Medicaid may be able to access depends on your income, household size, and state

Whether you can get Medicaid is determined by your state, not by the federal government. Each state sets its own income limits, and those limits change based on how many people live in your household. Most states use your Modified Adjusted Gross Income (MAGI) — roughly what you report on your tax return — to decide if you may have access to. Some states also look at assets, though most stopped checking those in 2020.

The fastest way to find out is to enter your household income and size into your state's Medicaid website or call your state's Medicaid office directly. They can tell you in minutes whether you meet the income threshold. If you are unsure what your state's office is, you can search "Medicaid [your state name]" or call 211, which connects you to local health programs.

Income limits vary widely. A single adult might may have access to in one state at $18,000 per year and in another at $25,000. A family of four might have a limit of $35,000 in one state and $55,000 in another. Your state's website will show the exact numbers for your household size.

Key Takeaways

  • Medicaid income limits are set by your state and depend on your household size, so you need to check your specific state's rules.
  • Most states use your Modified Adjusted Gross Income (MAGI) from your tax return to determine if you meet the income threshold.
  • You can find your state's income limits and contact information by searching "Medicaid [your state name]" or calling 211.
  • Some states also look at assets or citizenship status, so it is worth confirming all the rules that explore to you before you assume you do not may have access to.
  • If your income changes during the year, you may become newly may be able to access or lose coverage, so report changes to your state Medicaid office.

How your household income is counted

Your household income includes wages, self-employment income, Social Security, unemployment benefits, and child support you receive. It does not include food stamps, housing information, or most other government benefits. If you are married and file taxes jointly, both incomes count. If you file separately, only your income counts.

The income limit is based on the Federal Poverty Level (FPL), which changes each year. Most states set their Medicaid limit somewhere between 100% and 200% of the FPL, though a few go higher or lower. For example, if the FPL for a family of three is $22,000, a state that covers up to 138% of FPL would cover families earning up to about $30,360.

If you are self-employed, you report your net income (after business expenses). If you receive irregular income — seasonal work, freelance payments, or bonuses — average it over the past three months or use your most recent month, depending on your state's rules. Ask your state Medicaid office which method they use.

Special rules for certain groups

Some people may have access to for Medicaid even if their income is above the normal limit. Pregnant people often have higher income limits or separate programs in their state. Children typically may have access to at higher income levels than adults in the same household. People over 65 and people with disabilities may may have access to through different pathways that consider assets as well as income.

If you are receiving Supplemental Security Income (SSI) for disability or age, you usually may have access to for Medicaid automatically in most states. If you receive Social Security Disability Insurance (SSDI), you may may have access to depending on your state and how much you earn. Some states have programs specifically for working people with disabilities that allow higher income and assets.

If you are undocumented, most states do not cover you through regular Medicaid, though some states cover emergency services or pregnancy-related care. A few states cover all low-income undocumented residents. Check your state's specific rules.

What happens if your income changes

If your income drops during the year, you may become newly may be able to access for Medicaid even if you were not may be able to access before. You can report the change to your state Medicaid office and ask them to review your case. This usually takes a few weeks.

If your income rises above the limit, you will lose Medicaid coverage, though your state must give you notice before they end it. Most states allow a grace period of one or two months. If you lose coverage because of income, you may be able to move to a marketplace plan or your employer's insurance instead.

Some states have continuous enrollment rules that prevent them from ending your coverage for a set period — often 12 months — even if your income changes. Check your state's rules so you know when your coverage might end.

Assets and resources in some states

Most states stopped counting assets (savings, property, vehicles) when determining Medicaid may be able to access in 2020. However, a few states still do, and the rules vary. Some states count only liquid assets like bank accounts, while others count vehicles or property. Asset limits, when they exist, are usually between $2,000 and $3,000 for a single person.

If your state does count assets, certain things are usually not counted: your primary home, one vehicle, personal items, and money set aside for burial. Ask your state Medicaid office whether assets matter in your case.

Even if your state does not count assets now, rules can change. It is worth confirming the current rules for your state rather than assuming based on what you heard about another state.

Citizenship and residency requirements

To get Medicaid, you must be 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 some other immigration statuses. Undocumented immigrants do not may have access to for regular Medicaid in most states, though some states cover emergency care or pregnancy.

You must also live in the state where you are explore. If you recently moved, you may need to update your address with your old state's Medicaid office and explore in your new state. Some states allow you to keep coverage for a short period after you move; others require you to reapply when ready.

How to check your state's specific rules

The easiest way to find your state's income limits and rules is to visit your state Medicaid website. Search "[your state name] Medicaid" and look for a page about income limits or who qualifies. Most state websites have a tool where you enter your income and household size and get an answer in seconds.

If you cannot find the information online or want to talk to someone, call your state Medicaid office. The number is usually on the state website. You can also call 211, which is a free helpline that connects you to local health and human services programs. They can tell you your state's rules and help you understand whether you meet the requirements.

If you are over 65 or have a disability, you may also want to contact your local Area Agency on Aging or disability services office. They can explain special programs that might explore to you.

Frequently Asked Questions

Does having a job disqualify me from Medicaid?

No. Medicaid is based on income, not employment status. If your wages are below your state's income limit, you can get Medicaid even if you work full-time. Some states have special programs for working people that allow higher income limits.

What if I am married but my spouse has much higher income?

If you file taxes separately, only your income counts toward Medicaid. If you file jointly, both incomes count. Talk to a tax professional or your state Medicaid office about which filing status makes sense for your situation.

Can I get Medicaid if I have other health insurance?

Yes. Having other insurance does not disqualify you. Some people have both Medicaid and a marketplace plan or employer insurance. Medicaid becomes the secondary payer in that case.

What if I do not know my exact income for the year?

Use your best estimate based on recent paychecks or tax returns. Your state Medicaid office will ask you to verify your income later with pay stubs, tax returns, or other documents. If your estimate is wrong, they will adjust your coverage.

How long does it take to learn about I may have access to?

If you use your state's online tool, you can get an answer in minutes. If you call or mail in an process, it usually takes two to four weeks. Some states are faster; some are slower. Your state Medicaid office can tell you their current processing time.