Medicaid Income Limits 2026: Full Guide by State & Household Size

Medicaid income limits for 2026 depend on three things: your state, your household size, and which Medicaid program you are applying for. There is no single national income limit — each state runs its own Medicaid program within federal guidelines, and limits vary dramatically by eligibility category.

Quick answers for 2026:

  • Expansion states (40 + D.C.): Adults qualify up to 138% FPL — $22,025/year for one person, $45,540 for a family of four
  • Non-expansion states (10 states): Most adults cannot qualify; parents face limits as low as 13–25% FPL
  • Children: Covered up to 200–317% FPL in most states through Medicaid and CHIP combined
  • Pregnant women: Covered up to 185–220% FPL in most states
  • Nursing Home / HCBS Medicaid: $2,982/month for a single applicant (300% of the Federal Benefit Rate)

Use the free Federal Poverty Level Calculator to find your FPL percentage instantly — then use the tables below or our Medicaid Eligibility Calculator to understand what Medicaid programs your income may qualify you for.


2026 Medicaid Income Limits — Quick Reference Table

Medicaid CategoryIncome LimitWho It Covers
ACA Expansion Adults138% FPLAdults 19–64 in the 40 expansion states + D.C.
Non-Expansion Adults (parents)13%–75% FPLParents/caretakers in the 10 non-expansion states
Non-Expansion Adults (childless)Not eligibleChildless adults in non-expansion states
Children (Medicaid)133%–317% FPLVaries by state and child’s age
Pregnant Women138%–300%+ FPLAll 50 states; most cover at 185%–213% FPL
ABD Medicaid (aged/blind/disabled)~100% FPL or FBRElderly, blind, disabled individuals
Nursing Home Medicaid$2,982/month300% of Federal Benefit Rate (FBR)
HCBS Medicaid Waivers$2,982/monthHome and community-based care
Medicare Savings Programs100%–135% FPLHelps with Medicare premiums and costs

Note: Dollar amounts are based on 2026 FPL ($15,960 for one person in contiguous U.S.). All figures are approximate — programs round differently and states may apply additional rules.


138% FPL — The Medicaid Expansion Income Limit

In the 40 states plus Washington D.C. that expanded Medicaid under the Affordable Care Act, the income limit for most adults (ages 19–64) is 138% of the Federal Poverty Level. This equals:

Household SizeAnnual Income LimitMonthly Income Limit
1$22,025$1,835
2$29,863$2,489
3$37,702$3,142
4$45,540$3,795
5$53,378$4,448
6$61,217$5,101
7$69,055$5,755
8$76,894$6,408
Each additional+$7,838+$653

Source: HHS ASPE, 2026 Federal Poverty Guidelines. Effective January 14, 2026. Calculated as 100% FPL × 1.38, reflecting the ACA’s 5% income disregard applied to the 133% threshold.

Alaska and Hawaii have higher limits. In Alaska, 138% FPL for one person is $27,531/year. In Hawaii, it is $25,337/year. Both states have expanded Medicaid.

No asset test applies for ACA Medicaid expansion. Only income is evaluated. Working adults, homeowners, and people with savings or retirement accounts can all qualify based solely on income.

For a full explanation of why this threshold exists and how it’s calculated, see 138% of the Federal Poverty Level.


Medicaid Expansion States vs. Non-Expansion States (2026)

As of 2026, 40 states plus Washington D.C. have expanded Medicaid. 10 states have not. This is the most important factor in determining your eligibility.

Expansion States (40 + D.C.) — Adults Covered Up to 138% FPL

Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia, Washington D.C.

In all of these states, adults aged 19–64 earning at or below 138% FPL ($22,025/year for one person) qualify for full Medicaid coverage with no asset test and no requirement to have children, a disability, or be pregnant.

Work Requirements Note: Under the One Big Beautiful Bill Act (signed July 4, 2025), Medicaid expansion adults will be required to document 80 hours/month of work, job training, education, or community service to maintain coverage. This requirement is scheduled to take effect January 1, 2027 (with some states starting earlier — Nebraska began May 1, 2026). Exemptions apply for pregnant individuals, parents of children under 13, people with disabilities, full-time students, and others. Work requirements do not change the income limits.

