Medicaid Income Requirements by State 2026

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TL;DR

  • 2026 Federal Poverty Level baseline: HHS sets the poverty guideline at $15,960 for a single person, making 138% FPL = $22,000/year ($1,835/month) for a single adult in Medicaid expansion states.
  • 41 states + DC have expanded Medicaid under the ACA as of 2026, covering adults up to 138% FPL; the remaining 10 holdout states cap most non-disabled childless adults at 0–19% FPL, creating a coverage gap.
  • Medicaid uses MAGI (Modified Adjusted Gross Income) to determine eligibility – this excludes SSI payments, child support received, and veterans' benefits, and includes a built-in 5% income disregard that effectively raises the functional threshold to ~143% FPL.
  • Children and pregnant women qualify at higher thresholds than non-disabled adults – CHIP covers children up to 200–400% FPL depending on state, and pregnant women are covered up to at least 200% FPL in most states.

What Are the Medicaid Income Requirements for 2026?

Medicaid income eligibility is determined by comparing your household income to the Federal Poverty Level (FPL), which HHS updates annually. For 2026, the poverty guideline is $15,960 for a single person in the 48 contiguous states and DC, $21,640 for a family of two, and $27,320 for a family of three.

The key threshold is 138% FPL for expansion states. In states that have expanded Medicaid, adults under age 65 will qualify for Medicaid if they earn up to 138% of the FPL. For 2026, that equals roughly $22,000/year for a single adult or $37,700 for a household of three.

However, your state's expansion status is the biggest variable. In states that have not expanded Medicaid, adults without dependent children are generally ineligible regardless of income, while parents qualify at very low levels – often below 20% FPL depending on the state.

Income isn't the only factor. You'll also need to meet residency requirements, provide proof of citizenship or eligible immigration status, and report your Social Security number. The federal poverty level is used to determine eligibility for Medicaid and CHIP (the Children's Health Insurance Program); eligibility for Affordable Care Act premium tax credits and cost-sharing reductions (subsidies); and eligibility for Medicare Savings Programs (MSPs).

If you don't qualify for Medicaid, you may still qualify for subsidized coverage through the ACA marketplace during open enrollment.

Key Takeaway: 2026 Medicaid expansion threshold is 138% FPL (~$22,000/year for single adult). Non-expansion states cap childless adults at 0–19% FPL, creating a coverage gap affecting millions.

Medicaid Expansion States vs. Non-Expansion States: What Changes?

The single most impactful eligibility dividing line is whether your state adopted ACA Medicaid expansion. 41 states (including DC) have adopted the Medicaid expansion and 10 states have not adopted the expansion.

Expansion states cover adults up to 138% FPL. The Affordable Care Act's (ACA) Medicaid expansion expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($21,597 for an individual in 2025). This means a single adult earning $22,000/year in Virginia qualifies for Medicaid, while the same person earning $22,000/year in Texas does not.

Non-expansion states maintain pre-ACA eligibility rules. In Texas, parents are eligible for Medicaid up to a very low percentage of the federal poverty level. Childless adults are not eligible for Medicaid in Texas regardless of income. The 10 non-expansion states are: Texas, Florida, Georgia, Alabama, Mississippi, South Carolina, Tennessee, Kansas, Wyoming, and Wisconsin (which operates a waiver covering adults to 100% FPL).

Here's the income gap in dollars:

Household Type Expansion State (138% FPL) Non-Expansion State (Example: Texas)
Single Adult ~$22,000/year $0 (childless adults ineligible)
Parent + 1 Child ~$37,700/year Below 20% FPL
Pregnant Woman ~$31,300/year (200% FPL) ~$31,300/year (200% FPL)

A coverage gap exists in nine states as of 2026. This gap traps people earning too much for Medicaid but too little to qualify for marketplace subsidies (which begin at 100% FPL). If you live in a non-expansion state and earn above your state's Medicaid cap, you'll need to explore ACA marketplace plans with premium tax credits.

Key Takeaway: Expansion states cover adults to 138% FPL (~$22,000/year); non-expansion states cap childless adults at 0–19% FPL. The gap affects 1.5–2 million uninsured people annually.

