Medicaid covers people based on income, family size, citizenship, and sometimes disability or age

Medicaid is not one set of rules. Each state runs its own program within federal guidelines, so who qualifies in your state depends on where you live. The broadest rule: you must be a U.S. citizen or may have access to immigrant, have income below your state's limit, and fall into a category the state covers — usually low-income families with children, pregnant people, people over 65, or people with disabilities.

Your state's income limit is the first gate. A single person in one state might earn $1,500 a month and may have access to; in another state the limit might be $900. Family size matters too — a family of four has a higher income limit than a single person. If you earn above your state's limit, you do not may have access to through the standard path, though some states have separate programs for people just over the line.

Citizenship and immigration status are separate from income. You must be a U.S. citizen, a lawful permanent resident (green card holder), or in certain other immigration categories. Undocumented immigrants do not may have access to for regular Medicaid in most states, though some states cover emergency care or pregnancy-related care regardless of status.

Key Takeaways

  • Income limits vary by state and family size, so you must check your specific state's numbers rather than using a national figure.
  • You must be a U.S. citizen or in a may have access to immigration category; undocumented status bars you from most Medicaid programs.
  • Medicaid covers different groups — families with children, pregnant people, seniors, people with disabilities — and your state chooses which groups to cover beyond the federal minimum.
  • Some states expanded Medicaid to cover adults without children up to a certain income; others did not, so coverage rules differ sharply between states.
  • Your state's Medicaid office or a local 211 referral can tell you the exact income limit and categories your state covers.

Income limits and how family size affects them

Your state sets an income limit for each family size. The limit is usually expressed as a percentage of the federal poverty line. For example, one state might cover families at 138% of poverty; another at 100%. A single person at 100% of poverty earns roughly $1,100 per month (this number changes yearly). A family of four at the same percentage earns roughly $2,300 per month.

Income is counted in a specific way. Medicaid counts gross income — what you earn before taxes — not take-home pay. Self-employment income, wages, Social Security, unemployment benefits, and child support all count. Some income does not: the first $65 per month of wages, some child care costs, and certain other deductions vary by state.

If you are self-employed or have irregular income, Medicaid looks at your income over the past month or the past three months depending on your state. If you just lost a job, your income might drop enough to may have access to even if you earned too much the month before.

Citizenship and immigration status requirements

You must prove you are a U.S. citizen or a may have access to immigrant. may have access to immigrants include lawful permanent residents (green card holders), refugees, asylees, and people in certain other protected categories. Your state's Medicaid office will ask for proof — usually a birth certificate or passport for citizens, or a green card or immigration documents for may have access to immigrants.

Undocumented immigrants do not may have access to for regular Medicaid in most states. However, some states cover emergency medical care for anyone regardless of status, and a few states cover pregnancy-related care or care for children under a certain age. Check your state's rules directly, as these programs are state-specific and change.

If you are in the U.S. on a visa (student visa, work visa, tourist visa) but not a permanent resident, you do not may have access to for Medicaid. Temporary Protected Status (TPS) holders and Deferred Action for Childhood Arrivals (DACA) recipients also do not may have access to in most states, though some states have created their own programs for these groups.

Categories of people Medicaid covers

Federal law requires states to cover certain groups: children under 19, pregnant people, parents of dependent children (in some cases), people over 65, and people who are blind or disabled. Beyond that, states choose. Some states cover only these groups. Others have expanded to cover childless adults up to a certain income — this is called Medicaid expansion, and about half of U.S. states have done it.

If you are pregnant, you may may have access to for Medicaid even if you would not otherwise. Most states cover pregnant people at a higher income limit than they cover other adults. Coverage usually continues for 60 days after the pregnancy ends, whether the pregnancy resulted in birth or not.

If you are over 65, you may may have access to based on age alone, even if your income is higher than the limit for younger adults. If you are disabled, you may may have access to through Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), which have their own income and resource limits.

How Medicaid expansion changed who qualifies

Before 2014, Medicaid covered mainly children, pregnant people, parents, seniors, and people with disabilities. The Affordable Care Act allowed states to expand Medicaid to cover all adults earning up to 138% of the federal poverty line. As of now, about 38 states have expanded; about 12 have not.

If your state expanded Medicaid, you may may have access to as a childless adult with no disability, as long as your income is below the limit. If your state did not expand, you must fit into one of the traditional categories — usually meaning you have children, are pregnant, are over 65, or are disabled.

This creates a coverage gap in non-expansion states: people who earn too much for traditional Medicaid but too little to afford private insurance. If you live in a non-expansion state and do not fit a covered category, you may have other options through the health insurance marketplace or through your state's own programs, but regular Medicaid is not one of them.

Resources and assets: what you can own and still may have access to

Medicaid has resource limits — the amount of money and property you can own and still may have access to. For most people, the limit is $2,000 for a single person and $3,000 for a couple. Some assets do not count: your home, one car, household goods, and certain retirement accounts are usually excluded.

Cash, savings accounts, stocks, and second vehicles do count toward the limit. If you are over the limit, you do not may have access to unless your state has waived the resource limit for certain groups. Some states have removed resource limits for working-age adults; others have not.

If you receive Supplemental Security Income (SSI), you are already under a resource limit, and Medicaid usually follows SSI's rules. If you are applying for Medicaid on your own, ask your state's Medicaid office whether resources are counted in your situation.

How to find your state's specific rules

Because every state's rules are different, the only way to know whether you may have access to is to check your state's Medicaid program. You can find your state's Medicaid office through the Centers for Medicare and Medicaid Services website, or you can call 211 (a free referral line) and ask for your state's Medicaid contact information.

When you contact your state, have ready: your income for the past month or three months, your family size, your citizenship or immigration status, and any disability or pregnancy information. Your state's office can tell you the exact income limit, which categories they cover, and what documents you need to provide.

Some states let you check your likely status online before you formally apply. Others require you to apply to find out. Either way, there is no penalty for applying — if you do not may have access to now, you can reapply later if your circumstances change.

Frequently Asked Questions

Can I have a job and still may have access to for Medicaid?

Yes. Medicaid counts your gross income, not your employment status. If you work part-time or full-time and your income is below your state's limit, you may have access to. Some states have work incentive programs that let you earn a bit more and still keep Medicaid, especially if you have a disability.

What if I receive Social Security or SSI?

Social Security retirement or disability benefits count as income. If your benefits are below your state's Medicaid limit, you may have access to. SSI recipients are usually automatically enrolled in Medicaid in most states, though you should confirm with your state's office.

Do I lose Medicaid if my income goes up?

Yes, if your income rises above your state's limit, you lose Medicaid. However, most states have a grace period or allow you to keep Medicaid for a few months while your income is being reviewed. Report income changes to your state's Medicaid office as soon as they happen.

Can I may have access to if I am on a student visa or work visa?

No. Student visas, work visas, and tourist visas do not make you a may have access to immigrant for Medicaid purposes. You must be a U.S. citizen, a lawful permanent resident, or in another protected category like refugee or asylee status.

What if my state did not expand Medicaid and I do not fit a covered category?

You may be able to buy insurance through the health insurance marketplace at healthcare.gov, where you might may have access to for tax credits to lower your cost. Some states also run their own programs for people in this gap. Call 211 or your state's health department to learn what options exist in your state.