State-Specific Income Limits: A Medicaid Eligibility Reference by Category

How Medicaid Income Limits Work: The Foundation You Need First

Before diving into state-specific numbers, it helps to understand what those numbers actually represent. Medicaid income limits are expressed as a percentage of the Federal Poverty Level (FPL) — a nationally standardized income benchmark that the federal government updates annually. When a state says it covers adults up to 138% FPL, that percentage is applied to the FPL dollar amounts for your specific household size.

For example, in 2024, the FPL for a single individual in the contiguous U.S. is approximately $15,060 per year. At 138% of that, the income threshold becomes roughly $20,783 per year. A family of four has a higher FPL base, so their 138% threshold is a larger dollar amount. This is why income limits cannot be quoted as flat dollar figures without knowing both the household size and the applicable year. See our detailed explanation of how FPL thresholds work for the full breakdown.

Equally important: which income counts depends on the eligibility category. Most non-elderly, non-disabled groups are measured using MAGI (Modified Adjusted Gross Income), which is based on your tax-filing income. Elderly and disabled applicants are often evaluated under older, asset-based rules called non-MAGI rules, which can also count your savings and property. For a full glossary of these terms, see our Medicaid eligibility terms reference.

Understanding which category you fall into — adult, child, pregnant woman, senior, or person with a disability — determines both the income methodology and the specific threshold that applies to you. Each category is addressed separately below.

Adults Without Dependent Children: Expansion vs. Non-Expansion States

This category — often called the adult expansion group — is where state variation is most dramatic. Under the Affordable Care Act (ACA), states were given the option to extend Medicaid to adults ages 19–64 who earn up to 138% FPL, regardless of whether they have children. As of 2024, 40 states plus the District of Columbia have adopted this expansion. The remaining 10 states have not.

In expansion states, a single adult earning up to approximately $20,783 per year (138% FPL, 2024 guidelines) generally qualifies for Medicaid. This is a uniform floor — states may choose to go higher, but most set their limit at exactly 138%.

In non-expansion states, childless adults typically remain ineligible for Medicaid at any income level unless they have a separate qualifying condition such as a disability. Adults with dependent children may qualify, but at much lower thresholds — often 20% to 50% FPL, which translates to a few hundred dollars per month in income. The following table illustrates this contrast:

If you live in a non-expansion state and fall into the coverage gap — earning too much for traditional Medicaid but too little for ACA marketplace subsidies — you may have limited options. Our companion article on the expansion decision explains what's available to people in that situation and what advocacy efforts are underway in several holdout states.

Children and CHIP: Higher Thresholds Across the Board

Children consistently qualify for publicly funded health coverage at higher income levels than adults, primarily because states have strong incentive — and federal matching funds — to cover them. Medicaid and the Children's Health Insurance Program (CHIP) work in tandem here: Medicaid covers children in lower-income households, while CHIP picks up children in families that earn too much for Medicaid but too little for private insurance.

Here is a general overview of how states tend to structure children's coverage tiers:

A few states go further. New York covers children up to 400% FPL through its Child Health Plus program. California and Massachusetts offer near-universal coverage for children through a combination of Medicaid, CHIP, and state-funded programs. In practice, if you have a child and are concerned about income limits, the threshold is almost certainly higher than you expect — the question is usually whether the child lands in Medicaid or CHIP, and what cost-sharing (if any) applies.

Age matters too: federal rules require states to cover infants born to Medicaid-eligible mothers automatically for the first year of life, regardless of family income changes after birth. This automatic enrollment provision protects newborns from coverage gaps during their most vulnerable period.

Pregnant Women: Consistently the Highest Non-Elderly Thresholds

Pregnant women receive preferential treatment in nearly every state's Medicaid program — higher income thresholds, faster enrollment, and in many states, presumptive eligibility that allows coverage to begin before the formal application is approved. This is a deliberate policy choice driven by research showing that prenatal care reduces complications and long-term costs.

