Medicaid income limits vary by state and family size, and they change every year

There is no single national income limit for Medicaid. Each state sets its own threshold, and the federal government updates the poverty level each January, which triggers automatic increases in most state limits. A household that qualifies in one state may not may have access to in another, even with identical income. You need to check your specific state's current limit, not a national average.

Income limits also depend on family size. A single person has a different threshold than a family of four. Most states use the federal poverty level as a starting point and then set their own percentage above it — some states cover people at 100% of poverty, others at 138%, and a few go higher or lower. This means the actual dollar amount changes based on how many people live in your household.

Key Takeaways

  • Medicaid income limits are set by each state and change every January when the federal poverty level updates.
  • Your household size determines which income limit applies to you — a family of three has a different threshold than a single person.
  • Some states expanded Medicaid to cover people earning up to 138% of the federal poverty level, while others use lower percentages.
  • You can find your state's current income limit on your state Medicaid website or by calling your local Medicaid office.
  • Income includes wages, self-employment earnings, and some benefits, but the rules for what counts vary by state and program.

How states set their own income limits

States have flexibility in how they structure Medicaid. Under the Affordable Care Act, states could choose to expand Medicaid to cover adults earning up to 138% of the federal poverty level. As of 2024, about 40 states have done this expansion, but 10 states have not. If you live in a non-expansion state, the income limit for adult coverage is typically much lower — often around 50% to 100% of poverty, depending on the state.

Even within expansion states, different Medicaid categories have different limits. Parents may have one limit, pregnant people another, children a third, and seniors or people with disabilities a fourth. A parent earning $1,500 per month might may have access to under one category while a childless adult at the same income does not. Your state's Medicaid website lists these categories separately.

Income limits also shift when the federal poverty level changes. In January 2024, the poverty line for a family of four was $31,200 per year. In January 2025, it increased. States that use a percentage of poverty automatically adjust their limits upward, which means some people who did not may have access to in December may may have access to in January.

What counts as income for Medicaid purposes

Medicaid counts most earned income — wages, salary, tips, and self-employment earnings. It also counts many types of unearned income: Social Security benefits, unemployment benefits, child support, and pension payments. However, not all income counts the same way, and some income is excluded entirely.

Common exclusions include the first $65 per month of earned income (in many states), the first $20 per month of any unearned income, and certain types of assistance like Supplemental Security Income (SSI) in some circumstances. Some states also exclude student loans, tax refunds, or one-time payments. The rules are complex and vary by state, so you cannot assume that income you receive will count toward the limit.

Your state's Medicaid office can tell you which income sources count and how they are calculated. This matters because two households with the same gross income might have different countable income based on what they receive and where they live.

How to find your state's current income limit

The fastest way is to visit your state's Medicaid website directly. Search "[your state] Medicaid income limits" and look for a page labeled "Income Limits," "may be able to access," or "Financial Limits." Most states publish a table showing the limit for each household size and each Medicaid category.

If you cannot find it online, call your state Medicaid office. The number is usually on your state's health department website. Have your household size and state ready, and ask for the current income limit for the category you think applies to you (such as parent, child, or adult without dependents). They can also tell you whether your state expanded Medicaid and what that means for your situation.

You can also call 211 (a free referral service) and ask for help finding your state's Medicaid information. They have access to current limits and can walk you through the process of checking whether your income falls within your state's threshold.

Income limits for specific Medicaid categories

Medicaid covers different groups with different income thresholds. Children typically have the highest income limits — many states cover children in families earning up to 200% of poverty or higher. Pregnant people often have limits similar to or slightly higher than parents. Parents have lower limits than children in most states. Seniors and people with disabilities may have different limits depending on whether they receive SSI.

If you are applying for Medicaid, identify which category fits your situation first. A 35-year-old with no children in a non-expansion state might not may have access to at an income that would may have access to a parent or a child in the same state. The income limit you need to meet depends on who you are, not just how much you earn.

What happens if your income changes

If you are receiving Medicaid and your income increases above your state's limit, your coverage will end. Most states give you a grace period — often one to three months — before they terminate your Medicaid. You should report income changes to your Medicaid office, as they will tell you when your coverage ends and what options you have.

If your income drops below the limit, you may be able to re-enroll. Some states allow you to reapply immediately, while others require you to wait until the next open enrollment period. Check with your state Medicaid office about their rules for re-enrollment after a loss of income.

Frequently Asked Questions

Does my spouse's income count toward the Medicaid limit?

It depends on your state and whether you are married. In most states, a spouse's income counts if you are living together. However, some states have different rules for seniors and people with disabilities. Contact your state Medicaid office to confirm how spousal income is treated in your situation.

What if I am self-employed — how is my income calculated?

Self-employment income is usually counted as your net earnings (revenue minus business expenses). Some states allow you to deduct certain costs; others use a simpler calculation. Your state Medicaid office can explain how they count self-employment income and what documentation you need to provide.

Can I hide income to may have access to for Medicaid?

No. Medicaid requires you to report all income truthfully. Intentionally hiding income is fraud and can result in overpayment demands, loss of coverage, and legal consequences. If your income is borderline, work with your Medicaid office to understand what counts and what does not.

Do I have to report a one-time payment or bonus?

Yes, but the impact depends on your state's rules. Some states count one-time payments as income in the month received, which could temporarily push you over the limit. Others have different treatment. Report it to your Medicaid office and ask how it affects your coverage.

What if I live in a non-expansion state — can I still get Medicaid?

Yes, but only if you fit into a category your state covers, such as a child, pregnant person, parent, senior, or person with a disability. The income limit for these groups is typically much lower than in expansion states. Your state Medicaid office can tell you which categories are available and what their income limits are.