Do I Qualify for Medicaid? Income Limits and Who Is Eligible

1Find your door first

Medicaid has no single income limit. Federal law names the groups a state must cover and lets each state add others, so the question is not only how much you earn but which group you belong to. Most people fit one of five:

• Adults 19 to 64 in states that expanded Medicaid, judged on income alone.
• Parents and caretaker relatives of children at home, a group every state covers, at limits that vary widely.
• Children and pregnant women, covered at higher incomes everywhere.
• People 65 or older, blind or disabled, judged on income and savings.
• People who need long-term care, at home or in a nursing home, under the strictest look at assets.

Two tests apply at every door. You must live in the state where you apply, and you must be a U.S. citizen or have an immigration status that qualifies, a list that narrowed on October 1, 2026. Beyond that, the doors differ in what they count and where the line sits. If more than one could fit you, the state should consider each, so there is no need to pick the right one before applying.

2Adults in expansion states: the 138 percent line

The Affordable Care Act let states cover nearly every adult under 65 with income up to 138 percent of the federal poverty line. Forty states and the District of Columbia have done so, and there this is the simplest door: no children required, no disability, no savings test. A single adult with no income can qualify, and so can one who works full time at a low wage.

Swipe sideways to see the whole table.

Alaska and Hawaii have higher poverty lines and so higher limits. The law itself sets the line at 133 percent and then disregards 5 percent of income, which is why it is usually quoted as 138.

Medicaid looks at your current monthly income rather than last year's, so a job loss counts in the month it happens. If your income sits near the line, check the Medicaid income test for your household size, then apply anyway if it is close: the state counts income its own way and makes the final call.

3What counts as income, and who counts as household

For adults, parents, children and pregnant women, Medicaid counts income much as the tax system does, using a measure called modified adjusted gross income. In practice that means wages and salary, self-employment profit after expenses, unemployment benefits, pensions, taxable withdrawals from retirement accounts, interest, and Social Security benefits, including the part that is not taxed.

Several common kinds of money are left out entirely: Supplemental Security Income, child support you receive, veterans' disability benefits, workers' compensation, gifts and loans. Federal tax refunds, including the Earned Income Tax Credit, are not counted as income either. Savings do not count at all for these groups, so a family can have money in the bank and still qualify.

The household follows the tax return, too. Generally it is you, a spouse you live with, and anyone you claim as a dependent. An adult child who lives at home but files her own return and is not claimed is usually a household of one, which can mean she qualifies when her parents do not.

4If your state has not expanded Medicaid

Ten states have not expanded: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming. In most of them, low income is not enough on its own. Adults without children generally cannot qualify unless they are pregnant, disabled or 65 or older, and parents qualify only at incomes far below the poverty line. Wisconsin is the exception: it covers adults up to the poverty line without having expanded. Georgia covers some adults up to the poverty line through a program that requires work or other activities.

That leaves a gap. An adult with income below the poverty line in one of these states, under $15,960 a year for one person in 2026, may not qualify for Medicaid and yet earn too little for help with a Marketplace plan, because premium tax credits generally start at 100 percent of the poverty line. Above that line, the Marketplace is usually the door to try; our guide to Marketplace subsidies explains who gets them.

If you live in a non-expansion state, do not stop at the adult rules. Pregnancy, a child in the home, a disability or a large medical bill can each open a different door, and someone turned down in one group may qualify in another.

5Children and pregnant women

Every state covers children at higher incomes than adults. Medicaid must cover children up to at least 138 percent of the poverty line, and the Children's Health Insurance Program picks up many children above that, with limits of 200 percent or more in most states. Once enrolled, a child generally keeps coverage for 12 months even if family income rises. Our guide to CHIP explains how the two programs divide the work.

Pregnant women qualify in every state with income up to at least 138 percent of the poverty line, and many states go higher. For this test the unborn child counts in the household, so a pregnant woman living alone is counted as a household of two. Coverage lasts through the pregnancy and, in nearly every state, for 12 months after it ends, and a baby born to a mother on Medicaid is covered for the first year without a separate application.