Medicaid Income Limits by State 2026 (Full Reference)

Income thresholds vary dramatically by state and eligibility group. Below is a reference guide showing 2026 income limits for key categories:

State Expansion? Single Adult (% FPL) Family of 3 Monthly Children (% FPL) Pregnant Women (% FPL)
Alabama No 0% N/A 200% 200%
Alaska No 0% N/A 200% 200%
Arizona Yes 138% $3,065 200% 200%
Arkansas Yes 138% $3,065 200% 200%
California Yes 138% $3,065 266% 213%
Colorado Yes 138% $3,065 200% 200%
Connecticut Yes 138% $3,065 200% 200%
Delaware Yes 138% $3,065 200% 200%
Florida No 0% N/A 200% 200%
Georgia No 0% N/A 200% 200%
Hawaii Yes 138% $3,065 300% 200%
Idaho Yes 138% $3,065 200% 200%
Illinois Yes 138% $3,065 200% 200%
Indiana Yes 138% $3,065 200% 200%
Iowa Yes 138% $3,065 200% 200%
Kansas No 0% N/A 200% 200%
Kentucky Yes 138% $3,065 200% 200%
Louisiana Yes 138% $3,065 200% 200%
Maine Yes 138% $3,065 200% 200%
Maryland Yes 138% $3,065 200% 200%
Massachusetts Yes 138% $3,065 200% 200%
Michigan Yes 138% $3,065 200% 200%
Minnesota Yes 138% $3,065 200% 200%
Mississippi No 0% N/A 200% 200%
Missouri Yes 138% $3,065 200% 200%
Montana Yes 138% $3,065 200% 200%
Nebraska Yes 138% $3,065 200% 200%
Nevada Yes 138% $3,065 200% 200%
New Hampshire Yes 138% $3,065 200% 200%
New Jersey Yes 138% $3,065 200% 200%
New Mexico Yes 138% $3,065 200% 200%
New York Yes 138% $3,065 200% 200%
North Carolina Yes 138% $3,065 200% 200%
North Dakota Yes 138% $3,065 200% 200%
Ohio Yes 138% $3,065 200% 200%
Oklahoma Yes 138% $3,065 200% 200%
Oregon Yes 138% $3,065 200% 200%
Pennsylvania Yes 138% $3,065 200% 200%
Rhode Island Yes 138% $3,065 200% 200%
South Carolina No 0% N/A 200% 200%
South Dakota Yes 138% $3,065 200% 200%
Tennessee No 0% N/A 200% 200%
Texas No 0% N/A 200% 200%
Utah Yes 138% $3,065 200% 200%
Vermont Yes 138% $3,065 200% 200%
Virginia Yes 138% $3,065 200% 200%
Washington Yes 138% $3,065 200% 200%
West Virginia Yes 138% $3,065 200% 200%
Wisconsin Partial 100% $2,236 200% 200%
Wyoming No 0% N/A 200% 200%
DC Yes 138% $3,065 200% 200%

Key notes:

Key Takeaway: Income limits range from 0% FPL (non-expansion states, childless adults) to 300% FPL (Hawaii children). Most expansion states cap adults at 138% FPL (~$22,000/year single).

How Is Medicaid Income Calculated? What Counts (and What Doesn't)

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most applicants. This is critical because your MAGI may be significantly lower than your gross income, potentially qualifying you when you thought you wouldn't.

Income types that COUNT toward MAGI:

  • Wages and salary
  • Self-employment income (net profit from Schedule C, not gross revenue)
  • Social Security retirement and disability benefits (SSDI)
  • Alimony received
  • Interest and dividend income
  • Rental income

Income types that DO NOT count:

  • SSI (Supplemental Security Income) payments
  • Child support received
  • Veterans' benefits
  • SNAP (food stamps)
  • Gifts and inheritances
  • Worker's compensation
  • Certain tribal income

Here's a real example: You're a freelancer earning $28,000 gross annually. Your business expenses total $6,000 (software, equipment, home office). Your MAGI is $22,000 ($28,000 – $6,000). In an expansion state, you qualify for Medicaid at 138% FPL (~$22,000). Without understanding MAGI, you might think your $28,000 gross income disqualifies you.

The state applies a "Five Percent Disregard" to your Modified Adjusted Gross Income (MAGI), so the effective ceiling is 138% FPL. This effectively means you can actually earn up to 143% of the FPL and still maintain eligibility. So the functional threshold is closer to $22,380/year for a single adult in expansion states.

Household size matters too. Only certain people count toward your household for Medicaid purposes: you, your spouse (if married and filing jointly), and your tax dependents. If you have adult children living with you who aren't dependents, they don't count.

Key Takeaway: MAGI excludes SSI, child support, and veterans' benefits. Self-employment income counts as net profit, not gross. 5% disregard raises functional threshold to ~143% FPL.

Which Groups Have Different Income Thresholds?

