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

There is no single Medicaid income limit that applies everywhere. Each state sets its own threshold for who can receive Medicaid based on income. A person earning $1,500 per month might may have access to in one state and not in another. The limit also depends on whether you are applying as an individual, a parent, a child, a pregnant person, or a senior — each category has a different income cutoff.

Most states use the federal poverty level as a starting point and then set their own percentage above it. For 2024, the federal poverty level for a single person is about $14,600 per year; for a family of four, it is about $30,000 per year. But states can choose to cover people earning 100%, 138%, 200%, or even higher percentages of the poverty level. Some states cover very little above poverty; others cover people earning significantly more.

The income limit that matters for you depends on which category you fall into and which state you live in. Your state's Medicaid program website or your local department of social services can tell you the exact number for your situation.

Key Takeaways

  • Medicaid income limits vary by state and by category — a parent, a child, a pregnant person, and a senior can have four different income thresholds in the same state.
  • Most states use a percentage of the federal poverty level to set their limits, but the percentage differs from state to state.
  • You can find your state's specific income limits on your state Medicaid website or by calling your local department of social services.
  • Some states expanded Medicaid to cover adults earning up to 138% of the federal poverty level; others did not, creating significant differences between neighboring states.

How states set income limits differently

States have broad freedom to decide who qualifies for Medicaid based on income. The federal government sets a floor — states must cover certain groups like children and pregnant people up to at least a certain level — but states can go higher. Some states choose to cover very few people above the poverty line. Others cover people earning twice the poverty level or more.

The biggest difference between states came after the Affordable Care Act in 2010. States could choose to expand Medicaid to cover all adults earning up to 138% of the federal poverty level. About 40 states did; about 10 did not. This means a 40-year-old earning $20,000 per year might may have access to in an expansion state and not may have access to in a non-expansion state, even if they live just across the border.

Within a single state, the income limits also vary by category. A state might cover children earning up to 200% of poverty, parents earning up to 100% of poverty, and pregnant people earning up to 185% of poverty. You need to know which category you fall into to know which limit applies to you.

Income categories and how they affect your limit

Medicaid groups people into categories, and each category has its own income threshold. The main categories are children, parents or caretakers, pregnant people, seniors (age 65 and older), and people with disabilities. Some states have additional categories for specific groups.

Children usually have the highest income limits — many states cover children earning up to 200% or 300% of the federal poverty level. Parents typically have lower limits, often closer to 100% of poverty. Pregnant people often fall between the two. Seniors and people with disabilities may have different limits depending on whether they are already receiving Social Security or Supplemental Security Income.

If you have a household with multiple people in different categories — for example, a parent and two children — each person's income is counted toward the household total, but each person is evaluated against their own category's limit. The rules for what counts as income and what does not also vary by category and state.

What counts as income for Medicaid

Medicaid counts most money coming into your household as income, 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.

Some income does not count. Supplemental Security Income (SSI) is not counted as income for Medicaid purposes in most states — if you receive SSI, you are usually automatically Medicaid-may be able to access regardless of other income. Some states also exclude certain types of income like tribal payments or specific types of assistance. A few states have special rules for students or people in certain work programs.

The way your state counts income can make a real difference. Some states count gross income (before taxes); others count net income (after taxes). Some allow deductions for work expenses, childcare, or medical costs; others do not. You need to know your state's specific rules to know whether you are over or under the limit.

How to find your state's income limit

Your state Medicaid program publishes its income limits, usually on its website. Search for "[Your State] Medicaid income limits" or "[Your State] Medicaid may be able to access." Most state websites have a section for each category showing the monthly or annual income threshold.

If you cannot find it online or want to confirm the number, call your local department of social services, county health department, or your state Medicaid hotline. They can tell you the exact limit for your household size and category. Some states also have online screening tools where you enter your income and household information and get an immediate answer about whether you might be over or under the limit.

Keep in mind that income limits change periodically — usually once per year when the federal poverty level is updated. If you checked your state's limit a year ago, it may have changed. Checking again before you contact your state is worth the time.

What happens if your income is above the limit

If your income is above your state's Medicaid limit, you are not automatically disqualified from all health coverage. You may be able to purchase coverage through the health insurance marketplace (healthcare.gov or your state's equivalent) and may be may be able to access for a tax credit or cost-sharing reduction to lower your premium or out-of-pocket costs. The income limits for marketplace subsidies are higher than Medicaid limits — they go up to 400% of the federal poverty level in most cases.

Some states also have programs for people who earn too much for Medicaid but not enough to afford private insurance. These programs vary widely by state and are not available everywhere. Your state Medicaid website or a local health department can tell you whether your state has such a program.

If your income drops in the future — due to job loss, reduced hours, or other changes — you can reapply for Medicaid at any time. You do not have to wait for an annual open enrollment period the way you do with marketplace insurance.

Income limits for specific groups

Seniors and people with disabilities who receive Social Security or SSI have different rules. If you receive SSI, your Medicaid status is usually tied to your SSI status — you are Medicaid-may be able to access as long as you receive SSI, regardless of other income or resources. If you receive Social Security but not SSI, your state's regular income limits apply, but your state may have higher limits for seniors than for working-age adults.

Pregnant people often have higher income limits than other adults in the same state. Some states cover pregnant people earning up to 185% or 200% of the federal poverty level, even if parents earning the same amount would not may have access to. This is because federal law requires states to cover pregnant people and infants at higher income levels than other adults.

Children almost always have the highest income limits. Federal law requires states to cover children up to at least 133% of the federal poverty level, but most states go higher — many cover children up to 200% or 300% of poverty. A child in a household earning $60,000 per year might may have access to for Medicaid even if the parents do not.

Frequently Asked Questions

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

Yes. Your household size changes, which changes the poverty level used to calculate your limit. If you marry someone, your combined household income is now counted. If you have a baby, your household size increases, which raises the income threshold. You should report changes to your state Medicaid program, as they may affect whether you stay within the limit or whether a new household member qualifies.

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

Most states use your average income over the past few months or your expected income for the coming year. If you have a very low month followed by a high month, they average them. If your income is genuinely unpredictable, tell your state program — some have rules for self-employed people or seasonal workers that account for variation.

Can I have savings and still be under the income limit?

Income and resources are different. Income is money coming in; resources are money or assets you already have. Medicaid income limits only look at income. However, some categories of Medicaid (particularly those tied to SSI) do have resource limits — caps on how much money or property you can own. Ask your state program whether resource limits apply to your category.

If I live in a non-expansion state, can I move to an expansion state to may have access to for Medicaid?

Medicaid is tied to the state where you live, not where you are from. If you move to an expansion state, you can apply for Medicaid under that state's rules once you establish residency. However, moving solely to may have access to for Medicaid is not practical for most people. If you are uninsured and earn too much for Medicaid in your state, the marketplace is usually your next option.

How often do income limits change?

Federal poverty levels — which most states use to set their limits — are updated each year, usually in January. States then adjust their Medicaid income limits accordingly. Some states make other changes to their limits at different times of year. Check your state's website annually or when your income or household changes to confirm the current limit.