6People 65 and older, blind or disabled

For older people and people with disabilities, Medicaid usually looks at savings as well as income, and the rules often follow Supplemental Security Income. In most states, people who receive SSI qualify for Medicaid, many of them automatically. The SSI figures show the scale: in 2026 the federal SSI payment is $994 a month for one person, and countable savings must stay under $2,000, or $3,000 for a couple. A home you live in and one car generally do not count.

States can go further. Many cover people whose income is above the SSI level, some up to the poverty line or beyond, and many run medically needy programs that let people with high medical bills qualify by subtracting those bills from their income, a process often called spending down. Asset limits vary from state to state as well. Our guide to SSI's income and resource limits shows how that program counts both.

If you have Medicare and a modest income, check the Medicare Savings Programs even if full Medicaid is out of reach. Their limits are higher, they pay the Part B premium and sometimes more, and anyone in them also qualifies for Extra Help with drug costs.

7When the need is long-term care

Medicaid is the main payer for long stays in nursing homes and for much of the care people receive at home instead. To qualify, a person must need that level of care under the state's standard and meet income and asset limits that are usually the strictest in the program. States review gifts and transfers made in the five years before the application, and giving assets away for less than their value can delay coverage.

Spouses are protected: when one spouse needs care, a share of the couple's income and savings is set aside for the one who stays at home. After the death of someone who received long-term care, the state must try to recover what it paid from the estate, with exceptions that often protect a surviving spouse. Our guides to who pays for nursing home care and Medicaid estate recovery cover both in detail.

8Citizenship, immigration and where you live

You must live in the state where you apply, though you do not need a fixed address. You must also be a U.S. citizen or national, or have an immigration status that qualifies, and a change in federal law narrowed that list on October 1, 2026. Federal Medicaid now covers lawful permanent residents, who usually must wait five years after getting that status, Cuban and Haitian entrants, and people from the Marshall Islands, Micronesia and Palau living here lawfully. Refugees, asylees and several other groups who have not become permanent residents lost federal eligibility on that date.

States can still choose to cover lawfully residing children and pregnant women without the five-year wait, and many do; some also use their own money to cover people the federal rules leave out, so ask your state before assuming the answer. Anyone who meets every other rule can get emergency Medicaid for a medical emergency, including labor and delivery, whatever their status. And a parent applying for a child does not have to give their own immigration status.

9Applying, and what happens next

There is no enrollment season. You can apply any day through your state Medicaid agency, online, by phone, by mail or in person, or through HealthCare.gov, which sends your application to the state. Expect to show proof of identity, income, where you live and citizenship or immigration status; the state checks much of it electronically and asks for the rest. Our pages on benefits in your state list where to apply in sixteen states.

States have up to 45 days to decide most applications, or 90 when a disability must be decided. Medicaid can also pay medical bills from up to three months before the month you apply if you would have qualified then, which matters after a hospital stay. For applications from January 1, 2027, the 2025 budget law shortens that window to one month for adults in the expansion group and two months for most others.

If you are turned down, the notice must say why and how to ask for a fair hearing. Our guide to appealing a denied benefit decision walks through it.

10What the 2025 law changes next

The same law adds two rules for adults in the expansion group. By January 1, 2027, most of those aged 19 to 64 will have to show 80 hours a month of work, school, training or community service, or earnings to match, with exemptions for parents of young children, people with disabilities and others; a state can be given more time, until the end of 2028. And renewals for that group move from once a year to every six months. Our guide to SNAP and Medicaid work requirements explains who is exempt and what counts.

Neither rule changes the income limits, and neither reaches children, pregnant women or people who qualify through age or disability.

12What only your state can decide

Each state decides eligibility under its own Medicaid plan, and its limits, counting rules and covered groups change. The figures here are the federal minimums and the 2026 poverty line; your state may be more generous. Our calculator checks the adult income test for households of one to four, not the other doors.