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

There is no single national income cap for Medicaid. Each state sets its own limit based on the federal poverty level, and that limit differs depending on how many people live in your household. A single adult in one state might may have access to at $1,500 per month while the same person in another state would not. Additionally, some states have expanded Medicaid to cover more people, while others have not, which creates significant differences in who can get coverage.

Income limits also shift annually on January 1st when the federal poverty level updates. This means a household that may have access to last year might not may have access to this year, or vice versa. Your state's Medicaid office publishes current limits, and you can find them by searching "[your state] Medicaid income limits" or calling your local Medicaid program directly.

Key Takeaways

  • Medicaid income limits are set by each state and are based on the federal poverty level, so the same income may may have access to you in one state but not another.
  • Household size matters: a family of four has a higher income limit than a single person, and the limit changes if someone moves in or out.
  • Income limits update every January 1st when the federal poverty level is recalculated, so you should check your state's current numbers each year.
  • Some states have expanded Medicaid to cover people earning up to 138% of the federal poverty level, while others use lower percentages.
  • Your state Medicaid office or a local 211 referral can tell you the exact income limit for your household size and situation.

How states calculate their income limits

States use the federal poverty level as a starting point and then set their own percentage of that level. For example, a state might say "we cover people earning up to 138% of the federal poverty level" or "we cover people earning up to 100% of the federal poverty level." The higher the percentage, the more people can earn and still may have access to.

The federal poverty level itself changes every year. In 2024, the poverty level for a single adult was around $14,600 per year, and for a family of four it was around $30,000 per year. But these numbers shift, so a state's income cap shifts with them. If you earned $1,500 per month last year and may have access to, you might earn $1,520 this year and still may have access to—or you might not, depending on how your state's percentage and the new poverty level interact.

States that have expanded Medicaid under the Affordable Care Act typically cover people earning up to 138% of the federal poverty level. States that have not expanded cover much lower percentages—sometimes as low as 50% or 75% of the poverty level. This is why geography matters so much: two people with identical incomes and household sizes can have completely different Medicaid coverage depending on which state they live in.

What counts as income for Medicaid

Medicaid counts most money coming into your household, but not everything. Wages, self-employment income, Social Security, unemployment benefits, and child support all count. So do pensions, rental income, and interest from savings accounts.

Some income does not count. For example, Supplemental Security Income (SSI) is often excluded or counted differently depending on your state. Some states do not count the first $20 per month of unearned income, or the first $65 per month of earned income plus half of the rest. Food stamps, housing assistance, and certain tax credits also typically do not count as income for Medicaid purposes.

The rules are complex and vary by state, so when you contact your Medicaid office, bring documentation of all income sources—pay stubs, tax returns, benefit letters, anything showing money coming in. The caseworker will tell you what counts toward the limit and what does not.

Medicaid expansion and non-expansion states

In 2014, the Affordable Care Act allowed states to expand Medicaid to cover more people. States that expanded generally cover adults earning up to 138% of the federal poverty level, regardless of whether they have children or disabilities. States that did not expand typically cover only certain groups—children, pregnant people, parents, elderly people, or people with disabilities—and only if they earn below a much lower threshold.

In a non-expansion state, a single adult with no children might not may have access to for Medicaid at any income level, even if they are very poor. In an expansion state, that same person would likely may have access to if they earned below the 138% threshold. This is one of the largest differences between states, and it affects millions of people.

A few states have expanded Medicaid partially or are in the process of expanding. Your state's Medicaid website will clearly state whether your state has expanded and what that means for your income limit.

How to find your state's current income limit

The fastest way is to call your state Medicaid program directly. Search "[your state name] Medicaid" online and look for the phone number on the official state website. When you call, tell them your household size and ask for the current income limit. They can also tell you whether your specific income and situation would may have access to.

You can also use 211, a free referral service run by the United Way. Call 211 or visit 211.org, enter your zip code, and search for "Medicaid." The service will connect you with local programs and can answer questions about income limits in your area.

Many state Medicaid websites publish income limit charts that update every January. These charts show the limit for each household size. If you find your state's chart, look for the row that matches your household size and read across to find the monthly or annual income limit.

What happens if your income changes

If you are already on Medicaid and your income increases, you may lose coverage. Most states allow a grace period—usually one or two months—before they end your coverage, so you have time to report the change. If you do not report it and your income stays above the limit, your coverage will end retroactively, meaning you may owe for services you received.

If your income decreases, you should report that change to your Medicaid office. You may become newly may be able to access, or if you were already on Medicaid, your case will be updated. Some states have simplified reporting, where you can update your income online or by phone. Others require you to submit new paperwork.

Life changes like a job loss, a raise, a household member moving in or out, or a change in benefits should all be reported to Medicaid. The exact process and timeline vary by state, so ask your caseworker what you need to do and when.

Frequently Asked Questions

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

Yes, in most cases. Medicaid counts the income of your spouse and any dependents living in your household. If you are married and file taxes jointly, both incomes are included. Some states have different rules for certain situations, so ask your Medicaid office whether your spouse's income will be counted in your case.

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

Medicaid typically looks at your income over the past three months or your expected annual income, depending on your state. If you are self-employed, bring tax returns and recent profit-and-loss statements. If your income varies month to month, the caseworker will average it or use your most recent pay period to estimate what you will earn over the next year.

Can I get Medicaid if I earn slightly above the income limit?

Not through the standard income-based program. However, some states have programs for people who earn a bit above the limit—for example, programs for people with disabilities or pregnant people. Ask your Medicaid office whether any other programs might cover you, or whether your state has any income disregards that could lower your countable income.

Do I have to report my income every month?

Not necessarily. Most states use a 12-month certification period, meaning you report your income once and Medicaid covers you for a year. However, you must report major changes—a new job, a job loss, a household member moving in or out—within a set timeframe, usually 10 days. Check your state's rules or ask your caseworker what changes you need to report.

What if my state has not expanded Medicaid and I do not may have access to?

You may be able to get coverage through the Health Insurance Marketplace, where you can compare plans and see whether you may have access to for subsidies based on your income. You can also look into programs for specific groups—pregnant people, children, elderly people, or people with disabilities—which sometimes have different income limits. Call 211 or your state health department to learn what programs might be available to you.