Non-Expansion States (10) — Very Limited Adult Coverage

Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming

In these states, childless adults generally cannot qualify for Medicaid regardless of income. Parents and caretakers of dependent children may qualify, but at extremely low income thresholds:

StateParents/Caretakers Income Limit (% FPL)Approx. Monthly Limit (Family of 3)
Alabama~18% FPL~$410/month
Florida~26% FPL~$592/month
Georgia~35% FPL~$797/month
Kansas~38% FPL~$866/month
Mississippi~27% FPL~$615/month
South Carolina~67% FPL~$1,526/month
Tennessee~88% FPL~$2,004/month
Texas~17% FPL~$387/month
Wisconsin~100% FPL~$2,277/month
Wyoming~54% FPL~$1,230/month

Approximate figures. Source: CMS MAGI eligibility data. Dollar amounts calculated using 2026 FPL for a family of 3 ($27,320). Verify with your state agency.

Residents of non-expansion states who earn between roughly 50%–100% FPL fall into the Medicaid coverage gap — too much income for Medicaid, too little for ACA Marketplace subsidies (which start at 100% FPL). An estimated 1.4–1.9 million people nationally are in this gap, concentrated heavily in Texas, Florida, and Georgia.


Medicaid Income Limits for Children (2026)

Children have the most generous Medicaid income limits of any group. Federal law requires all states to cover children at a minimum income threshold, and most states go well above that floor through a combination of Medicaid and CHIP.

How Children’s Medicaid Coverage Works

  • Medicaid for children: Typically covers children up to 133%–200% FPL, depending on the child’s age and state
  • CHIP (Children’s Health Insurance Program): Picks up where Medicaid leaves off, usually covering up to 200%–317% FPL
  • Combined Medicaid + CHIP coverage: In most states, children in families earning up to $5,000–$5,500/month qualify for some form of public coverage

200% FPL — Common Children’s Medicaid Threshold (2026)

At 200% FPL, a family of three earning up to $54,640/year may qualify in many states. Monthly and annual limits:

Household Size200% FPL (Annual)200% FPL (Monthly)
1$31,920$2,660
2$43,280$3,607
3$54,640$4,553
4$66,000$5,500
5$77,360$6,447
6$88,720$7,393

Contiguous U.S. figures. Source: 2026 HHS FPL guidelines.


Medicaid Income Limits for Pregnant Women (2026)

All 50 states cover pregnant women at income levels above the standard adult Medicaid limit. Most states cover pregnant women at 185%–213% FPL, with several states going higher.

185% FPL — Common Pregnancy Medicaid Threshold (2026)

Household Size185% FPL (Annual)185% FPL (Monthly)
1$29,526$2,461
2$40,034$3,336
3$50,542$4,212
4$61,050$5,088
5$71,558$5,963
6$82,066$6,839

Contiguous U.S. figures. Source: 2026 HHS FPL guidelines.

Coverage typically continues for 60 days postpartum in most states. Under recent federal legislation, states were given the option to extend postpartum Medicaid coverage to 12 months — most states have adopted this extension. Verify your state’s specific pregnancy Medicaid limits with your state Medicaid agency.


Medicaid Income Limits for Elderly and Disabled (ABD Medicaid)

Regular Medicaid for Aged, Blind, and Disabled (ABD) individuals uses different income limits than ACA expansion Medicaid. This is the pathway for people 65+ or those receiving Social Security Disability who do not qualify for Medicaid through the ACA expansion.

Most states set the ABD Medicaid income limit at 100% FPL ($15,960/year / $1,330/month for one person in 2026) or at the Federal Benefit Rate (FBR) ($994/month in 2026).

Asset limits apply for ABD Medicaid — unlike expansion Medicaid. Most states limit assets to:

  • $2,000 for a single individual
  • $3,000 for a married couple

Exception: California eliminated its Medicaid asset test for most programs in 2024 but reinstated a $130,000 cap for non-MAGI long-term care programs as of January 1, 2026.

SSI-Linked Medicaid

In most states, individuals who qualify for Supplemental Security Income (SSI) are automatically enrolled in Medicaid without a separate application. The 2026 SSI Federal Benefit Rate is $994/month for an individual and $1,491/month for a couple.


Medicaid Income Limits for Nursing Home Care (2026)

Nursing Home Medicaid and HCBS (Home and Community Based Services) Medicaid Waivers use a separate income standard from the ACA expansion rules — one based on the Federal Benefit Rate rather than the FPL.

