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

There is no single income limit for Medicaid across the United States. Each state sets its own threshold, and that threshold changes based on how many people are in your household. A single person in one state might earn too much for Medicaid while the same income in another state qualifies them. Your state's limit also depends on which Medicaid category you fall into — whether you are applying as a parent, a child, a pregnant person, or someone with a disability.

The federal government sets a baseline, but states can and do go higher. Some states have expanded Medicaid to cover adults earning up to 138% of the federal poverty line; others have not expanded and use much lower limits. This means the only way to know whether your income qualifies is to check your specific state's rules.

Key Takeaways

  • Medicaid income limits vary by state and household size, so you must check your state's specific threshold rather than relying on a national figure.
  • States that expanded Medicaid typically cover adults earning up to 138% of the federal poverty line, while non-expansion states use lower limits.
  • Your household size includes you, your spouse if you are married, and any children under 19 you claim as dependents.
  • Income counts as wages, self-employment earnings, Social Security, unemployment benefits, and some other sources — but not all income is counted the same way.
  • You can check your state's Medicaid office website or call 211 to learn the exact income limit for your situation.

How states set their own income limits

The federal poverty line is the starting point. In 2024, the federal poverty line for a single person is around $15,000 per year, and it increases for each additional household member. States can set their Medicaid limit at any percentage of this line — 100%, 138%, 200%, or higher — depending on their budget and policy choices.

States that have expanded Medicaid under the Affordable Care Act generally cover adults earning up to 138% of the federal poverty line. That means a single adult in an expansion state might may have access to with an income around $20,700 per year. States that have not expanded Medicaid often use much lower limits — sometimes as low as 50% or 60% of the poverty line for parents, which can mean earning just $7,500 to $9,000 per year disqualifies you.

Your state's Medicaid office publishes these limits and updates them yearly. You can find them on your state health department website or by calling your state Medicaid program directly.

How household size affects your income limit

Medicaid counts your household as you, your spouse (if married), and any children under 19 you claim as dependents on your taxes. It does not count adult children, parents, or other relatives living with you, even if they share expenses.

The federal poverty line rises with each household member. For 2024, a family of three has a poverty line around $32,000, while a family of four is around $41,000. Your state's Medicaid limit is a percentage of that poverty line for your household size. A family of four in an expansion state earning $56,600 might may have access to (138% of the poverty line), while the same family in a non-expansion state might need to earn under $20,500.

When you contact your state Medicaid office or use their online tool, you will enter your household size and income. The system will then tell you whether you fall within that state's limit for your situation.

What counts as income for Medicaid

Medicaid counts most money you receive regularly as income: wages from a job, self-employment earnings, Social Security benefits, unemployment insurance, child support, and alimony. It also counts some retirement income and pension payments.

Some income does not count or counts differently. Supplemental Security Income (SSI) is counted, but some states have separate income limits for SSI recipients. Certain tax credits like the Earned Income Tax Credit (EITC) may not count as income for Medicaid purposes in some states. Gifts and one-time payments usually do not count. Student loans and financial aid for school expenses typically do not count either.

The rules vary by state, so if you have income from an unusual source — a settlement, a trust, rental property — ask your state Medicaid office whether it counts toward your limit. They can tell you exactly how your specific income is treated.

Income limits for different Medicaid categories

Medicaid is not one program with one income limit. It is a collection of categories, and each has its own threshold. A parent might not may have access to under the parent category but could may have access to under a disability category if they have a may have access to condition. A child has a separate limit from an adult.

Children often have higher income limits than adults in the same state. Pregnant people and new parents sometimes have higher limits than other adults. People receiving Supplemental Security Income (SSI) for disability or age have their own income rules. If you are over 65 or have a disability, your state may have a different limit than it does for working-age adults without disabilities.

When you contact your state Medicaid office, tell them your age, family situation, and whether you have a disability. They will tell you which category you fall into and what that category's income limit is.

How to find your state's specific income limit

The fastest way is to visit your state's Medicaid website directly. Most state health departments have a page showing current income limits by household size and category. You can also call your state Medicaid office — the number is on your state health department website — and ask the income limit for your household size and situation.

If you do not know your state's Medicaid office number, call 211 (a free helpline available in most areas). They can tell you your state's income limit and connect you to your local Medicaid office. Some states also have online tools where you enter your income and household size and get an immediate answer about whether you may be within the limit.

Keep in mind that income limits change once per year, usually in January. If you checked your limit last year, check again this year to see if it has changed.

What happens if your income is just over the limit

If your income is slightly above your state's Medicaid limit, you may still have options. Some states use "income disregards" — they subtract certain expenses from your income before comparing it to the limit. For example, some states disregard child care costs or work-related expenses, which can lower your countable income enough to may have access to.

If you earn too much for Medicaid but not enough for private insurance, you may be able to purchase coverage through the health insurance marketplace (Healthcare.gov) and receive a tax credit to lower your premium. The income thresholds for marketplace tax credits are higher than Medicaid limits in most states, so this is often an option for people just above the Medicaid line.

Some states also have programs for people with specific conditions — like breast cancer or diabetes — that have separate income limits. Ask your state Medicaid office whether any of these programs apply to you.

Frequently Asked Questions

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

Yes. Medicaid counts your spouse's income as part of your household income regardless of how you file taxes. If you are married, your spouse's earnings are included in the calculation, even if you keep finances separate.

If I get a raise, will I lose Medicaid immediately?

No. Most states have a process called "continuous enrollment" or a grace period. If your income goes over the limit, you usually have a chance to report the change, and your coverage does not end right away. Some states allow you to keep coverage for a few months after your income exceeds the limit. Contact your state Medicaid office to learn your state's rules on income changes.

Does my child's income count toward the household limit?

Only if your child is under 19 and you claim them as a dependent. If your child works and earns income, that income is part of your household's total for Medicaid purposes. Adult children's income does not count.

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

Self-employment income is usually calculated as your net profit (revenue minus business expenses) from the past year or the current year, depending on your state. You will need to provide tax returns or profit-and-loss statements. Ask your state Medicaid office which year's income they use and what documents they need to verify self-employment earnings.

Can I be denied Medicaid only because my income is too high?

Yes. If your income exceeds your state's limit for your household size and category, you do not meet the income requirement. However, you may still have other options, such as marketplace insurance with tax credits or state-specific programs for people with certain conditions.