Medicaid is based on income, family size, and citizenship — not on age or employment

Medicaid covers people whose household income falls below a threshold set by their state. That threshold changes based on how many people live in your home. You do not have to be elderly, disabled, or unemployed to get Medicaid — you have to meet the income and citizenship rules your state uses. Every state runs its own Medicaid program, so the income limit in one state may be higher or lower than in another, and some states have expanded Medicaid while others have not.

The federal government sets a floor — a minimum income level below which states must cover certain groups — but states can choose to cover more people and set higher income limits. This means your neighbor in a different state with the same income might may have access to while you do not, or vice versa. The only way to know whether you meet your state's rules is to check with your state Medicaid office or use your state's online screening tool.

Key Takeaways

  • Medicaid income limits vary by state and family size; you must check your specific state's threshold to know if you may have access to.
  • Citizenship or lawful immigration status is required in all states, though some states cover pregnant people and children regardless of status.
  • Your household income includes wages, self-employment earnings, Social Security, unemployment benefits, and child support — not all income sources count the same way.
  • Some states have expanded Medicaid to cover adults earning up to 138 percent of the federal poverty line; others have not, creating a coverage gap for working adults.
  • You can check whether you may be covered by contacting your state Medicaid office, calling 211, or using your state's online screening tool.

Income limits and how your state sets them

Your state Medicaid program uses a number called the federal poverty line as its starting point. For 2024, the federal poverty line for a single person is about $15,000 per year; for a family of four, it is about $31,000. Your state then decides what percentage of that line to use as its income limit. Some states cover people up to 100 percent of the poverty line. Others cover up to 138 percent or higher. A few states have not expanded their programs and cover only certain groups like children and pregnant people, leaving working-age adults without children with no Medicaid option.

Income limits also depend on family size. A single person has a lower limit than a married couple, who have a lower limit than a family of four. When you apply, your state counts your household income — usually your gross income before taxes — and divides it by the number of people in your home. If that number is below your state's limit, you may be covered.

Not all income counts the same way. Wages and self-employment earnings count fully. Social Security, unemployment benefits, and child support also count. But some income is excluded: the first $65 per month of earned income, certain student loans, and some types of assistance do not count toward the limit. Your state Medicaid office can tell you exactly which sources count in your situation.

Citizenship and immigration status requirements

You must be a U.S. citizen or have lawful immigration status to get Medicaid in any state. Lawful status includes having a green card, a valid visa, asylum status, or temporary protected status. Undocumented immigrants do not may have access to for regular Medicaid in any state.

A few states have created separate programs that cover pregnant people and children without regard to immigration status, using state funds rather than federal Medicaid money. California, Illinois, New York, and a handful of others offer this coverage. If you are undocumented, check whether your state has such a program by calling your state Medicaid office or 211.

Who Medicaid must cover in every state

Federal law requires all states to cover certain groups if their income is below the state limit. These groups include children under 19, pregnant people, parents and caretakers of dependent children, and people over 65. States must also cover people who are blind or have disabilities that prevent them from working, as determined by Social Security standards.

Beyond these mandatory groups, states can choose to cover other people. The biggest difference between states is whether they have expanded Medicaid to cover working-age adults without children. States that have expanded cover adults earning up to 138 percent of the federal poverty line. States that have not expanded typically cover only the mandatory groups, leaving a gap: a working adult without children might earn too much for Medicaid but too little to afford private insurance.

How to learn about you meet your state's rules

The fastest way is to use your state's online screening tool. Most states have a website where you enter your income and family size and get an immediate answer about whether you may be covered. Search "[your state] Medicaid screening tool" or "[your state] Medicaid income limits" to find it.

If you do not have internet access or prefer to speak with someone, call 211 and ask for Medicaid information for your state. 211 is a free helpline that connects you to local resources and can tell you your state's income limit, what documents you will need, and how to contact your state Medicaid office. You can also call your state Medicaid office directly — the number is on your state's health department website.

When you contact your state, have ready: your household income for the last month, the number of people in your home, your immigration status, and your Social Security number. You do not need to formally apply to get this information — you are just asking whether you meet the rules.

What counts as your household and income

Your household includes you, your spouse if you are married, and any children under 19 who live with you. Some states also count adult children or parents if they live in your home and you support them financially. Your state Medicaid office can tell you exactly who counts in your situation.

Household income is usually your gross monthly income — what you earn before taxes are taken out. If you are self-employed, it is your net income after business expenses. If you receive Social Security, unemployment, child support, or other benefits, those count as income. If you are married, both spouses' income counts even if only one person is applying. If you have a child who works, their income counts toward the household total.

Some income does not count: the first $65 per month of earned income is excluded in most states, certain student loans and scholarships do not count, and some types of assistance (like SNAP or housing vouchers) are excluded. Your state Medicaid office can walk you through which sources apply to your situation.

Special rules for pregnant people, children, and seniors

Pregnant people have higher income limits in most states — often 185 to 200 percent of the federal poverty line — and do not have to meet other work requirements. Children under 19 are covered in all states up to at least 133 percent of the poverty line; many states cover children up to 200 percent or higher. Seniors over 65 are covered if they meet the income limit, regardless of employment status.

People over 65 can also get Medicaid to pay for long-term care costs — nursing home or in-home care — even if they have some assets and income, as long as they meet specific rules about how much they can own. These rules are different from the regular income limits and are worth asking about if you or a family member needs long-term care.

Frequently Asked Questions

Does having a job disqualify me from Medicaid?

No. Medicaid is based on income, not employment. If you work but your household income is below your state's limit, you may be covered. Some states cover working adults earning up to 138 percent of the federal poverty line. Your state Medicaid office can tell you whether your job income puts you over the limit.

What if my income changes month to month?

Most states use your average income over the last month or three months. If you are self-employed or have irregular work, tell your state Medicaid office what you expect to earn over the next year — they will use that estimate. If your income drops later, you can report the change and your coverage may continue or restart.

Can I get Medicaid if I own a home or a car?

Yes. Regular Medicaid has no asset limit — you can own a home, a car, and savings and still be covered based on income alone. The only exception is long-term care Medicaid, which does have asset limits. Your state Medicaid office can explain the rules for your situation.

What if I am a legal resident but not a citizen?

If you have a green card or other lawful immigration status, you are covered by the same income rules as citizens. Some states have waiting periods — you may have to have had status for five years before you are covered — but many states waive this. Call your state Medicaid office to ask about the rules for your status.

How long does it take to learn about I may have access to?

Using an online screening tool takes minutes. Calling 211 or your state Medicaid office usually takes 15 to 30 minutes. Neither of these is a formal application — you are just getting information. A formal application, if you decide to submit one, usually takes two to four weeks for your state to process.