Medicaid income limits for seniors vary by state and program type

There is no single federal income limit for Medicaid that applies everywhere. Each state sets its own threshold, and most states use different limits depending on which Medicaid program you enter — regular Medicaid, Medicaid for the elderly and disabled, or a special program for people who need long-term care. A person aged 65 or older in one state might may have access to at an income level that disqualifies them in another state just miles away.

Income limits also change year to year. States adjust them based on federal poverty guidelines, and some states raise their limits periodically. The only way to know whether you meet your state's current limit is to check with your state Medicaid office or use your state's online screening tool.

What counts as "income" also matters. Medicaid typically counts wages, Social Security, pensions, and investment returns. Some income sources are excluded — for example, Supplemental Security Income (SSI) is usually not counted, and some states exclude certain types of retirement savings or home equity. The rules differ by state and by which Medicaid program you are entering.

Key Takeaways

  • Each state sets its own Medicaid income limit for seniors, so you must check your specific state's rules rather than relying on a national figure.
  • Most states have different income limits for regular Medicaid, Medicaid for elderly and disabled people, and long-term care Medicaid, so the program you enter affects whether you may have access to.
  • Income limits change annually and are tied to federal poverty guidelines, which increase most years.
  • Not all income counts toward the limit — Social Security, SSI, and certain retirement income may be excluded depending on your state and program type.
  • Your state Medicaid office or a local Area Agency on Aging can tell you the current limit and whether your income qualifies.

How states set income limits

Most states tie their Medicaid income limits to the federal poverty line. A state might set its limit at 100% of the federal poverty level, 138%, 200%, or another percentage. For 2024, the federal poverty line for a single person is $14,580 per year. A state that sets its limit at 138% of poverty would allow income up to roughly $20,120 for a single senior. A state at 200% would allow roughly $29,160.

Some states use a different approach called "medically needy" Medicaid. Under this system, your income can exceed the regular limit, but Medicaid will subtract your medical expenses from your income. If your remaining income falls below the state's threshold after those deductions, you may still may have access to. This route is common for seniors with high healthcare costs.

A handful of states have not expanded their Medicaid programs and maintain lower income limits than others. These states often have limits around 74% of the federal poverty line for regular Medicaid, though they may have separate programs for seniors with higher thresholds.

Different programs, different limits

Most states run more than one Medicaid program for seniors, and each has its own income limit. Regular Medicaid for elderly people typically has the lowest income threshold. Medicaid for Aged, Blind, and Disabled (ABD) often has a higher limit and is specifically designed for people 65 and older. Long-term care Medicaid — used to cover nursing home or home care costs — frequently allows higher income because the program assumes you will spend down assets on care.

Some states also offer Medicaid waiver programs that let seniors stay at home while receiving care that would normally require a nursing home. These programs sometimes have different income limits than facility-based long-term care Medicaid.

Because limits vary by program, an older adult who does not may have access to for regular Medicaid might may have access to for ABD or long-term care Medicaid. It is worth checking each program your state offers, not just the first one you encounter.

What income counts and what does not

Medicaid counts most regular income: wages, self-employment income, pensions, annuities, and interest or dividends. Social Security benefits are counted in most cases. However, Supplemental Security Income (SSI) is typically not counted — this matters because many seniors receive both Social Security and SSI, and only the Social Security portion affects the Medicaid limit.

Some states exclude certain types of retirement income or allow deductions for medical expenses, work-related costs, or dependent support. A few states do not count the income of a spouse who is not applying for Medicaid, which can help couples where one person has high income.

Asset limits are separate from income limits. Even if your income qualifies, Medicaid also looks at how much money and property you own. For regular Medicaid, most states set the asset limit at $2,000 for a single person and $3,000 for a couple, though these figures vary. Long-term care Medicaid often has higher asset limits or uses different rules for counting assets.

How to find your state's current limit

Your state Medicaid office publishes its income limits, usually on its website. Search "[your state] Medicaid income limits elderly" or "[your state] Medicaid ABD income limit" to find the official figure. Most state websites also have an online screening tool where you can enter your income and see which programs you might may have access to for.

If you cannot find the information online, call your state Medicaid office directly. The phone number is usually listed on your state's health department or human services website. Have your income information ready — they can often tell you on the phone whether you meet the threshold.

Your local Area Agency on Aging can also help. These agencies exist in every county and often have staff trained to explain Medicaid rules and help seniors understand whether they may have access to. You can find your local agency through the Eldercare Locator at 1-800-677-1116 or online at eldercare.acl.gov.

Income limits for couples and household size

Medicaid income limits are higher for couples than for single people, and they increase with household size. A state might set the limit for a single senior at $1,500 per month but $2,250 for a couple. If you have dependents living with you, the limit may be even higher.

However, the rules for counting a spouse's income differ by program. In regular Medicaid, both spouses' incomes are usually counted together. In long-term care Medicaid, some states use "spousal impoverishment" rules that protect the at-home spouse's income and assets, allowing the spouse in a facility to may have access to even if the household income would normally be too high.

If you are married and one spouse is applying for Medicaid while the other is not, ask your state Medicaid office how they count household income. The answer can significantly affect whether you may have access to.

What happens if your income exceeds the limit

If your income is above your state's Medicaid limit, you have several options. First, check whether your state offers a medically needy program — your medical expenses might bring you under the threshold. Second, ask about Medicaid spend-down, where you use excess income to pay for medical care, and Medicaid covers costs above that amount. Third, explore whether you may have access to for Medicare Savings Programs, which help pay Medicare premiums and cost-sharing for people with income slightly above Medicaid limits.

Some seniors also may have access to for Medicaid for Working People with Disabilities or other special programs that have higher income limits. If regular Medicaid does not work, your state Medicaid office can tell you what alternatives exist.

Frequently Asked Questions

Does Social Security count toward the Medicaid income limit?

Yes, in most states Social Security benefits are counted as income for Medicaid purposes. However, if you also receive Supplemental Security Income (SSI), that amount is usually not counted. Your state Medicaid office can tell you exactly how your specific Social Security and SSI amounts are treated.

If I am married, does my spouse's income count even if they are not applying for Medicaid?

In regular Medicaid, yes — both spouses' incomes are counted together. In long-term care Medicaid, some states protect the at-home spouse's income under spousal impoverishment rules. The answer depends on your state and which program you are entering, so ask your state Medicaid office.

What if my income changes after I am approved?

You must report income changes to your state Medicaid office. If your income rises above the limit, you may lose coverage. If it drops, you might become newly may be able to access or move to a different Medicaid program. Report changes promptly to avoid overpayments or coverage gaps.

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

Medicaid looks at your actual income, not income you choose not to receive. You cannot simply refuse a paycheck or pension payment to lower your counted income. However, legitimate expenses like medical costs or spousal support can sometimes reduce your countable income under your state's rules.

Where do I find the exact income limit for my state right now?

Call your state Medicaid office or visit your state's Medicaid website — limits change annually. You can also contact your local Area Agency on Aging at 1-800-677-1116, or use your state's online Medicaid screening tool if one is available.