What is different in Pennsylvania
- Pennsylvania has expanded Medicaid, so there is an income-only pathway for adults under 65.
What Is Medicaid?
Medicaid is a joint federal and state program that pays for health coverage — doctor visits, hospital stays, prescriptions, long-term care — for people with low income. Unlike Medicare, which is mainly for people 65 and over whatever they earn, Medicaid is based on financial need, and every state runs its own version within federal rules. That is why the answer to “do I qualify?” depends on where you live almost as much as on what you earn.
Expansion vs. Non-Expansion States
The Affordable Care Act let states extend Medicaid to nearly every adult under 65 whose income is at or below 138% of the federal poverty level. Most states took it up. In those states an adult with no children can qualify on income alone, and that is the case this calculator covers.
In states that did not expand, there is no income-only pathway for adults without dependent children — someone with almost no income at all can still be turned down. Those states usually cover parents only up to a much lower income, and other adults not at all. If you live in one, your state Medicaid agency is the place to ask which pathways are still open to you.
Current Income Limits for Expansion Adults
The limit is 138% of the federal poverty level for your household size. For 2026, in the 48 contiguous states and D.C.:
- 1 person: $15,960 poverty level, $22,025 Medicaid limit.
- 2 people: $21,640 poverty level, $29,863 Medicaid limit.
- 3 people: $27,320 poverty level, $37,702 Medicaid limit.
- 4 people: $33,000 poverty level, $45,540 Medicaid limit.
Alaska and Hawaii use higher poverty levels, so their limits are higher than the figures above.
Important Disclaimer
This is an educational estimate only, covering the single most common Medicaid pathway (adults under 65 in ACA expansion states). Medicaid has many other eligibility pathways — for children, pregnant women, seniors, and people with disabilities — that this calculator does not cover. For an official determination, contact your state's Medicaid agency. medicaid.gov
What If I’m 65+, Blind, or Disabled?
Then this is the wrong calculator. Medicaid for people 65 or older, blind, or with a disability is decided on a different pathway that counts assets as well as income, and in most states it follows the SSI rules closely — people who receive SSI are usually enrolled in Medicaid automatically.
Start with the SSI eligibility calculator on this site, then contact your state Medicaid agency: Open the SSI calculator
Is This Calculator Accurate?
It applies the published 2026 poverty levels and the 138% expansion threshold exactly, for the three household sizes it offers. What it cannot do is know which state you are in, count income the way your state counts it, or handle any of the other pathways — children, pregnant women, seniors, people with disabilities, medically needy programs. Treat a “likely qualify” here as a reason to apply, not as an approval. Only your state Medicaid agency decides.