2026 Nursing Home Medicaid Income Limit: $2,982/month (single applicant)

This equals 300% of the Federal Benefit Rate ($994 × 3 = $2,982). Most states use this as the monthly income cap for individuals applying for:

  • Nursing Home Medicaid (institutional care)
  • HCBS Medicaid Waivers (home-based care programs)

Important notes:

  • This increased from $2,901/month in 2025, following the annual FBR update
  • Married couples where both spouses apply are evaluated as two single applicants
  • Even if income exceeds the limit, applicants may still qualify through a Medically Needy pathway or a Miller Trust / Qualified Income Trust in states that allow them
  • Nursing home residents are required to contribute most of their income toward care costs, retaining only a small Personal Needs Allowance ($30–$200/month depending on state)

State-Specific Nursing Home Income Limits (Selected)

StateMonthly Income LimitNotes
Most states$2,982300% of 2026 FBR
Idaho$3,002State rounds FBR multiplier differently
Delaware$2,485State uses lower cap by policy
Illinois133% FPL ($1,769/month)Uses FPL rather than FBR
California$1,330/monthUses 100% FPL; reinstated asset cap Jan 2026

What Counts as Income for Medicaid?

Most Medicaid programs — including ACA expansion — use Modified Adjusted Gross Income (MAGI) to evaluate eligibility. MAGI is calculated as:

AGI + untaxed Social Security benefits + tax-exempt interest + excluded foreign income

For most people, MAGI is very close to gross income. Key rules:

Income TypeCounted for MAGI Medicaid?
Wages and salariesYes
Self-employment income (net)Yes
Social Security retirement (taxable portion)Yes
SSDI (taxable portion)Yes
Untaxed Social Security benefitsYes — added back to AGI
SSI (Supplemental Security Income)No
SNAP / EBT benefitsNo
Child support receivedNo
Veterans’ benefits (non-taxable)No
GiftsNo
Unemployment compensationYes
Lottery winningsYes
Rental income (net)Yes

No asset test applies for MAGI-based Medicaid (expansion adults, children, pregnant women). Asset tests only apply to ABD Medicaid and Nursing Home Medicaid.

Unlike SNAP, Medicaid does not allow deductions for shelter costs, childcare expenses, or earned income when comparing to the income limit.


How to Apply for Medicaid in 2026

Medicaid enrollment is open year-round — you can apply at any time without needing a qualifying life event or open enrollment period.

Three ways to apply:

  1. Online at your state Medicaid agency — Most states have online portals. Search “[your state] Medicaid apply” for the direct link.
  2. Through Healthcare.gov — When you apply for coverage, the site checks Medicaid eligibility automatically and refers you if you qualify.
  3. In person or by phone — Contact your local Department of Social Services or state Medicaid office directly.

What you’ll typically need:

  • Proof of identity (driver’s license, passport, or state ID)
  • Proof of income (recent pay stubs, tax return, or benefit award letters)
  • Proof of residency (utility bill, lease, or bank statement)
  • Social Security numbers for all household members
  • Immigration documents if applicable

Processing time: Most states must make an eligibility decision within 45 days of a completed application (90 days for disability-based applications). If approved, coverage is often retroactive to the first day of the month you applied.


Medicaid vs. CHIP: What’s the Difference?

Both Medicaid and CHIP provide low-cost health coverage, but they serve slightly different populations:

MedicaidCHIP
Who it coversLow-income individuals of all agesChildren whose families earn too much for Medicaid
Income limit (children)Typically up to 138%–200% FPLTypically 200%–317% FPL
Cost to enrolleeGenerally free (small copays in some states)Small premiums and copays may apply
Federal/state splitVaries by state (avg. ~65% federal)90% federal, 10% state
EnrollmentYear-round, open enrollmentYear-round in most states

Children whose family income exceeds Medicaid limits but falls below CHIP limits are covered under CHIP, which works similarly to Medicaid but may require small monthly premiums in some states.


Frequently Asked Questions About Medicaid Income Limits

What is the income limit for Medicaid in 2026?

It depends on your state and eligibility category. In the 40 expansion states + D.C., adults qualify at 138% FPL — $22,025/year ($1,835/month) for one person, or $45,540/year for a family of four. In non-expansion states, most adults cannot qualify at any income, while parents face limits as low as 13–26% FPL. Children qualify at much higher levels — often up to 200–300% FPL.

What is the Medicaid income limit for a single person in 2026?

