Medicaid income limits vary by state and family size, and they change yearly
There is no single income limit for Medicaid across the United States. Each state sets its own threshold based on the federal poverty level, which the government adjusts every January. A family of three in one state might may have access to at an income that disqualifies them in another state.
Most states use between 100% and 200% of the federal poverty level as their cutoff. This means a state might say: if your household income is below 138% of the poverty line, you may be covered. For 2024, 100% of the federal poverty level for a family of three is roughly $23,000 per year, but that number shifts annually and varies by family size.
The income limit also depends on which Medicaid program you are looking at. Medicaid for children, pregnant people, elderly adults, and people with disabilities each have different rules in most states. Some states have expanded Medicaid to cover more working-age adults; others have not.
Key Takeaways
- Your state's Medicaid program sets the income limit, not the federal government, so you must check your specific state's rules.
- Income limits are expressed as a percentage of the federal poverty level and change every January based on updated poverty figures.
- Different Medicaid categories (children, pregnant people, elderly, disabled) have different income thresholds within the same state.
- Your household income includes wages, self-employment earnings, Social Security, unemployment benefits, and other regular income sources.
- Some states count income before taxes; others count it after certain deductions, so the calculation method matters.
How to find your state's specific income limit
The fastest way is to visit your state Medicaid agency website directly. Search "[your state] Medicaid income limits" or go to the main Medicaid page for your state. Most state sites list the current limits by household size and program category in a table or downloadable document.
You can also call your state Medicaid office or visit a local office in person. Staff can tell you whether your household income falls within the limit for the program you are interested in. Many states also have online screening tools where you enter your income and family size to see what programs might be available to you.
If you cannot find the information online, 211.org is a free referral service that can direct you to your state Medicaid office or a local organization that can answer questions about income limits.
What counts as household income for Medicaid
Medicaid counts most regular money coming into your household. This includes wages from employment, self-employment income, Social Security benefits, unemployment insurance, child support, alimony, and rental income. Some states also count interest and dividends.
Not all income counts. Most states exclude certain items: the first $65 of monthly earned income (in some programs), student loans, tax refunds, and money from certain assistance programs. Some states have special rules for self-employed people or seasonal workers.
The key is whether the income is regular and predictable. A one-time gift or inheritance typically does not count. If you are unsure whether a specific income source counts, ask your state Medicaid office — the rules vary enough that it is worth confirming before you assume you are over or under the limit.
How states calculate household size
Household size is not always obvious. Generally, it includes you, your spouse (if you are married), and any children under 19 who live with you. Some states count adult children or other relatives living in your home; others do not.
If you are pregnant, some states count the unborn child as a household member for income purposes. If you are caring for a grandchild or foster child, the rules depend on your state and whether you receive support payments for that child.
Ask your state Medicaid office how they define your household before you calculate your income limit. A difference of one person can move you above or below the cutoff.
Medicaid expansion and higher income limits
In 2014, the Affordable Care Act allowed states to expand Medicaid to cover more working-age adults. States that expanded Medicaid typically raised their income limit to 138% of the federal poverty level. States that did not expand kept their old, lower limits.
As of 2024, about 40 states have expanded Medicaid, but roughly 10 states have not. If you live in a non-expansion state, your income limit for adult coverage may be much lower — sometimes as low as 50% of the poverty level. If you live in an expansion state, you may may have access to at a higher income even if you work full-time.
Check whether your state has expanded Medicaid. If it has not, you might still have other options: some non-expansion states have created their own programs, or you may be able to purchase coverage through the health insurance marketplace with tax credits if your income is above Medicaid but below a certain threshold.
Income limits for specific Medicaid categories
Children often have higher income limits than adults in the same state. A state might cover children up to 200% of the poverty level but only cover adults up to 138%. Pregnant people and new mothers also frequently have higher limits than other adults.
Elderly people and people with disabilities may have different limits again, and some states use different income-counting rules for these groups. For example, a state might exclude more income for a disabled person than for a working-age adult.
If you are applying for Medicaid in more than one category — for instance, you are pregnant and have a child — each person may have a different income limit. Your household income is counted the same way, but the threshold they are compared against may differ.
What happens if your income changes
Medicaid programs usually look at your income for the month you apply or the past month or two, depending on the state. If your income goes up after you are approved, you may lose coverage, but most states give you a grace period before they end your benefits.
If your income drops — you lose a job, hours are cut, or you retire — you may become newly covered or move to a different Medicaid program. Report income changes to your state Medicaid office. Many states now allow you to report changes online or by phone.
Some people cycle between Medicaid and marketplace insurance as their income changes. If you are near the income limit, ask your state Medicaid office about how changes are handled and whether there are programs that protect your coverage during transitions.
Frequently Asked Questions
Does my spouse's income count if we are married but file taxes separately?
Yes. Medicaid counts the income of your spouse regardless of how you file taxes. If you are married and living together, your spouse's income is part of your household income for Medicaid purposes. Some states have exceptions for legally separated spouses, so check your state's rules if that applies to you.
If I earn more than the limit, can I still get Medicaid?
Not through standard Medicaid, but you may have other options. Some states have programs for people with higher incomes who have significant medical expenses or disabilities. You might also be able to buy marketplace insurance with tax credits if your income is above Medicaid but below 400% of the poverty level. Contact your state Medicaid office or visit healthcare.gov to explore what is available to you.
What if my income is seasonal or varies month to month?
Most states average your income over a period of time — often the past month or the past three months — rather than looking at a single paycheck. If you are self-employed or have seasonal work, bring documentation of your typical annual income. Some states have special rules for seasonal workers that may help you may have access to.
Do I have to report my income every month?
Not usually. Most states ask you to report income changes only when they happen — if you get a raise, lose a job, or start receiving benefits. Some states do periodic reviews and may ask you to verify your income once a year. Check your state's rules or ask when you apply.
Can I reduce my income to may have access to for Medicaid?
You cannot intentionally reduce your income just to may have access to. Medicaid programs look at your actual income and expect you to work or earn what you can. However, certain deductions and exclusions are built into the rules — for example, some states exclude the first $65 of earned income — so you may may have access to even if you work.