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

Medicaid does not have one income cutoff that applies everywhere. Each state sets its own limit based on the federal poverty level, and that limit changes with family size. A single person might earn up to 138% of the federal poverty level in one state and 100% in another. A family of four has a different threshold than a family of two in the same state. You need to know your state's specific number and how your household income is counted.

The federal poverty level itself changes every year. In 2024, the poverty line for a single person was around $15,000 per year, and for a family of four it was around $31,000. But again, your state may allow you to earn more or less than that. Some states have expanded Medicaid to cover people earning up to 138% of poverty; others cap it at 100% or lower.

Key Takeaways

  • Your state, not the federal government, decides the income limit for Medicaid, so you must check your specific state's number.
  • Income limits are based on a percentage of the federal poverty level and vary by family size — a family of four has a higher limit than a single person.
  • Medicaid counts gross income before taxes, and includes wages, self-employment income, Social Security, and unemployment benefits.
  • Some states have expanded Medicaid to 138% of poverty; others use 100% or lower, which means your may be able to access depends partly on where you live.
  • Your state's Medicaid office or a local community health center can tell you the exact income limit for your household size in your state.

How your state calculates the income limit

Your state takes the federal poverty level for your family size and multiplies it by a percentage. Most states that have expanded Medicaid use 138%. States that have not expanded use 100% or sometimes lower. A few states use percentages between 100% and 138%.

For example, if the federal poverty level for a family of three is $20,000, and your state uses 138%, the income limit would be $27,600. If your state uses 100%, it would be $20,000. If you earn $27,500 and your state uses 138%, you may be within the limit. If your state uses 100%, you would be over it.

The federal poverty level is updated every January, so income limits shift slightly each year. Your state's Medicaid office publishes the new limits, usually in January or February. If you are close to the cutoff, check whether the new year's numbers changed your status.

What counts as income for Medicaid

Medicaid counts gross income — the money you earn before taxes are taken out. This includes wages from a job, self-employment income, Social Security benefits, Supplemental Security Income (SSI), unemployment benefits, and child support you receive. It also includes certain types of unearned income like interest and dividends, though most people do not have enough of these to matter.

Some income does not count. Gifts, tax refunds, and money from selling something you own are usually not counted. Food stamps (SNAP) and housing vouchers do not count as income. Certain types of support for students, like Pell Grants, may not count depending on your state. Child support you pay out does not reduce your income for Medicaid purposes — only support you receive counts.

If you are self-employed, Medicaid counts your net self-employment income (what you earn after business expenses). You will need to show tax returns or profit-and-loss statements. If you are in a household with multiple earners, all wages are added together before the limit is checked.

How family size affects your income limit

Medicaid defines family size based on who lives with you and who you claim as dependents on your taxes. A spouse and all children under 19 (or up to 26 if they are a student in some states) usually count. Adult children living with you may or may not count depending on your state's rules.

The income limit rises as family size increases. A single person earning $15,000 might be over the limit in a state using 100% of poverty, but a family of four earning $31,000 would be under it in the same state. If you have a new baby or a dependent moves in, your family size increases and your income limit goes up.

Some states count only the income of the person applying, not the whole household. Others count the income of everyone in the household. A few states have different rules for different age groups. You need to know your state's specific rule, because it changes what income is counted against you.

Differences between states that expanded Medicaid and those that did not

States that expanded Medicaid under the Affordable Care Act allow people earning up to 138% of the federal poverty level to enroll. As of 2024, about 40 states have expanded. In these states, a single adult with no children can get Medicaid if they earn under the 138% limit, even if they do not fit into a traditional category like parent, child, or senior.

States that have not expanded Medicaid use lower income limits and restrict coverage to specific groups: children, pregnant people, parents of minor children, seniors, and people with disabilities. A single adult without children earning $20,000 per year might not may have access to in a non-expansion state, even though they would in an expansion state. The same person in the same income situation has different access depending on state law.

If you live in a non-expansion state and do not fit into a covered group, you may still have other options. Some states have separate programs for low-income adults, or you may be able to enroll in a marketplace plan with a tax credit. Your state's Medicaid office can tell you what programs exist where you live.

What to do if your income is close to the limit

If you earn within a few hundred dollars of your state's limit, gather your recent pay stubs, tax returns, and any other income documents. Bring them when you contact your state's Medicaid office or a local community health center. Do not assume you are over the limit — the exact calculation matters, and small details can change the result.

Some states allow deductions from income before checking the limit. For example, some states deduct child care costs or work-related expenses. A few states have a "medically needy" program that lets people with high medical bills become may be able to access even if their income is over the limit. These programs vary widely by state, so ask specifically whether your state has them.

If your income changes — you lose a job, get a raise, or a household member moves out — your Medicaid status may change. Report changes to your state's Medicaid office within 30 days. If you become ineligible, you may be able to enroll in a marketplace plan or another program. If you become may be able to access, you can enroll right away.

How to find your state's specific income limit

Your state's Medicaid office publishes income limits for each family size every year. You can find this information on your state's Medicaid website, usually under a section called "Income Limits" or "may be able to access." The website address follows the pattern medicaid.gov, but with your state's abbreviation — for example, medicaid.ny.gov for New York or medicaid.ca.gov for California.

If you cannot find it online, call your state's Medicaid office directly. They can tell you the exact limit for your family size and whether your income falls within it. You can also visit a local community health center, hospital, or social services office — staff there often have the current limits printed and can answer questions about your specific situation.

211.org is a free referral service that can connect you to your state's Medicaid office and other local resources. You can call 2-1-1 from any phone or search online by zip code. They can tell you where to apply and what documents to bring.

Frequently Asked Questions

Does my spouse's income count if we are married but file taxes separately?

Yes, in most states Medicaid counts the income of both spouses regardless of how you file taxes. A few states have different rules for spouses who live apart. Contact your state's Medicaid office to confirm how they handle your situation.

What if I am self-employed and my income varies month to month?

Medicaid usually looks at your income over the past 12 months or your expected income for the next 12 months, whichever is higher. Bring tax returns and recent profit-and-loss statements. If your income is dropping, you may be able to show expected income instead of past income.

Do I have to report a raise or new job right away?

Yes, report income changes within 30 days. If your new income puts you over the limit, you will lose Medicaid, but you may be able to enroll in a marketplace plan. If you report early, you have time to plan rather than losing coverage suddenly.

Can I reduce my income to may have access to for Medicaid?

No, Medicaid counts actual income, not income you choose not to earn. You cannot turn down a raise or reduce your hours to become may be able to access. However, if your circumstances genuinely change — you lose a job, a household member moves out — that change affects your may be able to access.

What happens if my income goes down after I enroll?

Your Medicaid coverage continues. You do not lose it because your income dropped. Report the change to your state's Medicaid office so your records are accurate, but a lower income does not end your coverage.