Your children's Medicaid may be able to access depends on your household income, your state, and their age

Whether your children can get Medicaid is determined by your state's income limits and rules — not by a single national standard. Each state sets its own threshold for how much your household can earn and still have children covered. Most states cover children in families earning up to 200% of the federal poverty level, but some go higher and some lower. Your state's Medicaid office is the only source that can tell you whether your specific household qualifies.

Children under 19 are covered in every state's Medicaid program, though the income limit varies. Infants and toddlers under 6 often have higher income limits than older children in the same state. Pregnant teenagers are usually treated as adults for may be able to access purposes, which can change the household calculation. Immigration status also matters — U.S. citizens and certain may have access to immigrants can get coverage, but rules differ by state.

Key Takeaways

  • Your state's Medicaid program sets the income limit for children, and most states cover families earning between 150% and 300% of the federal poverty level.
  • Children under 6 often have higher income limits than children 6 and older in the same state, so you may need to check limits separately for each child.
  • Your household income is calculated by adding up earnings from all family members living with you, and some states count child support or alimony differently.
  • You can find your state's current income limits and start the process through your state Medicaid office or by calling 211 for a local referral.

How your state calculates household income for children

States count income differently, so knowing what your state includes matters. Most states count wages, self-employment income, Social Security benefits, and child support received. Some states count alimony; some do not. A few states count tax refunds or lump-sum payments. Your state Medicaid office can tell you exactly what counts toward your household total.

The household size used for Medicaid is usually everyone living with you — parents, children, and sometimes other relatives. If you are married but filing taxes separately, your spouse's income still counts. If you are unmarried and living with a partner, their income may or may not count depending on your state's rules. Foster children living in your home are typically counted as household members.

Once you know your household income and size, your state compares that number to its income limit. If you are at or below the limit, your children may be covered. If you are above it, they would not be covered through regular Medicaid, though some states have separate programs for children in families earning more.

Income limits vary significantly by state and child age

Federal law requires states to cover children under 19 whose family income is at or below 133% of the federal poverty level. However, most states have chosen to cover children at higher income levels. As of 2024, some states cover children in families earning up to 200% of the poverty level, while others go as high as 300% or more. A few states have set their limits lower, closer to the federal minimum.

The federal poverty level changes each year. For 2024, the poverty line for a family of three (two parents and one child) is approximately $23,000 annually, though this figure is updated yearly. At 200% of that level, a family of three could earn roughly $46,000 and still have children covered in a generous state. In a state at 133%, the same family would need to earn under $30,600. Your state Medicaid office publishes its current limits and updates them when federal poverty guidelines change.

Many states also set different income limits for children at different ages. Infants and children under 6 frequently have higher limits than children 6 to 18. For example, a state might cover children under 6 in families earning up to 250% of poverty but only cover older children up to 200%. You need to check the limit for each child's age group in your state.

Other factors that affect whether children get covered

Income is the main factor, but your state also checks citizenship or immigration status. U.S. citizens and certain may have access to immigrants — including lawful permanent residents, refugees, and asylees — can get Medicaid. Undocumented immigrants are generally not covered by regular Medicaid, though some states offer separate programs for children regardless of status. Your state Medicaid office can tell you what documentation you will need to provide.

Your state may also have a waiting period or enrollment window. Some states cover children when ready once you submit information; others have a waiting period of a few days or weeks. A few states have enrollment periods — for example, they may only accept applications during certain months. Your state Medicaid office can tell you whether there is a waiting period or enrollment window that applies.

If your income is above your state's limit, your children might still be covered through a separate program. Many states run programs specifically for children in families earning too much for regular Medicaid but not enough to afford private insurance. These programs often have different names — some call them CHIP (Children's Health Insurance Program), others use state-specific names. Your state Medicaid office can tell you whether such a program exists in your state and what its income limit is.

How to find your state's income limits and next steps

Your state Medicaid office publishes its current income limits on its website. You can find your state office by searching "[your state] Medicaid" or by visiting the federal Centers for Medicare & Medicaid Services website, which links to every state program. When you find your state's page, look for a section titled "Income Limits," "may be able to access," or "Children's Coverage." The limit will be listed as a percentage of the federal poverty level or as a dollar amount for different household sizes.

Once you know whether your income falls within your state's limit, you can contact your state Medicaid office to learn what information you will need to provide. Most states ask for proof of income (pay stubs, tax returns, or a letter from your employer), proof of household members' identities, and proof of citizenship or immigration status for each child. Some states let you submit this information online; others require you to mail it or visit an office in person.

You can also call 211 — a free referral service — and ask for your local Medicaid office or process site. Many communities have local offices or partner organizations that help with Medicaid information and paperwork. Calling 211 can connect you to the nearest location and tell you what hours they are open.

What happens if your income changes during the year

If your household income drops during the year, you can report the change to your state Medicaid office at any time. Your children's coverage may start or increase depending on the new income level. If your income rises above your state's limit, your children's coverage will end on a date your state specifies — usually the end of the month in which you reported the change, or the following month.

Some states have a process called "continuous may be able to access," which means your children stay covered for a set period (often 12 months) even if your income rises above the limit during that time. Other states do not have this protection. Your state Medicaid office can tell you whether continuous may be able to access applies in your state and for how long.

Frequently Asked Questions

Does my child's age change the income limit?

Yes, in most states. Children under 6 usually have higher income limits than children 6 to 18. For example, your state might cover children under 6 in families earning up to 250% of the federal poverty level but only cover older children up to 200%. Check your state's limits for each age group.

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

States typically use your most recent tax return or an average of recent months to calculate self-employment income. If your income varies month to month, tell your state Medicaid office — they may ask for recent pay stubs, bank statements, or a letter from your accountant to determine your average income.

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

Yes. For Medicaid purposes, married couples' income is counted together regardless of how they file taxes. If you are married but living apart, your state may have different rules — contact your state Medicaid office to ask how your situation is handled.

Can my children get Medicaid if I am not a U.S. citizen?

Your citizenship status does not determine your children's coverage — their status does. U.S. citizen children can get Medicaid based on your household income, regardless of your immigration status. Immigrant children may be covered depending on their status and your state's rules. Contact your state Medicaid office to ask about your specific situation.

What if my income is above the limit but I cannot afford insurance?

Many states have a separate program for children in families earning too much for Medicaid but not enough to afford private coverage. These programs often have higher income limits than Medicaid. Ask your state Medicaid office whether such a program exists in your state and what its income limit is.