In most states, you can qualify for Medicaid if your household income is at or below 138% of the federal poverty level. For a single person in 2026, that means earning roughly $22,000 a year or less. For a family of four, the cutoff is about $45,540. But your actual limit depends heavily on which state you live in, whether your state expanded Medicaid, and who in your household needs coverage.
Income Limits in Expansion States
Forty states and Washington, D.C. have expanded Medicaid under the Affordable Care Act. In these states, any adult under 65 with a household income at or below 138% of the federal poverty level qualifies. That 138% figure includes a built-in 5% income disregard, meaning the official threshold is technically 133%, but the effective cutoff you’ll see on applications is 138%.
Here’s what that looks like in actual dollars for 2026, based on the latest federal poverty guidelines:
- 1 person: $22,025 per year ($1,835 per month)
- 2 people: $29,863 per year ($2,489 per month)
- 3 people: $37,702 per year ($3,142 per month)
- 4 people: $45,540 per year ($3,795 per month)
- 5 people: $53,378 per year ($4,448 per month)
- 6 people: $61,217 per year ($5,101 per month)
If you earn below these amounts and live in an expansion state, you likely qualify regardless of whether you have children, a disability, or any other special circumstance. That’s the key difference expansion made: it opened Medicaid to all low-income adults, not just specific groups.
Income Limits in Non-Expansion States
Ten states have not expanded Medicaid, and their income limits are dramatically lower. In these states, Medicaid is generally restricted to parents, pregnant women, children, people with disabilities, and seniors. Childless adults typically cannot qualify at any income level.
For parents and caretakers, the income ceilings in non-expansion states are strikingly tight. Texas sets its limit at just 12% of the federal poverty level, meaning a parent in a family of three would need to earn less than about $3,278 a year to qualify. Alabama’s limit is 13%. Florida allows up to 24%, and Georgia up to 28%. Even the most generous non-expansion state for parents, Tennessee, caps eligibility at 84% of the poverty level.
These numbers create a well-known problem called the coverage gap. If you live in a non-expansion state and earn too much for Medicaid but less than 100% of the poverty level (under $15,960 for an individual in 2026), you fall into a range where you don’t qualify for Medicaid and also can’t get subsidized Marketplace insurance. The ACA’s premium subsidies were designed to start at 100% of the poverty level, assuming Medicaid would cover everyone below that line. In states that didn’t expand, that assumption left a gap.
Children Qualify at Much Higher Incomes
Regardless of whether your state expanded Medicaid, children are eligible at significantly higher income levels than adults. Every state covers children through a combination of Medicaid and the Children’s Health Insurance Program (CHIP), with income limits ranging from 170% to 400% of the federal poverty level depending on the state and the child’s age.
For a family of three in 2026, 200% of the poverty level is about $54,640 per year, and many states go well above that. So even if you as a parent don’t qualify for Medicaid, your children very likely do. Pregnant women also qualify at higher income thresholds in every state, typically between 138% and 200% of the poverty level or more.
How Medicaid Counts Your Income
Medicaid uses a method called Modified Adjusted Gross Income, or MAGI, for most applicants. This is essentially the same income figure you’d calculate on your federal tax return, with a few adjustments. It includes wages, salary, self-employment income, Social Security benefits, unemployment compensation, interest, dividends, and foreign income.
A few things are specifically excluded. Scholarships, awards, and fellowship grants used for tuition and education expenses (not living costs) don’t count. Lump-sum payments, like a one-time inheritance or legal settlement, only count as income in the month you receive them, not spread across the year. Certain distributions to American Indian and Alaska Native individuals from tribal lands, trusts, and natural resources are also excluded.
One important note: for MAGI-based Medicaid (which covers most adults, children, and pregnant women), there is no asset or resource test. It doesn’t matter how much you have in savings, whether you own a home, or what your car is worth. Only income matters. This is different from Medicaid for elderly individuals and people with disabilities, which can include asset limits as low as $2,000 for an individual.
How Household Size Is Determined
Your household size directly affects your income limit, so getting it right matters. Medicaid generally follows tax-filing rules: your household includes you, your spouse if you’re legally married, and anyone you claim as a tax dependent. You include your spouse and dependents even if they don’t need health coverage themselves.
Children you’ll claim as dependents count regardless of their age. Children under 21 who live with you and are in your care count even if you won’t claim them on your taxes. But a roommate, an adult sibling you don’t claim as a dependent, or a parent you don’t claim as a dependent would not be part of your household for Medicaid purposes. A larger household size raises the income threshold, so including all eligible members can make the difference between qualifying and not.
Elderly and Disabled Applicants Face Different Rules
If you’re applying for Medicaid based on age (65 and older) or a disability, your state may use different eligibility criteria that go beyond income alone. These programs often impose asset limits. In Texas, for example, individuals applying for disability-based Medicaid or long-term care coverage must have no more than $2,000 in countable resources ($3,000 for a couple). Home equity up to $752,000 is generally excluded, as are certain personal belongings and one vehicle.
Medicare Savings Programs, which help pay Medicare premiums and cost-sharing, have somewhat higher resource limits. As of 2026, individuals can have up to $9,950 in countable resources ($14,910 for couples) and still qualify for most of these programs. These limits and the specific rules around what counts as a “resource” vary by state and program, so checking with your state Medicaid office gives you the most accurate picture.
How to Check Your State’s Limits
The fastest way to find out if you qualify is to apply through your state’s Medicaid agency or through HealthCare.gov. The application process itself will determine your eligibility based on the income and household information you provide. You don’t need to calculate your percentage of the poverty level on your own.
If you want to estimate before applying, take your household’s expected annual income and compare it to the poverty level figures for your household size. For a single person in 2026, 100% of the poverty level is $15,960. For a family of four, it’s $33,000. In expansion states, multiply by 1.38 to get your cutoff. In non-expansion states, you’ll need to look up your state’s specific percentage, which can be as low as 12% for parents and zero for childless adults.