Three things decide whether you qualify for Medicaid: your state, your household size, and which category you fall into. That’s it. People assume this program runs the same way everywhere because it’s federal — it doesn’t. Medicaid is a partnership between Washington and each state, and that’s exactly why the rules in California barely resemble the rules in Texas.
Below are the actual 2026 numbers, who they apply to, and — if you’re sitting just above the line — what you can still do about it.
What Is the Medicaid Income Limit in 2026?
Quick Answer: In 2026, most adults in Medicaid expansion states eligible with income up to 138% of the Federal Poverty guidelines, about $22,025 per year or $1,835 per month for one person. Children, pregnant female, disable people and seniors follow different thresholds.
No single number covers everyone. Where you live matters. So does household size. So does which eligibility group you land in. All of it starts from the Federal Poverty Level (FPL), a figure HHS resets every January.
Also See Your State’s Medicaid Reimbursement Rate
2026 Federal Poverty Level — Key Thresholds
$15,960 for one person. $27,320 for a family of three. That’s the 2026 baseline, and Medicaid programs build on it with a percentage multiplier depending on who’s applying.
| Household Size | 100% FPL | 138% FPL | 200% FPL |
|---|---|---|---|
| 1 | $15,960 | $22,025 | $31,920 |
| 2 | $21,640 | $29,863 | $43,280 |
| 3 | $27,320 | $37,702 | $54,640 |
| 4 | $33,000 | $45,540 | $66,000 |
Source: 2026 HHS Federal Poverty Guidelines
Medicaid Income Limits for All States
The list below provides a state-level details of how Medicaid eligibility differs across the country.
Expansion States vs. Non-Expansion States: The Biggest Factor
One thing determines your medicaid eligibility more than anything else: did your state expand Medicaid under the ACA or not?
Say yes, and you’re one of 41 states plus D.C. where most adults eligible up to 138% of the Federal Poverty guidelines — $22,025 a one year, $45,540 for a household of 4.
Say no, and things get harder fast. Ten states never expanded: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming. In those states, adults without kids often face income limits that are either brutally low or simply don’t exist. Whether you qualify depends on dependents, disability status, pregnancy — not much else.
That gap has a name: the coverage gap. Too much income for Medicaid, not enough for ACA subsidies. A single adult with no kids and no disability, living in one of those ten states, can end up with almost nowhere to turn regardless of how little they make.
Also Get Step-by-Step Guidance With Your Medicaid Application
Income Limits by Eligibility Category
Adults Ages 19–64
$1,835/month for a single adult in an expansion state. $3,795/month for a family of four. Simple as that.
Non-expansion states aren’t simple at all. Texas parents qualify only around 17% FPL — about $273/month for a family of three. Childless adults? Usually locked out entirely unless a disability opens a different door.
Children
Kids win here, no contest. Every state must cover children to at least 133% FPL — most go far past that, some reaching 200%–317% FPL once you combine Medicaid and CHIP. A family of four bringing in $5,500/month can still get a child covered in a lot of states.
CHIP picks up where Medicaid stops for kids whose family income runs a bit higher. One application usually covers both programs. You don’t sort out which one applies — the system does that part for you.
Pregnant Women
Higher thresholds than most adults get. 185%–213% FPL is standard across most states, and a handful push past 300%.
California sets the bar. Standard Medi-Cal covers pregnancy to 213% FPL. The Medi-Cal Access Program takes it further still — 322% FPL for pregnancy-related care.
Seniors and People with Disabilities
Different rulebook entirely. Forget MAGI — seniors 65 and older, along with people with disabilities, get evaluated on income and assets both. That combination is what makes this category genuinely hard to plan around.
Most states cap regular ABD Medicaid — Aged, Blind, and Disabled — at 100 percent of FPL ($1,330 per month) or the SSI Federal Benefit Rate, whichever applies. That rate lands at $994 per month for one person, $1,491 for a married couple, in 2026.
Automatic Medicaid comes with SSI in most states. But SSA disability determinations can take months. Sometimes years. Which is exactly why the majority of disabled Medicaid enrollees get there through a separate pathway — not through SSI itself.
Long-Term Care (Nursing Home) Medicaid
$2,982/month. That’s the income ceiling for a single senior applying for nursing home Medicaid in 2026 — 300% of the SSI Federal Benefit Rate. Same cap covers assisted living and in-home care under HCBS waivers.
Assets get counted too, and most states hold the line at $2,000 for long-term care applicants. New York is looser — $33,038 for nursing home applicants. California brought asset limits back for non-MAGI Medi-Cal starting January 1, 2026: $130,000 for a one person, $195,000 couple.
How Medicaid Counts Your Income: MAGI vs. Non-MAGI
The method of counting matters just as much as the limit itself.
MAGI-based Medicaid — most adults, kids, pregnant women — follows the same math as the ACA marketplace. No asset test. Several income types don’t even factor in: child support received, SSI payments, workers’ comp, most veterans’ benefits.