Medicaid has separate income rules for distinct eligibility categories. This is where many people miss out – they assume they don't qualify based on adult thresholds, not realizing their group qualifies at a higher level.

Children (Medicaid and CHIP): A child ages 0 through 18 may be eligible if the family income is $2,807/month or less. Most states cover children up to 200% FPL; some go as high as 300–400% FPL. Medi-Cal for Children up to 266% FPL. If your child's income exceeds Medicaid limits, they may qualify for CHIP coverage options, which bridges the gap to higher thresholds.

Pregnant women: A pregnant person may be eligible if the family income is $3,535/month or less (includes one unborn child). All states cover pregnant women at or above 200% of the federal poverty level through Medicaid or CHIP perinatal programs, regardless of ACA expansion status. For 2026, 200% FPL equals roughly $31,300/year for an individual. Some states like California cover pregnant women up to 213% FPL.

Aged, Blind, and Disabled (ABD): An applicant must be at least 65 years of age or blind or living with a disability. These applicants use pre-ACA eligibility rules tied to SSI (Supplemental Security Income) limits, typically around $994/month for individuals. They also face asset tests – the limit for countable resources is $2,500 for an individual and $3,000 for a couple.

Long-term care (nursing home): Persons residing in Medicaid-funded nursing homes are generally permitted to have monthly income as high as $2,982 in 2026. However, nearly all of their income except for a Personal Needs Allowance must go towards paying for their care costs.

Medicare Savings Programs (QMB, SLMB, QI): If you're 65+ and on Medicare, you may qualify for programs that pay your premiums and cost-sharing. For qualified Medicare beneficiaries, the monthly income limit is 100% of the federal poverty level plus $20. For all states except Alaska and Hawaii, dollar amounts are $1,350 per individual (an increase of $25 from 2025) and $1,824 per couple.

Key Takeaway: Children qualify up to 200–400% FPL; pregnant women up to 200%+ FPL; elderly/disabled tied to SSI limits (~$994/month). Long-term care allows up to $2,982/month income.

How Do You Apply for Medicaid in 2026?

Once you've confirmed you meet income requirements, applying is straightforward. Unlike ACA marketplace plans, Medicaid has no open enrollment window – you can apply year-round.

Where to apply:

  1. Your state Medicaid agency website – Most states have online portals where you can submit applications electronically.
  2. HealthCare.gov – You can apply for Medicaid through your state Medicaid agency website, through Healthcare.gov if you live in a state that uses the federal marketplace, or at a local social services office.
  3. Local DSS (Department of Social Services) office – You can apply in person with staff assistance.

Documents you'll need:

  • Proof of income (recent pay stubs, tax returns, self-employment records)
  • Photo ID or other identity verification
  • Proof of residency (utility bill, lease, mortgage statement)
  • Social Security number
  • Proof of citizenship or eligible immigration status
  • Birth certificates for dependents

Timeline: States must process most Medicaid applications within 45 days (90 days for disability-based applications). Many states now process MAGI-based applications in 24–72 hours using real-time data matching with IRS and Social Security records. According to MACPAC's research on eligibility, enrollment, and renewal processes, states that have invested in automated verification systems consistently achieve faster determination times and lower error rates across eligibility categories.

Retroactive coverage: Medicaid may cover bills for medical care received up to 3 months before the month of application if the person was eligible during that time. This is valuable if you had medical expenses before applying.

Post-unwinding landscape: The Medicaid continuous enrollment requirement ended March 31, 2023. By 2026, all states have returned to standard redetermination processes. New applicants face standard 30–45 day determination periods with no special protections.

If you're self-employed or a gig worker with variable income, consider consulting with a benefits advisor. Health Coverage like a BOSS! helps self-employed individuals and freelancers navigate Medicaid eligibility and compare it against marketplace subsidies to find the best option for your situation.

Key Takeaway: Apply online, by mail, or in person. Standard processing: 30–45 days. Gather income, ID, residency, and citizenship docs. Retroactive coverage available up to 3 months prior.

Frequently Asked Questions About Medicaid Income Limits

Does Medicaid have an asset limit in 2026?

Direct Answer: Most MAGI-based Medicaid applicants (non-elderly, non-disabled adults) have no asset limit. However, elderly, blind, and disabled applicants do face asset tests.

The limit for countable resources is $2,500 for an individual and $3,000 for a couple. Countable assets include bank accounts, stocks, and real estate (excluding your primary home). Non-countable assets include your car, household items, and life insurance. If you're applying as an elderly or disabled person, verify your state's specific asset limits – they vary slightly.

