Medicaid income limits are set by your state, not by the federal government, and they change based on family size and composition

There is no single Medicaid income limit that applies everywhere. Each state sets its own threshold for who can receive coverage, and those thresholds vary widely — a household income that qualifies you in one state may disqualify you in another. Your state's limit also depends on how many people live in your household and, in some cases, your age or disability status.

The federal government sets a baseline called the federal poverty level, which changes each year. Most states use this as a starting point and then set their own limits as a percentage of it — commonly 100%, 138%, or 200% of the federal poverty level, depending on which Medicaid category you fall into. For 2024, the federal poverty level for a single person is approximately $15,000 per year, though this figure adjusts annually and varies by family size.

To find your state's exact income limit, you need to contact your state Medicaid office or check your state's Medicaid website directly. The limit that applies to you depends on which Medicaid program you are seeking — coverage for children, pregnant people, parents, seniors, or people with disabilities all have different income thresholds within the same state.

Key Takeaways

  • Income limits are set by each state individually, so you must check your specific state's rules rather than relying on a national figure.
  • Most states base their limits on the federal poverty level, but express them as a percentage — 100%, 138%, or higher — which means the actual dollar amount varies by state.
  • Your household size determines which income limit applies to you, and limits are recalculated each year when the federal poverty level changes.
  • Different Medicaid categories (children, parents, seniors, disabled people) often have different income limits within the same state.
  • Your state Medicaid office or your state's Medicaid website is the only reliable source for your actual income limit.

How states calculate income limits from the federal poverty level

States express their Medicaid income limits as a percentage of the federal poverty level. If your state's limit for a family of three is 138% of the federal poverty level, and the federal poverty level for a family of three is roughly $23,000, then your state's income limit would be approximately $31,740. But because the federal poverty level changes each year, your state's dollar-amount limit also changes each year.

Some states use 100% of the federal poverty level as their limit, meaning your income cannot exceed the poverty line itself. Other states use 138%, 150%, 200%, or even higher percentages. A few states have set their limits below the federal poverty level, which means they cover fewer people. The percentage your state uses depends on which Medicaid program you are seeking and when that program was established or last updated.

Your state's Medicaid office publishes these percentages and the resulting dollar amounts each January, when the new federal poverty level takes effect. You can find this information on your state's Medicaid website, usually in a document titled "Income Limits" or "Medicaid may be able to access Standards."

What counts as income for Medicaid purposes

Medicaid counts most money you receive as income, but not all of it. Wages from employment, self-employment income, Social Security benefits, unemployment benefits, and child support all count. Interest, dividends, and rental income count. Pensions and retirement account withdrawals count.

Some types of money do not count. Supplemental Security Income (SSI) is often excluded or counted differently depending on your state. Certain tax credits, like the Earned Income Tax Credit, may not count. Gifts and loans typically do not count as income. Some states exclude a portion of work income to encourage employment — for example, they might ignore the first $65 of monthly wages plus half of the remainder.

The rules for what counts as income are complex and vary by state and by which Medicaid program you are in. When you contact your state Medicaid office, ask specifically what types of income they count and what exclusions apply to your situation. Bring documentation of all income sources so the caseworker can make an accurate information.

How family size affects your income limit

Medicaid income limits increase as your household size increases. A single person has a lower limit than a family of two, which has a lower limit than a family of three, and so on. Your state's Medicaid office publishes a table showing the income limit for each family size from one person up to eight or more people.

Your household size includes you, your spouse if you are married, and any children under age 19 who live with you and are claimed as dependents. Some states count other relatives or people who live in your home; others do not. If you are unsure whether someone in your household counts toward your family size, ask your state Medicaid office before you submit information.

If your household size changes — a child is born, a family member moves in or out, or you marry or divorce — your income limit changes immediately. You should report changes to your state Medicaid office as soon as they happen, because your coverage may change as a result.

Different income limits for different Medicaid categories

Your state may have different income limits depending on which Medicaid program you are seeking. Medicaid for children often has a higher income limit than Medicaid for parents. Medicaid for pregnant people may have its own limit. Medicaid for seniors and people with disabilities may use a different calculation altogether.

Some states also offer Medicaid expansion under the Affordable Care Act, which covers adults without children up to 138% of the federal poverty level. Not all states have adopted this expansion, so the income limit for this group varies dramatically by state — from no coverage at all in some states to 138% of poverty in others.

When you contact your state Medicaid office, tell them which category you believe you fall into, and they will tell you the specific income limit that applies to you.

How to find your state's current income limits

Your state Medicaid office publishes income limits on its website, usually in a document you can download or view online. Search for "[Your State] Medicaid income limits" or "[Your State] Medicaid may be able to access standards." The document will show the dollar amount for each family size and each Medicaid category.

You can also call your state Medicaid office directly and ask for the current income limit that applies to your household size and situation. Have your family size and the names of household members ready when you call. The caseworker can tell you whether your income falls within the limit and what documents you need to provide.

If you cannot find your state's information online or by phone, contact your local health department or a community health center — they often have printed copies of current income limits and can help you understand how your household's income is counted.

What happens if your income is above the limit

If your income exceeds your state's Medicaid limit, you may still have other options. Some states offer Medicaid spend-down programs, which allow you to reduce your countable income by paying medical expenses, and then become may be able to access for Medicaid. This is most common for seniors and people with disabilities.

You may also be able to purchase coverage through the Health Insurance Marketplace, where you might receive a tax credit or cost-sharing reduction if your income falls within certain ranges. The Marketplace has different income thresholds than Medicaid, and you can explore your options on Healthcare.gov or your state's health insurance website.

Some people with income just above the Medicaid limit find that they are better off financially with Marketplace coverage and a tax credit than they would be with Medicaid. A caseworker at your state Medicaid office or a community health worker can help you compare your options.

Frequently Asked Questions

Does my income limit change if I get a raise or lose a job?

Yes. Your income limit itself does not change, but your may be able to access does if your income changes. If you get a raise and your income exceeds the limit, you may lose Medicaid coverage. If you lose a job and your income drops below the limit, you may become newly may be able to access. Report income changes to your state Medicaid office as soon as they happen so your coverage can be updated.

Are Social Security benefits counted as income?

Usually yes, but it depends on which Medicaid program you are in and your state's rules. For most Medicaid categories, Social Security is counted as income. For Supplemental Security Income (SSI) recipients, the rules are different and vary by state. Ask your state Medicaid office how your specific Social Security benefits are counted.

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

Self-employment income is usually counted as your net income after business expenses, not your gross revenue. You will need to provide tax returns or other documentation showing your actual profit. Some states allow deductions for business expenses; others use a different calculation. Bring your most recent tax return when you contact your state Medicaid office.

Can I reduce my countable income by giving money away?

No. Medicaid rules prevent you from deliberately reducing your income to become may be able to access. If you give away money or assets specifically to may have access to for Medicaid, your state may penalize you or deny your request. However, normal living expenses and charitable giving are not considered deliberate reduction. Ask your state Medicaid office if you are unsure whether a specific transaction would affect your may be able to access.

Do I need to report income from my spouse if we are married?

Yes, in most cases. Medicaid counts your spouse's income as part of your household income, even if you file separate tax returns. If you are legally separated or divorced, your ex-spouse's income does not count. If you are married but living apart, ask your state Medicaid office how your situation is handled, because rules vary.