Non-MAGI Medicaid covers seniors, people who are blind or disabled, and long-term care applicants. Income and assets get counted separately here, which explains why a senior with a modest monthly check but real savings can still get shut out without proper planning.
If you’re working-age, or applying for a child, or pregnant — your bank balance doesn’t come into it. Full stop.
What If You’re Over the Income Limit?
A little over the line doesn’t mean the door’s closed.
- Medically needy / spend-down programs — deduct documented medical expenses from your income until you land under the threshold. The median medically needy limit went from $511/month in 2025 to $563/month in 2026. Not every state runs this program.
- Income cap states like Texas and Florida. Cross $2,982/month for long-term care Medicaid, and a Qualified Income Trust (Miller Trust) can redirect the overage into a dedicated account.
- ACA marketplace subsidies. Expansion state, income between 100%–400% FPL? Premium tax credits on HealthCare.gov are probably waiting for you. Marketplace and Medicaid thresholds were built to link up without a gap.
- CHIP for children. Miss Medicaid by a little, and CHIP almost always catches your kid — same application, usually free or close to it.
Heading toward long-term care as a senior? Talk to an elder law attorney first — before you touch those assets. Irrevocable trusts and compliant annuities can protect savings while keeping eligibility intact.
State-by-State Highlights
California (Medi-Cal): 138% FPL for adults. No asset test under MAGI for working-age adults and kids. Long-term care asset limits came back January 2026 — $130,000 individual.
Texas: Non-expansion. Childless adults, essentially no pathway. Parents cap out around 17% FPL. Long-term care income limit: $2,982/month, Miller Trust required above that.
Florida: Non-expansion. Adult coverage is thin. Kids covered to 210% FPL through Medicaid and CHIP combined. Pregnant women, up to 191% FPL.
New York: Generous by comparison. Kids covered to 400% FPL through Child Health Plus. Single nursing home applicants need income under $1,836/month and assets under $33,038 in 2026.
Washington D.C.: 215% FPL for adults — the highest expansion-level floor anywhere.
How to Apply for Medicaid in 2026
- Nail down your category — adult, child, pregnant, senior, long-term care.
- Estimate your household income against the FPL table above.
- Round up your paperwork — photo ID, Social Security number, proof of income, residency, citizenship or immigration status.
- Apply through HealthCare.gov or your state’s Medicaid portal.
- Move fast on document requests. Missing paperwork is the number one reason applications stall.
- Watch your status. Most decisions come back within 45 days — 90 for disability-based cases.
Backdating exists too — up to three months before you apply, as long as you had qualifying medical expenses in that window. Honestly, hardly anyone asks about this, and they should. If you’ve got unpaid bills sitting around, bring it up.
FAQs About Medicaid income limits by state
What is the Medicaid income limit for a single person in 2026?
$22,025/year, $1,835/month, in expansion states. That’s 138% of the Federal Poverty Level.
Does Medicaid check your bank account or savings?
Not under MAGI rules — most adults, kids, and pregnant women skip the asset test entirely. Seniors, disabled applicants, and long-term care cases are different; your financial records get reviewed there.
Can I get Medicaid if I’m self-employed or my income varies?
Yes. Medicaid works off projected annual income, not one paycheck. Estimate your expected yearly earnings, and it gets reassessed at renewal.
Does Social Security income count toward Medicaid income limits?
For non-MAGI programs, yes — Social Security retirement and SSDI count. SSI payments don’t count as income under MAGI-based programs.
Can I get Medicaid retroactively for past medical bills?
Usually, yes. Up to three months of backdated coverage, as long as you’d have qualified during that stretch and had medical bills to show for it.
What is the Medicaid 5-year lookback rule?
For long-term care Medicaid, the state checks asset transfers made in the 60 months before you apply. Gift something away or sell it below market value in that window, and you could trigger a penalty period — no Medicaid coverage for nursing home care until it clears.
What happens if my income goes up after I’m approved?
Report it. If it crosses the threshold, coverage can end — though in expansion states, you’d usually roll straight into subsidized marketplace coverage without a gap.
Conclusion
A lot of moving parts here — expansion status, household size, category, MAGI versus non-MAGI. But don’t let that scare you off. The program reaches further than most people think, and kids, pregnant women, and adults in expansion states have real, workable access to coverage at income levels that describe a huge share of working America.
Not sure where you land? Apply anyway. It costs nothing to find out, and with retroactive coverage on the table, waiting rarely helps you.
Official Resources
- Check Your Eligibility — Medicaid.gov
- Apply for Medicaid Now — HealthCare.gov
- Verify 2026 Poverty Guidelines — ASPE (HHS)
- Find Your State Medicaid Agency — USA.gov
Disclaimer: This article is for general guidance purposes only and does not constitute official, medical, or financial advice. Medicaid eligibility policies change frequently and vary significantly by state. Always check new medicaid income limits and program rules directly with your state Medicaid agency or a qualified benefits counselor before making healthcare decisions.