Can I have a job and still qualify for Medicaid?

Direct Answer: Yes. Medicaid counts earned income toward your eligibility threshold, but you can still qualify if your total household income is below your state's limit.

If you earn $20,000/year and live in an expansion state, you qualify for Medicaid (138% FPL = ~$22,000). Your job doesn't disqualify you – only your income level matters. Some states have work incentive programs for people with disabilities that allow higher earnings.

What happens to my Medicaid if my income goes up during the year?

Direct Answer: You must report income changes to your state Medicaid agency. If your income exceeds the threshold, your coverage ends, typically at the end of the month in which you report the change.

However, you may qualify for ACA marketplace subsidies if your income rises to 100–400% FPL. Report the change promptly to avoid overpayments or coverage gaps. Some states allow a grace period before terminating coverage.

How is Medicaid different from marketplace health insurance?

Direct Answer: Medicaid is a joint federal-state program with no premiums for eligible low-income individuals. Marketplace plans are private insurance with premiums, deductibles, and copays – though subsidies reduce costs for those earning 100–400% FPL.

Medicaid typically has lower out-of-pocket costs and broader provider networks. Marketplace plans offer more choice and portability across states. If you qualify for both, compare coverage and provider access in your area.

Does self-employment income count toward Medicaid eligibility?

Direct Answer: Yes. For self-employed individuals, Medicaid counts net self-employment income (gross income minus allowable deductions) as defined by IRS Schedule C.

If you earn $28,000 gross but have $6,000 in business expenses, your countable income is $22,000. This is a major advantage for freelancers and gig workers – you can deduct legitimate business costs before Medicaid calculates your eligibility.

What state has the highest Medicaid income limit in 2026?

Direct Answer: For non-disabled adults, all expansion states cap eligibility at 138% FPL (~$22,000/year for a single adult). For children, Hawaii and California have the highest limits at 300% and 266% FPL respectively.

Medi-Cal for Children up to 266% FPL. If you're relocating, check your new state's thresholds – they vary significantly for children and pregnant women.

Can I apply for Medicaid at any time or only during open enrollment?

Direct Answer: You can apply for Medicaid at any time – there is no open enrollment window. Unlike ACA marketplace plans, Medicaid accepts applications year-round.

However, if you're also considering marketplace plans, remember that marketplace open enrollment runs November 1 – January 15 annually. If you miss that window and don't qualify for Medicaid, you'll need to wait until the next open enrollment period.

Finding Help: Local Medicaid Resources and Guidance

Navigating Medicaid eligibility can be complex, especially when comparing it against marketplace options or managing variable income as a freelancer or gig worker. If you're self-employed or have irregular income, understanding how MAGI calculations affect your eligibility is critical – and it's easy to miscalculate on your own.

Health Coverage like a BOSS! specializes in helping self-employed individuals, freelancers, and independent contractors evaluate Medicaid eligibility alongside marketplace subsidies. Rather than assuming you don't qualify based on gross income, their advisors walk through MAGI calculations, deductions, and state-specific thresholds to identify your actual options. For young families, they compare Medicaid and CHIP coverage to ensure children are protected at the lowest cost. They also help gig economy workers understand how variable monthly income affects Medicaid renewal and when to reapply.

The key advantage: you get personalized guidance on whether Medicaid, marketplace plans with subsidies, or a combination makes sense for your situation. Learn more about Health Coverage like a BOSS! here.

Ready to Get Started?

For personalized guidance, visit Health Coverage like a BOSS! to learn how we can help.

Conclusion

Medicaid income eligibility in 2026 hinges on three factors: your state's expansion status, your household income calculated as MAGI, and your eligibility group (adult, child, pregnant woman, elderly, or disabled). 41 states (including DC) have adopted the Medicaid expansion and 10 states have not adopted the expansion, creating vastly different thresholds.

If you live in an expansion state, the 138% FPL threshold (~$22,000/year for a single adult) is your benchmark. If you live in a non-expansion state, check your state's specific limits – they're often much lower for childless adults. Remember that MAGI excludes certain income types and includes a 5% disregard, so your countable income may be lower than your gross income.

The application process is straightforward: gather documents, apply online or in person, and expect a decision within 30–45 days. If you don't qualify for Medicaid, explore ACA marketplace plans with premium tax credits. If you're self-employed or have variable income, take time to calculate your actual MAGI before concluding you're ineligible – many freelancers and gig workers qualify without realizing it.

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