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 based on the federal poverty level, and that threshold varies by family size. A single adult might may have access to at one income level while a parent of three children qualifies at a higher one in the same state. Some states are more generous than others — a household that earns too much for Medicaid in one state may may have access to in a neighboring state.

The federal government sets a baseline (the federal poverty level), but states can choose to go above or below it. This means you need to check your specific state's rules, not a national average. Your state's Medicaid agency publishes its current income limits, and they change once per year when the federal poverty level updates.

Key Takeaways

  • Income limits are set by each state and based on the federal poverty level, which changes yearly.
  • Your household size matters as much as your income — a family of four has a higher limit than a single person in every state.
  • Some states expanded Medicaid to cover adults earning up to 138% of the federal poverty level; others have lower limits.
  • You can find your state's exact income limit on your state Medicaid agency's website or by calling their customer service line.

How states calculate income limits

States express their Medicaid income limits as a percentage of the federal poverty level. The federal poverty level itself is updated each year by the U.S. Department of Health and Human Services. For 2024, the federal poverty level for a single person is around $15,000 per year, and for a family of four it is around $31,000 per year (these numbers change annually).

A state might say its Medicaid limit for adults is 138% of the federal poverty level. That means if the poverty level for a single person is $15,000, the state's limit would be roughly $20,700. Another state might set its limit at 100% of poverty, which would be $15,000. A third state might use 200% of poverty for families with children. The percentage varies by state and by category (children, pregnant people, parents, disabled adults, elderly adults).

Income limits also change based on who you are. Most states have different limits for children than for adults, different limits for pregnant people, and different limits for elderly or disabled individuals. A child might may have access to at 200% of poverty while an adult qualifies at 100% of poverty in the same state.

The difference between Medicaid expansion and non-expansion states

After the Affordable Care Act passed in 2010, states had the option to expand Medicaid to cover more adults. States that expanded Medicaid generally cover adults earning up to 138% of the federal poverty level. States that did not expand have lower income limits, often covering only parents below a certain threshold or not covering non-disabled, non-elderly adults at all.

This creates a significant gap. In an expansion state, a single adult earning $20,700 per year might may have access to for Medicaid. In a non-expansion state, that same person might not may have access to unless they are pregnant, disabled, elderly, or caring for a child. Which states have expanded and which have not is a matter of state policy and changes periodically as legislatures vote.

How income is counted for Medicaid

Not all money counts as income for Medicaid purposes. Gross income (what you earn before taxes) is typically what matters, but some types of income are excluded. For example, Supplemental Security Income (SSI) may not count the same way as wages, and some states exclude certain types of unearned income.

If you are self-employed, Medicaid counts your net income (income minus business expenses). If you receive child support, it counts as income. If you receive unemployment benefits, they count. Social Security benefits count. The exact rules vary by state and by the type of Medicaid program you are applying for.

Your state's Medicaid agency can tell you which types of income they count and how they calculate your total household income. This is important because two people earning the same gross amount might have different countable income depending on what types of income they receive.

Finding your state's specific income limit

Your state Medicaid agency publishes its current income limits on its website. You can search "[your state] Medicaid income limits" or go directly to your state health department's website. Most states have a table showing the limit for each household size and each category of person (child, adult, pregnant person, elderly, disabled).

If you cannot find the information online, you can call your state Medicaid office directly. They can tell you whether your household income falls within the limit for your state and your situation. Some states also have online screening tools that ask you a few questions and tell you whether you may be within the income range.

Keep in mind that being within the income limit is only one part of Medicaid may be able to access. You also have to meet other requirements, such as being a U.S. citizen or may have access to immigrant, living in the state, and meeting any category-specific rules (such as being pregnant, disabled, or caring for a child).

What happens if your income changes

If you are already enrolled in Medicaid and your income increases above the limit, you will lose coverage. Most states give you a grace period (often a month or more) to report the change, but you are required to tell them. If your income drops back below the limit, you can reapply or ask to be reinstated.

If you are not yet enrolled and your income is close to the limit, remember that income limits can change. Your state updates its limits once per year when the federal poverty level changes. An income that disqualifies you now might may have access to you next year if the federal poverty level increases and your state's percentage-based limit rises with it.

Income limits for specific populations

Children often have higher income limits than adults in the same state. Many states cover children up to 200% or even 300% of the federal poverty level through Medicaid or the Children's Health Insurance Program (CHIP). Pregnant people frequently have higher limits than non-pregnant adults. Elderly and disabled individuals may have different limits depending on whether they receive SSI.

If you are applying for Medicaid for a specific reason — because you are pregnant, because you are caring for a child, because you are elderly, or because you have a disability — ask your state Medicaid agency which income limit applies to your situation. The limit that matters is the one for your category, not the general adult limit.

Frequently Asked Questions

Is there a national Medicaid income limit I can use to check myself?

No. Each state sets its own limit based on a percentage of the federal poverty level. You must check your state's specific limit. A household that qualifies in one state may not may have access to in another, even if the income is identical.

Does my income limit change if I move to a different state?

Yes. If you move, you will need to check your new state's Medicaid income limits. You may lose coverage in your old state and have to reapply in your new state. Some states have higher limits than others, so your may be able to access may change when you move.

If I am married, do both spouses' incomes count?

Yes, household income includes all income from everyone living in your home, including spouses. Medicaid counts combined household income, not individual income, so both spouses' earnings are added together when determining whether you meet the income limit.

What if my income is slightly above the limit?

If you are above the income limit, you do not may have access to for Medicaid based on income alone. However, you may be able to deduct certain expenses (such as medical expenses or childcare costs) in some states, which can lower your countable income. Ask your state Medicaid agency whether any deductions apply to your situation.

How often do income limits change?

Income limits change once per year, usually in January, when the federal poverty level is updated. Your state will publish its new limits at that time. If your income was above the limit last year, it is worth checking again this year in case the limit increased.