Medicaid income limits depend on your state and family size

There is no single maximum income for Medicaid across the United States. Each state sets its own income threshold, and the amount you can earn and still receive coverage depends on where you live, how many people are in your household, and which Medicaid program you are entering through. Some states use the federal poverty level as their baseline; others set limits higher or lower. A single person in one state might earn $1,500 per month and may have access to, while the same person in another state might may have access to at $2,000 per month.

The income limit also changes based on family size. A household of three has a higher threshold than a household of one, because the federal poverty level itself scales with family size. When you contact your state Medicaid office or apply online, you will enter your household size and monthly income, and the system will tell you whether you fall within that state's current limit.

Key Takeaways

  • Each state sets its own Medicaid income limit, so you must check your specific state's threshold rather than relying on a national number.
  • Income limits are based on the federal poverty level and scale upward as your household size increases.
  • Your state Medicaid office or the Healthcare.gov website can tell you the exact limit for your household size in your state.
  • Some states have expanded Medicaid to cover people earning up to 138 percent of the federal poverty level, while others use lower thresholds.
  • Income includes wages, self-employment earnings, Social Security, unemployment benefits, and child support, but some income sources are excluded or counted differently.

How states calculate the income limit

Most states base their Medicaid income limit on a percentage of the federal poverty level. The federal poverty level is set each year by the U.S. Department of Health and Human Services and varies by family size. For 2024, the federal poverty level for a single person is approximately $15,060 per year, or $1,255 per month. For a family of four, it is approximately $31,200 per year, or $2,600 per month. These figures change annually.

A state might set its Medicaid limit at 100 percent of the federal poverty level, meaning you can earn up to that amount. Another state might set it at 138 percent, allowing higher earnings. Some states use different percentages for different groups—for example, children might have a higher income limit than adults. After the Affordable Care Act, many states expanded Medicaid to cover adults earning up to 138 percent of the federal poverty level, but not all states have done so. Your state's specific percentage determines your threshold.

Income sources that count toward the limit

Medicaid counts most forms of income when determining whether you fall within the limit. Wages from employment, self-employment income, and net business income all count. Social Security benefits, unemployment insurance, workers' compensation, and disability payments count as well. Child support and alimony you receive are included. Rental income and interest or dividend income are counted.

Some income sources are excluded or treated differently. Supplemental Security Income (SSI) has its own rules and is often handled separately from regular Medicaid. Certain types of assistance—such as Temporary Assistance for Needy Families (TANF) or food stamps—may not count as income for Medicaid purposes in some states, though this varies. Tax refunds and one-time payments like gifts or inheritances typically do not count as ongoing income. Your state Medicaid office can clarify which income sources apply to your situation.

How to find your state's specific income limit

The fastest way to learn your state's income limit is to visit your state Medicaid office website directly. Search "[Your State] Medicaid income limits" to find the official page. Most state sites display a table showing the monthly or annual limit for each household size. You can also call your state Medicaid office and ask the limit for your household size, and they will give you the number immediately.

Healthcare.gov also displays income limits by state. Go to Healthcare.gov, select your state, and look for the Medicaid section. The site shows the income threshold and tells you whether your state has expanded Medicaid. If you are unsure whether you fall within the limit based on the numbers you see, you can start an application online or by phone, and the system will calculate your status based on your actual household income and size.

What happens if your income is slightly above the limit

If your income is above your state's Medicaid limit, you may still have other options. Some states run separate programs for people who earn too much for Medicaid but not enough to afford private insurance. These programs have different names in different states but often cover basic services. You may also be able to purchase coverage through the Health Insurance Marketplace, and depending on your income, you might receive a tax credit to lower your monthly premium.

If your income changes—for example, you lose a job or your hours are cut—your Medicaid status can change too. Many states allow you to report a change in income at any time, not just during the annual open enrollment period. If you were denied Medicaid because your income was too high, contact your state Medicaid office again if your situation changes, because you may now fall within the limit.

Income limits for specific Medicaid groups

Medicaid has different programs for different populations, and income limits can vary by group. Children often have higher income limits than adults in the same state. Pregnant women may have a separate, higher threshold. Elderly people and people with disabilities may be covered under different rules. Some states have a Medicaid program specifically for working people with disabilities that allows higher earnings than standard Medicaid.

If you are applying for Medicaid as a parent, a child, a pregnant woman, or a person with a disability, ask your state Medicaid office which income limit applies to your category. The limit for your group may be different from the general adult limit, and you may fall within the threshold for one category but not another.

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 household members when calculating your household income. If you are married and living together, both incomes are added together to determine whether your household falls within the limit. Some states have exceptions for certain situations, so ask your state Medicaid office if you have questions about your specific case.

What if I am self-employed or have irregular income?

Self-employment income counts toward the Medicaid limit. You will need to report your net business income (income minus business expenses) for the past three months or the past year, depending on your state's rules. If your income varies month to month, some states average it over a period of time. Contact your state Medicaid office to learn how they calculate self-employment income for your situation.

Can I lose Medicaid if my income goes up?

Yes. If your income rises above your state's limit, you may lose Medicaid coverage. However, most states allow a grace period or a process to report changes. Some states also have programs that let you keep Medicaid for a few months even if your income temporarily exceeds the limit. Report any income change to your state Medicaid office as soon as it happens.

Are there income limits for Medicaid expansion states versus non-expansion states?

Yes. States that expanded Medicaid under the Affordable Care Act typically cover adults earning up to 138 percent of the federal poverty level. States that did not expand Medicaid often have lower limits, sometimes covering only people earning up to 100 percent of the federal poverty level or less. Your state's expansion status directly affects the income threshold you must meet.