Medicaid covers people based on income, family size, age, disability status, and pregnancy — but the exact rules depend on which state you live in

Medicaid is not one program with one set of rules. Each state runs its own version within federal guidelines, so who qualifies in your state may not may have access to in another. The federal government sets a floor — certain groups must be covered — but states can expand beyond that floor and often do. Your income limit, what counts as income, and whether you may have access to at all can change based on where you live.

The fastest way to know if you might may have access to is to enter your state, income, and household size into your state's Medicaid website or call your state's Medicaid office directly. They will tell you whether you meet the income threshold and what documents you need. Do not assume you do not may have access to based on what you have heard — income rules are often higher than people expect, and some states have programs for people who earn too much for standard Medicaid.

Key Takeaways

  • Income limits vary by state and family size; a single person might may have access to in one state at $1,500 per month but not in another at $1,200 per month.
  • Children, pregnant people, parents, seniors, and people with disabilities have different income thresholds, often higher than the general adult limit.
  • Some states have expanded Medicaid to cover adults earning up to a certain percentage of the federal poverty level, while others have not.
  • Your state's Medicaid office or a 211 referral can tell you in one call whether you meet the income and other requirements.

Income-based groups: the main path to Medicaid

Most people on Medicaid may have access to because their income falls below a certain threshold. That threshold is set by your state and changes each year. For a single adult with no dependents, the income limit might be $1,200 per month in one state and $2,000 in another. For a family of three, the limit is higher — again, by different amounts in different states.

Income means wages, self-employment income, Social Security, unemployment benefits, and some other sources. Not all income counts the same way. Some states disregard the first $65 of monthly earnings or allow deductions for work expenses. Your state's Medicaid office will tell you exactly what counts and what does not when you contact them.

If your income is just above the limit, you may still may have access to through a medically needy program (available in some states). This path lets you "spend down" medical bills to reach the income limit. For example, if you earn $100 too much per month but have $500 in medical bills, some states will count you as may have access to. Not all states offer this, and the rules are strict — ask your state Medicaid office whether it exists where you live.

Children and parents: higher income limits in most states

States must cover children under 19 whose family income is at or below 133 percent of the federal poverty level. Many states go higher — some cover children in families earning up to 200 or 300 percent of poverty. A child in a family of three might may have access to at a household income where an adult in the same family would not.

Parents and caretakers also often have higher income limits than childless adults, though this varies by state. Some states cover parents up to 100 percent of poverty; others go to 200 percent or higher. If you have children, always check your state's rules for parents separately from the general adult limit.

Pregnant people and postpartum coverage

Pregnant people may have access to for Medicaid in every state, regardless of immigration status in most cases. The income limit for pregnancy is usually the same as or higher than the general adult limit in your state. You stay covered through the end of the month in which your pregnancy ends, whether the pregnancy results in birth or not.

After pregnancy ends, coverage continues for 12 months postpartum in all states (this expanded from 60 days in 2023). If your income is above the regular Medicaid limit, you may lose coverage after the 12-month postpartum period ends unless you may have access to through another category.

Seniors and people receiving Social Security

People 65 and older can may have access to for Medicaid based on income, just like younger adults. The income limit is the same as the general adult limit in your state. If you receive Social Security, that counts as income toward the limit.

If you are 65 or older and have very low income, you may may have access to for Supplemental Security Income (SSI), which automatically qualifies you for Medicaid in most states. SSI is a federal program separate from regular Social Security. Your state's Medicaid office can tell you whether SSI recipients automatically may have access to in your state or whether you must apply for Medicaid separately.

People with disabilities: SSI and other pathways

People who receive Supplemental Security Income (SSI) for disability automatically may have access to for Medicaid in most states. SSI is for people under 65 who have a disability, blindness, or both, and whose income and resources are very low. If you receive SSI, contact your state Medicaid office to confirm you are enrolled; in a few states you must apply separately.

If you do not receive SSI but have a disability and low income, you may still may have access to for Medicaid through the regular income-based path. Some states also have Medicaid Buy-In programs that let people with disabilities work and earn more than the usual limit while keeping Medicaid coverage. These programs exist in most but not all states, and the rules differ. Ask your state Medicaid office whether a Buy-In program exists where you live.

Medicaid expansion states: coverage for adults without children

Some states have expanded Medicaid to cover adults earning up to 138 percent of the federal poverty level, regardless of whether they have children or a disability. In 2024, most but not all states have adopted this expansion. If you are a childless adult with low income, you may may have access to in an expansion state but not in a non-expansion state.

Your state's Medicaid website will clearly state whether expansion is in place. If you live in a non-expansion state and are a childless adult, your options are narrower — you would need to may have access to through disability, pregnancy, or another category. Some non-expansion states have created their own programs with different names and rules; your state Medicaid office can explain what is available.

Immigration status and Medicaid

Medicaid is available to U.S. citizens and certain immigrants. Lawful permanent residents (green card holders) may have access to in most states. Refugees, asylees, and some other groups also may have access to. Undocumented immigrants do not may have access to for regular Medicaid in most states, though some states cover emergency services or pregnancy regardless of status.

If you are unsure about your immigration status and how it affects Medicaid, contact your state Medicaid office or a local legal aid organization. Immigration status questions are sensitive, and many offices have staff trained to discuss them confidentially.

Frequently Asked Questions

Does my income have to be below the poverty line to may have access to?

No. Medicaid income limits are often higher than the federal poverty line. Many states cover people earning 100 to 300 percent of poverty, depending on your age, family size, and whether you have children or a disability. Your state's specific limit is the only one that matters for you.

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

Self-employment income counts toward the limit. Most states average your income over a period (often three months) to account for ups and downs. Some allow deductions for business expenses. Contact your state Medicaid office with details about your work; they will explain how they count your specific situation.

Do I have to be unemployed to may have access to?

No. Many people on Medicaid work. You may have access to based on income level, not employment status. If you work and earn below your state's limit, you can be on Medicaid. Some states have work incentive programs that let you earn more and keep coverage.

Can I may have access to if I own a home or car?

Medicaid looks at both income and resources (savings, investments, property). Most states do not count your primary home or one vehicle toward the resource limit. Other savings and property do count. Resource limits vary by state. Your state Medicaid office will tell you the exact limits and what counts.

What happens to my Medicaid if my income goes up?

You will lose coverage if your income rises above your state's limit. Most states give you a grace period (often one or two months) before coverage ends, so you have time to find other insurance. Report income changes to your Medicaid office right away rather than waiting for them to find out.