Medicaid income limits depend on your state, your household size, and which program you're in

There is no single national income limit for Medicaid. Each state sets its own threshold, and the amount changes based on how many people live in your household. A single person earning $1,500 per month might may have access to in one state and not in another. Some states also run separate programs — like Medicaid for pregnant people or children — with different income cutoffs than the main program.

The federal government sets a baseline, but states can choose to go higher or lower. This means you need to check your specific state's numbers, not a national average. Your state's Medicaid office or your local 211 service can tell you the exact limit that applies to you.

Key Takeaways

  • Income limits vary by state and household size; a limit that applies in California does not apply in Texas.
  • Most states use the federal poverty level as a starting point, then adjust it — some cover people at 138% of poverty, others at 100% or lower.
  • Your state's Medicaid office website lists the current income limit for your household size in plain language.
  • Income includes wages, self-employment earnings, Social Security, unemployment benefits, and child support — but not all income counts the same way.
  • If you earn slightly above the limit, you may still may have access to through a separate program or a work incentive if you receive disability benefits.

How states set their own income limits

The federal poverty level is the baseline most states use. For 2024, the federal poverty level for a single person is around $14,600 per year, and it rises with each household member. Many states cover people up to 138% of that level — meaning a single person could earn roughly $20,100 annually and still may have access to. Other states cover only people at 100% of poverty or below.

A handful of states have set their limits much lower, covering only the poorest households. Meanwhile, some states have expanded Medicaid to cover people earning up to 200% or more of the federal poverty level. The difference between states is real and significant: a family of four earning $55,000 per year might may have access to in one state and be over the limit in another.

Your state's Medicaid program publishes its current income limits on its website, usually in a table organized by household size. That table is the authoritative source for your situation.

What counts as income and what does not

Medicaid counts most money coming into your household: wages from a job, self-employment income, Social Security benefits, unemployment insurance, child support, and alimony. If you receive disability payments or retirement benefits, those count too. Some states also count unearned income like interest or dividends, though the amounts are usually small enough not to matter.

Certain income does not count. Supplemental Security Income (SSI) is excluded in most states. Some states do not count the first $65 of monthly earnings plus half of the rest if you are working. Food assistance (SNAP) and housing assistance do not count as income. Tax refunds and one-time payments like insurance settlements usually do not count either. The rules vary by state, so ask your state Medicaid office which deductions apply to your situation.

If you are self-employed, most states count your net income — what you earn after business expenses — not your gross revenue. Keep records of your expenses to show what you actually take home.

Income limits for specific Medicaid programs

Some states run separate Medicaid programs for children, pregnant people, or parents, each with its own income limit. A child might may have access to at a higher income level than an adult in the same household. Medicaid for pregnant people often has a higher threshold than regular Medicaid. These programs exist because federal law allows states to cover certain groups more broadly.

If you do not may have access to for regular Medicaid but have a child or are pregnant, check whether your state runs one of these targeted programs. Your state Medicaid office can tell you which programs exist and what the income limits are for each one. Some states also run programs for people with disabilities or chronic conditions that have separate income rules.

What happens if you earn slightly above the limit

If your income is just above your state's Medicaid limit, you have a few options. Some states use a "medically needy" program that lets you "spend down" your income by paying medical bills, bringing your countable income below the limit. This is most common for people with high medical expenses.

If you receive Social Security Disability Insurance (SSDI), you may may have access to for Medicaid through a work incentive program even if your earnings are above the regular limit. These programs are designed to let people with disabilities work without losing coverage. Your state's Medicaid office or your local disability work incentive program can explain whether you may have access to.

You can also look into the health insurance marketplace. If your income is between 100% and 400% of the federal poverty level, you may be able to buy a plan through the marketplace with a tax credit that lowers your monthly cost.

How to find your state's income limit

Start with your state Medicaid office website. Search "[your state] Medicaid income limits" and look for a page titled something like "Income and Resource Limits" or "Who Can Get Medicaid." The page should show a table with limits for different household sizes. Write down the number that matches your household size.

If you cannot find it online, call your state Medicaid office directly. The number is usually on the Medicaid website. You can also call 211 (dial 2-1-1 from any phone) and ask for your state's Medicaid income limit. They can tell you over the phone whether you are likely to may have access to based on your household size and income.

If your income is close to the limit, bring recent pay stubs or tax returns when you contact Medicaid. They can give you a more precise answer about whether you may have access to, because they can account for deductions and exclusions that apply in your state.

Income limits change — check the current numbers

Income limits are adjusted each year, usually in January, to account for inflation. The federal poverty level rises, and most states raise their Medicaid limits along with it. If you were over the limit last year, you might may have access to this year. If you may have access to before, you should still may have access to unless your state lowered its limit — which is rare but has happened.

Before you assume you do not may have access to, check your state's current limits. Do not rely on information from last year or from another state. Your state Medicaid office updates its income limits annually and publishes them online.

Frequently Asked Questions

Does my spouse's income count if we are married?

Yes, in most cases. Medicaid counts the income of your spouse and any dependents in your household. Some states have different rules for elderly or disabled people, so ask your state Medicaid office whether spousal income applies to your situation.

What if my income varies month to month because I work irregular hours?

Most states average your income over the past three months or use your most recent month as a snapshot. Self-employed people and those with seasonal work should provide documentation of typical earnings. Tell your Medicaid office about the variation when you report your income.

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

No. Most states have a process called "continuous may be able to access" that keeps you covered for a set period — often 12 months — even if your income rises above the limit. After that period ends, your coverage is reviewed. Ask your state Medicaid office about the continuous may be able to access period in your state.

Do I have to report income changes to Medicaid?

Yes. If your income rises significantly, you are required to report it. The timing depends on your state — some want notification within 10 days, others within 30 days. Failure to report can result in overpayment that you may owe back. Check your state's reporting requirements when you first enroll.

What if I am unemployed — do I still have to meet an income limit?

Yes, but unemployed people often may have access to because their income is zero or very low. If you receive unemployment benefits, those count as income. Once unemployment ends, your income drops and you are more likely to may have access to. Report your status change to Medicaid.