Short answer
What is the income limit for Medicaid?
It depends on your state and your group. In states that expanded Medicaid, adults under 65 may qualify on income alone if household income is below 133 percent of the federal poverty level, which works out to 138 percent because of how income is counted. (HealthCare.gov, Medicaid expansion and you) (42 CFR 435.119) (42 CFR 435.603) In states that did not expand, many adults with low incomes do not get Medicaid on income alone. Children, pregnant people, seniors, and people with disabilities have their own limits everywhere. (HealthCare.gov, Medicaid expansion and you) (HealthCare.gov, Getting Medicaid and CHIP) Your state Medicaid agency decides.
| Group | What sets the limit |
|---|---|
| Adults 19 to 64, expansion states | 133 percent of the poverty level, effectively 138 percent |
| Adults, states that did not expand | Lower limits for adults; check your state page |
| Children, pregnancy, 65 and older, disability | Separate groups with their own limits in all states |
| 2026 HHS poverty guideline, 48 states and DC | Official: $15,960 a year for 1 person, $33,000 for 4 |
Source: HealthCare.gov and HHS ASPE 2026 poverty guidelines, with 42 CFR 435.119. Verified .
Your state Medicaid agency decides eligibility. Benefit Bull is free and never applies for you.
How do poverty level percentages turn into dollars?
| Household size | 2026 poverty guideline (official, per year) |
|---|---|
| 1 | $15,960 |
| 2 | $21,640 |
| 3 | $27,320 |
| 4 | $33,000 |
| 5 | $38,680 |
| 6 | $44,360 |
| 7 | $50,040 |
| 8 | $55,720 |
| Each additional person | +$5,680 |
Medicaid limits are written as a percent of these figures. (HealthCare.gov, Medicaid expansion and you) (HHS ASPE, 2026 poverty guidelines) As an illustration of the percentage, not your state's limit: 138 percent of the $15,960 guideline for 1 person is about $22,025 a year. Alaska and Hawaii have their own, higher guidelines. (HHS ASPE, 2026 poverty guidelines)
Your state page shows the exact figure your state agency uses. States may list limits by month and update them on their own date.
Find your household size in the table, then check your state page for the limit your agency actually uses.
Did your state expand Medicaid, and why does it matter?
HealthCare.gov says that whether you may qualify for Medicaid "depends partly on whether your state has expanded its program." (HealthCare.gov, Medicaid expansion and you) In states that expanded, adults may qualify on income alone. Federal rules cover adults age 19 to 64 with household income at or below 133 percent of the poverty level, and the state subtracts an amount equal to 5 percentage points of the poverty level when it counts income, which is why the limit works out to 138 percent. (42 CFR 435.119) (42 CFR 435.603) (HealthCare.gov, Medicaid expansion and you) HealthCare.gov notes that a few states use a different income limit. (HealthCare.gov, Medicaid expansion and you)
In states that did not expand, adults with incomes below the poverty line who do not get Medicaid based on disability, age, or other factors can fall into a gap between Medicaid and Marketplace savings, according to HealthCare.gov. (HealthCare.gov, Medicaid expansion and you) See HealthCare.gov's Medicaid expansion page for how this works.
If your neighbor in another state got a different answer, expansion is usually the reason. Check the rules where you live.
Are the limits different for children, pregnancy, seniors, or disability?
Yes. Who may qualify for Medicaid depends on your group as well as your income. HealthCare.gov says that in all states, Medicaid covers low-income people, including families and children, pregnant women, the elderly, and people with disabilities, and that eligible income levels may be different from state to state. (HealthCare.gov, Getting Medicaid and CHIP) In certain states, CHIP also covers children and pregnant women in families that earn too much for Medicaid. (HealthCare.gov, Getting Medicaid and CHIP)
For examples of how pregnancy and children's limits look in one state, see Texas Medicaid income limits. If you have Medicare, see Medicare Savings Programs income limits.
If anyone in your home is pregnant, under 19, 65 or older, or has a disability, check that group on your state page.
What if your income is too high for Medicaid?
When you submit a Marketplace application, you also find out whether you may get cost savings on a Marketplace plan. If you are turned down for Medicaid or CHIP, HealthCare.gov says you may be able to get Marketplace coverage instead. (HealthCare.gov, Getting Medicaid and CHIP) Even in a state that did not expand, HealthCare.gov says you should fill out a Marketplace application. (HealthCare.gov, Medicaid expansion and you)
Our guide to ACA open enrollment for 2027 covers the dates and steps.
If Medicaid says no, apply on the Marketplace. You may still get help with the cost of a plan.
What are the Medicaid rules in your state?
| State | Our guide | Official agency |
|---|---|---|
| Massachusetts | MassHealth income limits | MassHealth (Mass.gov) |
| Indiana | Indiana Medicaid income limits and HIP work requirements | Indiana Medicaid (FSSA) |
| Texas | Texas Medicaid income limits | Texas Health and Human Services |
| Kentucky | Kentucky Medicaid income limits | Kentucky Department for Medicaid Services |
| Minnesota | Minnesota Medical Assistance income limits | Minnesota Department of Human Services |
For any other state, HealthCare.gov's Getting Medicaid and CHIP page lets you select your state to get your Medicaid agency's contact information. (HealthCare.gov, Getting Medicaid and CHIP)
Open your state page next. It has the limit your state uses and how to apply there.
How do you apply, and what happens at renewal?
You can apply through the Marketplace, which sends your information to your state agency if it looks like anyone in your household may qualify, or apply directly through your state Medicaid agency. (HealthCare.gov, Getting Medicaid and CHIP) Once you are covered, your state checks eligibility again at renewal; see our Medicaid renewal guide.
You submit your application yourself on the official site. Benefit Bull is free and never files for you.
Apply even if you are not sure. Your state Medicaid agency decides, and you may qualify under a group you did not expect.
Which Medicaid numbers matter most?
- 133%
- Federal poverty level limit for adults 19 to 64 in expansion states
- 138%
- What 133 percent works out to after the 5 point income disregard
- $15,960
- Official 2026 poverty guideline, 1 person, 48 states and DC
- $33,000
- Official 2026 poverty guideline, household of 4
See which health and other programs may fit your household, with estimated values and official links.
Sources: (HealthCare.gov, Medicaid expansion and you) (HHS ASPE, 2026 poverty guidelines) (42 CFR 435.119) (42 CFR 435.603)
What this adds up to
Medicaid income limits are percentages of the poverty guidelines, $15,960 a year for 1 person and $33,000 for 4 in 2026 (official). (HHS ASPE, 2026 poverty guidelines) In expansion states, adults 19 to 64 may qualify at up to 133 percent, effectively 138 percent. (42 CFR 435.119) (42 CFR 435.603) (HealthCare.gov, Medicaid expansion and you) Other states and other groups use different limits, so your state page is the place to check. Your state decides, and you apply yourself.
Sources
Every claim above links to the source it came from. Figures checked October 2026. Last updated October 23, 2026.
- HealthCare.gov, Medicaid expansion and what it means for you (accessed October 23, 2026)
- HealthCare.gov, Medicaid and CHIP coverage (Getting Medicaid and CHIP) (accessed October 23, 2026)
- HHS Office of the Assistant Secretary for Planning and Evaluation, 2026 Poverty Guidelines (accessed October 23, 2026)
- 42 CFR 435.119, Coverage for individuals age 19 or older and under age 65 at or below 133 percent FPL (eCFR, up to date as of October 21, 2026) (accessed October 23, 2026)
- 42 CFR 435.603, Application of modified adjusted gross income (eCFR, up to date as of October 21, 2026) (accessed October 23, 2026)