Federal law requires states to cover pregnant women up to at least 133% FPL, but the vast majority of states have set their thresholds significantly higher. Here is a representative sample:

Notice that even non-expansion states like Texas, Florida, and Georgia — which cover very few low-income adults otherwise — extend Medicaid to pregnant women well above 190% FPL. This inconsistency is an important feature of the patchwork Medicaid system: a person's eligibility can change dramatically depending on their circumstances, not just their state.

Coverage typically extends through 60 days postpartum under standard rules, but as of 2022, states have the option under the American Rescue Plan to extend postpartum coverage to 12 months. As of 2024, over 35 states have adopted this 12-month extension. For full detail on what's covered and how postpartum coverage transitions work, see our guide on Medicaid for pregnant women.

Seniors and People With Disabilities: Different Rules, Asset Tests, and Pathways

For individuals 65 and older and people with qualifying disabilities, Medicaid eligibility works quite differently. These groups are generally evaluated under non-MAGI rules, which means both income and assets (sometimes called resources) are assessed. The thresholds are also lower and more variable than those for the adult expansion group.

Seniors Seeking Long-Term Care or Medicare Cost-Sharing Help

Many seniors qualify for Medicaid not to replace Medicare, but to help pay Medicare premiums, deductibles, and copayments through Medicare Savings Programs (MSPs), or to cover long-term care services that Medicare does not pay for. Income limits for MSPs are set federally and are relatively modest:

• Qualified Medicare Beneficiary (QMB): Up to 100% FPL (helps with Part A and B premiums, deductibles, coinsurance)
• Specified Low-Income Medicare Beneficiary (SLMB): 100%–120% FPL (helps with Part B premiums)
• Qualifying Individual (QI): 120%–135% FPL (helps with Part B premiums on a first-come basis)

For full Medicaid long-term care coverage, most states use an income limit of around 300% of the SSI Federal Benefit Rate — approximately $2,742/month in 2024 for an individual — though this varies. Asset limits typically cap at $2,000 for individuals in most states, though several states have eliminated or raised asset tests following recent federal guidance.

People With Disabilities

Adults under 65 with disabilities often qualify through two main routes: automatic enrollment tied to SSI (Supplemental Security Income) receipt, or through a separate Medicaid pathway with its own income and asset rules. Some states also use special needs waivers (home and community-based services waivers) that have their own eligibility criteria and often have waiting lists. Our dedicated article on Medicaid for people with disabilities covers these pathways in depth.

A critical concept for this population is the Medicaid spend-down: if your income is above the threshold but you have significant medical expenses, many states allow you to deduct those expenses from your income calculation until you reach the eligibility level. Not all states offer spend-down, but for those that do, it can be the difference between qualifying and not.

How to Look Up Your State's Actual Numbers

Reference tables give you a useful framework, but Medicaid income limits are updated annually and states can change their thresholds through legislation or federal waiver approval. The only way to get a confirmed, current threshold for your specific situation is to go directly to an authoritative source.

Step-by-Step: Finding Your State's Current Limits

1. Identify your eligibility category first — adult, child, pregnant, senior/disabled. Each has a different threshold even within the same state.
2. Visit your state's Medicaid agency website. Every state has one; search for " Medicaid eligibility" to find it. Look for an income eligibility chart or a benefit screening tool.
3. Use HealthCare.gov's screening tool if you are in an ACA expansion state — it can give you a quick estimate of whether you fall into Medicaid or marketplace territory.
4. Call your state's Medicaid hotline if you have a complicated situation (self-employment income, variable hours, recent life change). Eligibility workers can walk you through the calculation.
5. Apply and let the state determine eligibility. You do not need to be certain you qualify before applying. States are required to screen every application and transfer it to the correct program if you don't qualify for Medicaid but may qualify for CHIP or marketplace plans.

If you believe you were wrongly denied, you have the right to appeal. Every state Medicaid program must offer a fair hearing process. Keeping documentation of your income and any correspondence with the agency is important if you pursue this route.

For a broader overview of the categories and rules discussed throughout this article, see our foundational guide: Medicaid eligibility explained. And if you're in a state that has implemented or is pursuing work requirements as an additional condition of eligibility, our article on Medicaid work requirements explains what those mean and how they've fared legally.