The limits are set as a percentage of the federal poverty level. CMS
The income rules generally subtract an amount equal to 5% of the poverty level, so a 133% limit works out to about 138%. CMS
Medicaid Income Limit Calculator
Pick a state, a coverage group and a household size to see the income limit in dollars, from the 2026 poverty guidelines and CMS’s table of state rules as of Dec. 1, 2023. Other rules also apply, and each result says which.
How to answer this
The limits are set as a percentage of the federal poverty level. CMS
The adult expansion group covers people 19 to 64 who aren’t pregnant and aren’t entitled to or enrolled in Medicare. 42 CFR 435.119(b)
These income rules don’t apply to people 65 or older when age is a condition of eligibility, or to people being evaluated on the basis of blindness or disability; those groups use other financial rules. 42 CFR 435.603(j)
Look up one person at a time; people in one family can fall in different groups, and one person can fit two (a pregnant 17-year-old or a 17-year-old parent, for example), so check each. Under 65 with a disability and not on Medicare? Check the adult or parent group here too; on Medicare and pregnant or raising a child? Choose that group; disability-based coverage also has its own rules. 65 or older and raising a child? Choose the parent group.
How this lookup works:
- The Centers for Medicare & Medicaid Services (CMS) table of state Medicaid and CHIP income limits shows state decisions as of Dec. 1, 2023. CMS
- The limits are set as a percentage of the federal poverty level. CMS
- The income rules generally subtract an amount equal to 5% of the poverty level, so a 133% limit works out to about 138%. CMS
- 2026 poverty levels are used to check Medicaid and CHIP eligibility. HealthCare.gov
How the Lookup Works
- The Centers for Medicare & Medicaid Services (CMS) table of state Medicaid and CHIP income limits shows state decisions as of Dec. 1, 2023. CMS
- The limits are set as a percentage of the federal poverty level. CMS
- The income rules generally subtract an amount equal to 5% of the poverty level, so a 133% limit works out to about 138%. CMS
- 2026 poverty levels are used to check Medicaid and CHIP eligibility. HealthCare.gov
Expansion and Non-Expansion States
- Some states have expanded Medicaid to cover all people with household incomes below a certain level, and others haven’t. HealthCare.gov
- The adult expansion group covers people 19 to 64 who aren’t pregnant and aren’t entitled to or enrolled in Medicare. 42 CFR 435.119(b)
- In states that expanded Medicaid, parents and caretaker relatives above the parent limit may qualify in the adult group. CMS
- CMS notes that D.C., Massachusetts and Maine cover ages 19 and 20 at higher levels than other adults, and Florida covers them up to 24% of the poverty level. CMS
- Some states cover more low-income adults under a section 1115 demonstration, which can limit eligibility or benefits, leave out some residents, or cap enrollment. CMS
- In Minnesota and New York, adults above 133% and up to 200% of the poverty level are covered through the Basic Health Program rather than Medicaid. CMS
The 2026 Poverty Guidelines
- The 2026 poverty guideline is $15,960 for one person in the 48 contiguous states and D.C., plus $5,680 for each additional person beyond eight. HHS
- Alaska and Hawaii have higher poverty guidelines. HHS
- 2026 poverty levels are used to check Medicaid and CHIP eligibility. HealthCare.gov
Who Counts in the Household, and What Counts as Income
- For someone who files taxes and isn’t claimed as a dependent, the household is that person plus everyone they expect to claim as a tax dependent. 42 CFR 435.603(f)(1)
- For someone who neither files taxes nor is claimed, the household is that person plus, if living with them, a spouse and their own children (birth, adopted or stepchildren, not grandchildren, nieces or nephews) under 19, or 21 for full-time students in some states; for a child, it includes parents and young siblings. 42 CFR 435.603(f)(3)
- For a pregnant woman, Medicaid counts her plus the number of children she expects to deliver. 42 CFR 435.603(b)
- Income here means modified adjusted gross income; for most people it’s the same or very close to adjusted gross income. HealthCare.gov
- For people applying, Medicaid looks at current monthly household income, not last year’s total. 42 CFR 435.603(h)(1)
Children, Pregnancy and People 65 or Older
- CHIP covers children from birth up to age 19 unless the table notes otherwise. CMS
- Minnesota covers children up to age 2 at a higher limit, and California covers certain children up to age 2 at a higher limit. CMS
- Where CMS notes CHIP starts at age 1, babies under 1 use the Medicaid limit. CMS
- These income rules don’t apply to people 65 or older when age is a condition of eligibility, or to people being evaluated on the basis of blindness or disability; those groups use other financial rules. 42 CFR 435.603(j)
Other Rules and How to Apply
- Other rules also apply, such as citizenship, immigration status and state residency. CMS
- Apply even if income seems too high: states have options for children, pregnancy and disability, and weigh age and other factors. HealthCare.gov
- Medicaid and CHIP applications are open any time of year, through HealthCare.gov or the state Medicaid agency. HealthCare.gov