Medicaid income limits are set by your state, not by the federal government, and they vary widely depending on which Medicaid program you are trying to enter

There is no single Medicaid income limit that applies everywhere. Each state decides how much money a household can earn and still receive Medicaid coverage. A family of three earning $2,000 per month might may have access to in one state and not in another. The limit also depends on which Medicaid category you fall into — whether you are applying as a parent, a child, a pregnant person, a disabled adult, or someone over 65.

Federal law sets a floor, meaning states cannot go below a certain threshold, but most states set their own limits higher than the federal minimum. Some states use the federal poverty line as their starting point and then add a percentage on top. Others use a different calculation altogether. This is why the first step is always to check your specific state's rules, not a national average.

Key Takeaways

  • Medicaid income limits are set by each state individually, so the limit in your state may be completely different from a neighboring state.
  • The limit you face depends on your household size, your age, and your category — parent, child, pregnant person, elderly, or disabled.
  • Most states use a percentage of the federal poverty line to set their limits, but the percentage varies by state and by category.
  • Your state's Medicaid office or a 211 referral can tell you the exact income limit for your situation in minutes.

How states calculate income limits

Most states express their Medicaid income limits as a percentage of the federal poverty line. The federal poverty line changes every year — for 2024, the poverty line for a family of three is approximately $23,000 per year, though this figure shifts annually. A state might say "we cover parents up to 138% of the federal poverty line" or "we cover children up to 200% of the federal poverty line."

This means a state covering children at 200% of poverty would cover a child in a family earning up to roughly $46,000 per year (200% of $23,000). But that same state might cover parents only up to 138% of poverty, which would be around $31,740 per year. The percentage is different for each category because federal law allows states to set different thresholds for different groups.

A handful of states do not use the poverty line at all. They use a different measure called MAGI, or Modified Adjusted Gross Income, which is based on tax return information. Under MAGI, the calculation is more straightforward but still varies by state and by category.

Income limits by household category

Medicaid programs within a single state often have different income limits depending on who you are. Children typically have higher limits than parents. Pregnant people often have higher limits than non-pregnant adults. Elderly and disabled adults may have different limits than working-age adults. A state might cover a child whose family earns $50,000 per year but not cover that child's parent at the same income level.

Expansion states — those that expanded Medicaid under the Affordable Care Act — generally cover adults up to 138% of the federal poverty line. Non-expansion states often have much lower limits for adults without children or disabilities. In a non-expansion state, an adult earning $20,000 per year might not may have access to for Medicaid at all, while in an expansion state, that same person would may have access to.

The state you live in matters more than your income level. Two people earning identical amounts in different states can have completely different Medicaid coverage.

What counts as income for Medicaid

Medicaid counts most types of income: wages from a job, self-employment income, Social Security, unemployment benefits, child support, and rental income. However, some income does not count. Supplemental Security Income (SSI) is usually not counted. Some states exclude certain types of support, like food assistance or housing vouchers.

If you are self-employed, Medicaid counts your net business income, not your gross revenue. If you earn $60,000 in gross revenue but have $30,000 in business expenses, Medicaid counts $30,000 as your income. You will need to provide tax returns or business records to prove this.

Household size matters because the poverty line is different for each size. A single person has a lower poverty line than a family of four. If you add a household member or lose one, your income limit changes. Some states count only people living in your home; others count people you claim as dependents even if they live elsewhere.

How to find your state's specific income limit

Your state Medicaid office publishes its income limits online, usually on the state health department website. Search "[your state] Medicaid income limits" and you will find a table or document showing the threshold for each category. The document may be called "Medicaid may be able to access standards" or "income and resource limits."

If you cannot find it online or the information is unclear, call your state Medicaid office directly. They can tell you in one conversation whether your household income falls below the limit for your situation. You can also call 211 (dial 2-1-1 from any phone) and a local specialist can look up your state's limits and tell you whether you likely may have access to.

Bring your most recent pay stubs, tax return, or a list of all household income sources when you contact them. Having this information ready means you can get an answer the same day instead of waiting for a callback.

What happens if your income is slightly above the limit

If your household income is above the Medicaid limit, you may still have other options. Some states have programs that cover people slightly above the Medicaid income limit. Others allow you to deduct certain expenses — like child care, medical costs, or work-related expenses — from your income before comparing it to the limit. These deductions can lower your countable income enough to may have access to.

If you do not may have access to for Medicaid, you may be able to purchase coverage through the Health Insurance Marketplace (healthcare.gov). Depending on your income, you might receive a tax credit that reduces your monthly premium. The Marketplace has different income thresholds than Medicaid, and they are based on a percentage of the federal poverty line as well, but the percentages are higher — usually up to 400% of poverty.

Your income can also change. If you lose a job, have your hours cut, or experience another change, your new income might fall below the Medicaid limit. You can report the change to your state Medicaid office and reapply at any time during the year.

Income limits for elderly and disabled adults

Medicaid for elderly and disabled adults often has different rules than Medicaid for parents and children. Some states use a higher income limit for elderly and disabled people. Others use the same limit but count income differently — for example, by excluding certain types of income or allowing larger deductions.

Supplemental Security Income (SSI) recipients in most states are automatically may be able to access for Medicaid, regardless of the income limit, because SSI itself is considered a pathway to Medicaid. However, a few states have their own rules and do not automatically cover all SSI recipients. If you receive SSI, contact your state Medicaid office to confirm whether you are covered.

Frequently Asked Questions

Does my income limit change if I get married or have a baby?

Yes. Medicaid recalculates your household size and income limit when your household changes. If you marry someone with income, that income is now counted as part of your household. If you have a baby, your household size increases and your income limit may increase as well. Report changes to your state Medicaid office so your coverage is updated.

What if I work part-time and my income varies month to month?

Medicaid usually looks at your average income over the past three months or your expected income for the next month, depending on your state. If your income is unpredictable, bring documentation of recent pay stubs and explain the variation. Some states will average your income; others will use your most recent month as the basis for the decision.

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

No. Medicaid requires you to report all household income truthfully. Providing false information is fraud and can result in repayment of benefits you received, fines, and criminal charges. If your income changes, report it. If you are unsure whether something counts as income, ask your Medicaid office before you apply.

Do I have to be a citizen to have an income limit apply to me?

Medicaid has separate rules for citizens and non-citizens. Most non-citizens are not covered by regular Medicaid, though some states cover certain groups like pregnant people or children regardless of immigration status. Your immigration status affects which Medicaid programs you can enter, but income limits still apply to the programs you are may be able to access for. Contact your state Medicaid office to learn which programs are open to you.

If I am on disability, is my income limit different?

Yes, in most states. Disabled adults often have a higher income limit than working-age adults without disabilities. Some states use a different calculation for disabled people altogether. If you receive disability benefits or have a disability, tell your state Medicaid office so they apply the correct income limit to your situation.