Medicaid Income Limit Calculator

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

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

Related GovFacts Articles

• Medicaid Eligibility: Income Limits by State (2025 Guide)
• Medicaid Expansion Under the ACA: A State-by-State Guide
• Understanding Medicaid: Your Guide to Basic Eligibility and Coverage