults. States that expanded typically cover adults earning up to 138% of the federal poverty level. States that did not expand often have much lower limits — sometimes as low as 50% or 60% of the poverty level, or they may not cover non-disabled, non-elderly adults at all.

This creates a significant gap. In an expansion state, a single adult earning $20,000 per year might may have access to for Medicaid. In a non-expansion state, that same person might earn only $8,000 per year and still not may have access to. The expansion states are concentrated in the Northeast, Midwest, and West Coast, while most non-expansion states are in the South and parts of the Midwest.

If you live in a non-expansion state and earn too much for traditional Medicaid but cannot afford private insurance, you may be caught in a coverage gap. Some people in this situation look into marketplace insurance through Healthcare.gov to see if they may have access to for subsidies based on their income.

Income limits for specific Medicaid programs

Medicaid for children often has higher income limits than Medicaid for adults in the same state. Many states cover children in families earning up to 200% or 300% of the federal poverty level, even if adult Medicaid stops at 138%. Pregnant people and new parents also frequently have higher limits.

Medicaid for seniors and people with disabilities works differently. These groups often may have access to based on SSI rules, which use a different income calculation than regular Medicaid. SSI has a federal income limit of $943 per month for an individual (as of 2024, though this changes yearly), and some states add their own supplement on top of that.

If you are disabled or over 65, your income limit may be higher or lower than the regular adult Medicaid limit in your state, depending on which program you are seeking. When you apply, make sure you understand which program you are applying for, because the income rules are not the same across all of them.

What happens if your income changes

If you are on Medicaid and your income increases above the limit, your coverage will end. Most states give you a grace period — usually one to three months — before they terminate your Medicaid. During that time, you should look for other coverage options, such as marketplace insurance or employer coverage.

If your income drops back below the limit, you can reapply for Medicaid at any time. You do not have to wait for an annual enrollment period the way you do with marketplace insurance. Many states allow you to report income changes online or by phone, and they will update your case quickly.

Some states have programs that let you keep Medicaid for a few months even after your income goes above the limit, if the increase is due to starting a job. This is called a work incentive or employment continuation. Ask your state Medicaid office whether this applies to you.

How to find your state's specific income limit

The fastest way is to visit your state Medicaid agency website directly. Search "[your state] Medicaid income limits" or "[your state] Medicaid may be able to access." Most state sites have a table showing the current limits by family size. You can also call your state Medicaid office and ask for the income limit that applies to you.

Healthcare.gov also has links to each state's Medicaid program and income information. If you are unsure whether you may have access to, you can start an application on Healthcare.gov or your state's site, and the system will tell you whether your income falls within the limit. You do not have to complete the full application to get this answer.

If you are applying for Medicaid through a specific program — such as for a child, a pregnant person, or someone with a disability — ask the Medicaid office which income limit applies. The limit for your situation may be different from the general adult limit.

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 and any dependents living in your household. Some states have different rules for seniors or people with disabilities, so ask your state Medicaid office about your specific situation. If you are married but file taxes separately, tell the Medicaid office — the rules may differ.

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

Self-employment income counts toward your Medicaid limit. You will need to provide tax returns or profit-and-loss statements to prove your income. If your income varies month to month, your state will usually average it over a period of time, often three months or a year. Bring documentation of your actual earnings to your application.

Can I hide income to stay under the Medicaid limit?

No. Medicaid requires you to report all income honestly. If you misreport your income and are later found to have done so intentionally, you may have to repay benefits and face penalties. If your income genuinely changes, report it to your Medicaid office — they will update your case.

Do I lose Medicaid immediately if my income goes over the limit?

No. Most states give you a notice and a grace period, usually one to three months, before they end your coverage. This gives you time to find other insurance. Check your state's rules, because the grace period length varies. If your income drops back below the limit during that time, you may be able to keep your Medicaid.

What is the income limit for Medicaid in my state?

That depends on your state and family size. Visit your state Medicaid agency website, search for the current income guidelines table, or call your state Medicaid office. Income limits change every year in January or April, so make sure you are looking at the current year's limits, not old information.