In expansion states, a single adult qualifies for Medicaid with income up to $22,025/year ($1,835/month) — that is 138% of the 2026 FPL. In non-expansion states, a single childless adult generally cannot qualify for Medicaid at any income level through regular pathways. Alaska: $27,531/year. Hawaii: $25,337/year.

What is the Medicaid income limit for a family of 4 in 2026?

In expansion states, a family of four qualifies for Medicaid with household income up to $45,540/year ($3,795/month). This is 138% of the 2026 FPL for a four-person household. In non-expansion states, limits for parents are far lower — often below $1,000/month.

Does the Medicaid income limit count gross or net income?

Medicaid uses Modified Adjusted Gross Income (MAGI) — essentially your gross income with a few specific additions (untaxed Social Security, tax-exempt interest). Unlike SNAP, Medicaid does not allow deductions for shelter costs, childcare, or other expenses. For elderly and disabled Medicaid, some states use net income after certain medical deductions.

Is there an asset limit for Medicaid in 2026?

For ACA expansion Medicaid (most adults and children): No asset limit. Only income matters. For ABD Medicaid (aged, blind, disabled): most states limit assets to $2,000 (individual) or $3,000 (married couple). For Nursing Home Medicaid: strict asset limits apply, typically $2,000 for a single applicant, though spousal protections allow the community spouse to retain more.

Can I get Medicaid if I work full time?

Yes. Working does not disqualify you from Medicaid. If your income falls below your state’s Medicaid limit, you qualify regardless of employment status. A single person working full time at or below approximately $10.59/hour ($22,025/year) in an expansion state qualifies. Starting January 1, 2027, expansion adults must document 80 hours/month of qualifying activity (work, training, education, or community service) to maintain coverage under the One Big Beautiful Bill Act.

What is the Medicaid income limit for pregnant women?

Most states cover pregnant women at 185%–213% FPL — $29,526–$33,999/year for one person in the contiguous U.S. Coverage typically continues for 60 days after delivery, and many states have extended postpartum coverage to 12 months. All 50 states provide Medicaid for pregnant women.

What is the Medicaid income limit for children in 2026?

Children are covered at the most generous income levels. Most states cover children at 200%–300% FPL through a combination of Medicaid and CHIP. A family of four earning up to $66,000–$99,000/year may qualify for their children’s coverage depending on the state.

What is the income limit for nursing home Medicaid in 2026?

The income limit for Nursing Home Medicaid in most states is $2,982/month for a single applicant — 300% of the 2026 Federal Benefit Rate ($994 × 3). This increased from $2,901/month in 2025. Even if income exceeds this limit, you may still qualify through a Qualified Income Trust (Miller Trust) in states that allow them.

What is the Medicaid coverage gap?

The Medicaid coverage gap affects people in the 10 non-expansion states who earn between roughly 0%–100% FPL. They earn too much for that state’s Medicaid (which has very low adult limits) but too little for ACA Marketplace subsidies (which start at 100% FPL). An estimated 1.4–1.9 million people fall into this gap, with the largest concentrations in Texas, Florida, and Georgia.

How is Medicaid different from Medicare?

Medicaid is based on income — it serves low-income individuals of all ages. Medicare is based on age and disability status — it serves people 65 and older and certain disabled individuals regardless of income. Some people qualify for both (“dual eligibles”). For income-based eligibility, only Medicaid uses FPL thresholds. Medicare Savings Programs (which help with Medicare costs) also use FPL-based income limits.


Calculate Your Medicaid Eligibility

The first step is finding your FPL percentage. Use the free Federal Poverty Level Calculator to:

  • Enter your household income (annual, monthly, biweekly, or weekly)
  • Select your household size
  • Get your FPL percentage instantly
  • Compare against the Medicaid threshold for your state

Then check whether your state has expanded Medicaid using the expansion list above, and apply directly through your state Medicaid agency or at healthcare.gov.


Related Pages


Sources: U.S. Department of Health and Human Services, ASPE (2026 Federal Poverty Guidelines); Centers for Medicare & Medicaid Services (CMS), Medicaid.gov MAGI eligibility tables; Social Security Administration (2026 Federal Benefit Rate); Kaiser Family Foundation (KFF) Medicaid expansion status tracker, March 2026. Program rules and income limits are subject to change. Always verify current eligibility with your state Medicaid agency before applying.