Medicaid income limits vary by state and family size, and they change yearly

There is no single maximum income for Medicaid across the United States. Each state sets its own limits based on the federal poverty level, and those limits differ for different types of coverage. A single adult in one state might may have access to at an income that disqualifies someone in another state. Even within a state, the limit for a parent with children is different from the limit for a childless adult or a senior.

Income limits also shift every year on January 1st, when the federal poverty level adjusts. If you earned too much last year, you may may have access to this year — or the reverse. The only way to know your actual limit is to check your state's Medicaid program directly, because published numbers become outdated quickly.

Key Takeaways

  • Each state sets its own Medicaid income limit, usually expressed as a percentage of the federal poverty level, so the same income qualifies in one state but not another.
  • Income limits are different for parents, children, seniors, and people with disabilities, even within the same state.
  • Limits change every January 1st when the federal poverty level updates, so you may may have access to this year even if you didn't last year.
  • Your state's Medicaid office or a local community health center can tell you the current limit for your household size and situation in minutes.

How states calculate their income limits

Most states express their Medicaid income limit as a percentage of the federal poverty level (FPL). For 2024, the federal poverty level for a single adult is $14,600 per year. A state might say its limit is 138% of the FPL, which means a single adult could earn up to about $20,100 and still may have access to. Another state might set its limit at 100% of the FPL, capping it at $14,600.

The percentage varies by state and by category. A state might cover parents at 138% of the FPL but cover childless adults at only 100%. Some states have expanded Medicaid under the Affordable Care Act and cover more people; others have not expanded and cover fewer. This is why two people with identical incomes and family sizes can have opposite outcomes depending on which state they live in.

Income limits also depend on what counts as income. Wages and salary count. Social Security counts. Child support counts. But some income does not — certain types of disability payments, some student loans, and some types of assistance may be excluded. Your state's Medicaid office can tell you which forms of income they count toward the limit.

Income limits for different household types

Medicaid has separate income limits for parents, children, seniors (age 65 and older), and people who are blind or disabled. A parent with two children might may have access to at a much higher income than a childless adult in the same state, because the limit is based on household size and composition.

Children often have the highest income limits because states receive federal matching funds to cover them. A child in a household earning 200% of the federal poverty level might may have access to in a state where a parent in the same household does not. Seniors and people with disabilities may have different limits again, sometimes lower and sometimes higher depending on the state's choices.

If you have a mixed household — for example, a parent, a child, and a grandparent — each person's income limit is calculated separately based on their category. The program looks at whether each person meets the threshold for their own group.

How to find your state's current income limit

Your state's Medicaid office publishes its income limits online, but the pages are often hard to navigate. The fastest way is to call your state's Medicaid hotline directly and give them your household size and composition. They can tell you the exact limit in under five minutes. Most state Medicaid offices have a phone number on their website, and many have online chat.

You can also contact a local community health center, hospital social worker, or nonprofit that helps people with Medicaid. They work with these limits every day and can tell you whether your income qualifies. If you are unsure whether to count certain income, ask them to walk you through it — they know which types of income your state includes and which it excludes.

The Centers for Medicare & Medicaid Services (CMS) maintains a map showing each state's income limits by category, updated yearly. Searching "[your state] Medicaid income limits 2024" will usually pull up your state's official page quickly.

What happens if your income changes during the year

Medicaid programs look at your income at the time you apply, not your income for the whole year. If you earn $25,000 in January and then lose your job in March, your income for the purpose of Medicaid is what you expect to earn going forward — not your annual total. This means a job loss can make you newly may be able to access even if you earned too much earlier in the year.

If your income rises after you are already enrolled, you usually have a grace period before Medicaid ends your coverage. Most states allow you to stay on Medicaid for at least one month after your income exceeds the limit, and some allow longer. You should report the income change to your state's Medicaid office so they can tell you exactly when your coverage will end and what your options are.

Some people move between Medicaid and other programs like the Affordable Care Act marketplace as their income changes. If your income rises above Medicaid's limit, you may become may be able to access for a tax credit on the marketplace instead. Your state's Medicaid office or a local navigator can explain what coverage is available at your new income level.

Income limits for seniors and people with disabilities

Seniors and people receiving Supplemental Security Income (SSI) are covered under different Medicaid rules in most states. SSI recipients are automatically may be able to access for Medicaid in many states, regardless of income, because SSI itself is a needs-based program. In other states, SSI recipients must still meet a separate Medicaid income limit, though it is often higher than the limit for working-age adults.

Seniors age 65 and older have their own income limits, which vary by state. Some states use the same percentage of the federal poverty level as they do for other groups; others use a different threshold. Medicare beneficiaries who are also may be able to access for Medicaid (called "dual may be able to access") have income limits that reflect both programs' rules.

People with disabilities who are not receiving SSI may have income limits that are higher than the limit for childless working-age adults, depending on the state. Some states have special programs for working people with disabilities that allow higher earnings. Your state's Medicaid office can tell you which category applies to your situation.

Frequently Asked Questions

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

Yes, in most cases. Medicaid counts the income of your spouse and any dependents in your household when determining whether you may have access to. If you are married but file taxes separately or live apart, ask your state's Medicaid office whether spousal income counts — the rules vary by state and situation.

What if I am self-employed — how do they count my income?

Self-employment income counts toward the Medicaid limit, but your state may allow you to deduct certain business expenses before calculating what counts. Ask your state's Medicaid office which expenses they allow — this can make a real difference if you have significant costs. Bring tax returns or profit-and-loss statements when you apply so they can see your actual net income.

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

No. Medicaid programs verify income through tax records, employment verification, and bank statements. Lying about income is fraud and can result in being required to repay benefits, fines, and criminal charges. If your income is close to the limit, ask your state's Medicaid office whether any income is excluded — that is the legal way to lower your countable income.

If I live in a state that did not expand Medicaid, can I still may have access to?

Yes, but the income limit is lower. Non-expansion states usually cover only parents, children, seniors, and people with disabilities at or near the federal poverty level. A childless adult earning $15,000 per year might not may have access to in a non-expansion state but would may have access to in an expansion state. Check your state's specific rules to see which groups are covered.

Do I need to report income changes to Medicaid?

Yes. You should report significant income changes — like a new job, a job loss, or a raise — to your state's Medicaid office. They will tell you whether your coverage continues, ends, or changes. Failing to report changes can result in overpayment of benefits that you may be asked to repay later.