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

Medicaid is not one national program with one set of rules. Each state runs its own Medicaid program within federal guidelines, which means who gets covered varies significantly by location. A person who qualifies in one state may not may have access to in another, even if their income and family situation are identical.

The broadest categories are income-based: Medicaid covers people whose household income falls below a certain percentage of the federal poverty line. That percentage differs by state and by category (children, parents, pregnant people, elderly adults, people with disabilities). Some states have expanded Medicaid to cover more working-age adults; others have not. Beyond income, you must be a U.S. citizen or may have access to immigrant, and you must live in the state where you are applying.

Key Takeaways

  • Income limits vary by state and by who you are — a parent, child, pregnant person, elderly adult, or person with a disability — so you cannot know if you may have access to without checking your specific state's rules.
  • Fourteen states have not expanded Medicaid to cover working-age adults without children or disabilities, so your options depend on where you live.
  • You must be a U.S. citizen or a may have access to immigrant (green card holder, refugee, or asylee, among others) to get Medicaid in most states.
  • Household size matters: Medicaid counts income for everyone living with you, not just you alone, so a spouse's or parent's earnings affect whether you may have access to.
  • Your state's Medicaid office or a local community health center can tell you the exact income limit for your situation in minutes.

How income limits work and why they differ by state

Medicaid income limits are set as a percentage of the federal poverty line. The federal poverty line itself changes each year — in 2024, the poverty line for a single adult was about $15,000 per year, and for a family of four about $31,000. But Medicaid programs do not use that number directly. Instead, each state sets its own percentage.

For example, a state might cover children up to 200% of the poverty line (roughly $30,000 for a single child) but cover parents only up to 100% of the poverty line (roughly $15,000). Another state might cover children up to 300% of the poverty line and parents up to 150%. These percentages are set by state law and can change, though usually only when the state legislature acts.

The most significant difference is whether a state has expanded Medicaid under the Affordable Care Act. Expansion states cover working-age adults without children or disabilities if their income is below a certain threshold (usually around 138% of the poverty line). Non-expansion states do not cover this group at all, no matter how low their income is. As of 2024, 38 states plus Washington, D.C. have expanded; 12 states have not.

Who qualifies: the main categories

Children have the most generous income limits in most states. Many states cover children up to 200% or 300% of the poverty line. Some states cover children in families earning $50,000 or more per year. Income limits for children are usually higher than for adults in the same state.

Pregnant people and parents with young children are covered in all states, but the income limit varies. Some states cover parents up to 100% of the poverty line; others go higher. Pregnant people are often covered up to a higher income than parents are.

Working-age adults without children or disabilities are covered only in expansion states, and only if their income is below the expansion threshold (usually around 138% of the poverty line, or roughly $20,000 per year for a single adult in 2024). In non-expansion states, this group has no Medicaid path regardless of income.

People over 65 are covered if their income and assets fall below the state's limits. These limits are usually lower than for working-age adults, and asset limits apply (typically $2,000 for a single person, though this varies by state).

People with disabilities can may have access to through Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), or through state disability programs. Income and asset limits apply and are usually strict. Some states have waiting lists for disability Medicaid.

Citizenship and immigration status requirements

You must be a U.S. citizen or a may have access to immigrant to get Medicaid in most states. may have access to immigrants include green card holders, refugees, asylees, and certain other categories defined by federal law. Undocumented immigrants do not may have access to for regular Medicaid in any state, though some states cover emergency services or pregnancy-related care regardless of status.

If you are a citizen, you will need to prove it — usually with a birth certificate, passport, or naturalization papers. If you are an immigrant, you will need your green card, refugee or asylee documentation, or other proof of may have access to status. Your state's Medicaid office can tell you what documents they accept.

Some states have their own programs for immigrants who do not may have access to for federal Medicaid. California, Illinois, and New York, for example, cover some undocumented immigrants through state-funded programs. Check your state's Medicaid website to see whether such a program exists where you live.

How household size affects your income limit

Medicaid counts the income of everyone living in your household, not just you. If you are married, your spouse's income counts. If you live with your parents, their income counts. If you have adult children living with you, their income counts. The income limit rises as household size grows, but usually not by much.

For example, if a state's income limit for a single adult is $15,000, the limit for a family of two might be $20,000, and for a family of four might be $30,000. The exact amounts depend on the state and the category. Some states use the federal poverty line percentages directly; others use their own tables.

If you live alone, only your income matters. If you live with a partner but are not married, your partner's income may or may not count depending on your state's rules — this is one area where states differ significantly. Ask your state's Medicaid office whether unmarried partners' income counts in your situation.

Asset limits and what they mean

Most Medicaid programs have asset limits — a cap on how much money and property you can own and still may have access to. For working-age adults and children, asset limits are often high or nonexistent. For elderly adults and people with disabilities, asset limits are usually strict: typically $2,000 for a single person and $3,000 for a couple, though some states are higher.

Assets usually include savings accounts, checking accounts, stocks, and bonds. They do not include your home (if you live in it), your car (usually), or personal belongings. Some states exclude additional items like life insurance or retirement accounts. The rules are complex and vary by state.

If you are close to an asset limit, ask your state's Medicaid office what counts and what does not. Some people can reduce countable assets through legal planning before applying, though this requires professional advice and is not always possible.

How to find out the exact rules for your state

The fastest way to learn your state's income limits is to call your state's Medicaid office directly or visit its website. Most state Medicaid programs have an online income calculator where you enter your household size and income and get an answer in seconds. Some states also have local offices you can visit in person.

If you do not know your state's Medicaid office number, call 211 (a free referral line) and ask for your state Medicaid program. You can also search "[your state] Medicaid" online — the official state website usually appears first. Community health centers and legal aid organizations in your area can also tell you whether you may have access to and help you gather documents.

Income limits change each year (usually in January) when the federal poverty line updates. If you were told you did not may have access to last year, it is worth checking again this year — your state's limit may have risen.

Frequently Asked Questions

Does my spouse's income count if we are married but file taxes separately?

Yes, in most states. Medicaid counts the income of your spouse regardless of how you file taxes. A few states have different rules for spouses who live apart, but the default is that marriage means income counts together. Check your state's specific rules if you have an unusual living situation.

What if my income is just slightly above the limit?

You do not may have access to for regular Medicaid, but you may may have access to for a subsidized health plan through the federal marketplace (Healthcare.gov). Marketplace subsidies are based on income and are separate from Medicaid. You can also check whether your state has a program for people just above the Medicaid limit — some do.

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

No. Medicaid is based on income, not employment status. You can work full-time and still may have access to if your income is low enough. Many Medicaid recipients are employed; they simply earn below their state's income limit.

If I get a job or a raise, do I lose Medicaid immediately?

No. Most states allow a grace period — usually one to three months — before your Medicaid ends when your income rises above the limit. Report the change to your state's Medicaid office. Some states also have programs that let you keep Medicaid for a few months after your income rises, especially if you are working.

Can I may have access to for Medicaid in one state if I just moved there?

Yes, but you must live in the state to apply. You do not have to have lived there for a certain amount of time. Once you move, you can apply to your new state's Medicaid program. If you were on Medicaid in your old state, contact that state's office to end your coverage there.