What is Medicaid?
Medicaid is a government health insurance program that provides free or very low-cost health coverage to people with low incomes. It is jointly funded by the federal government and each state, which is why the rules and income limits are slightly different depending on where you live.
Medicaid covers doctor visits, hospital stays, prescriptions, mental health services, dental care (in most states), and much more — all at little or no cost to you.
How is the income limit calculated?
Medicaid uses the Federal Poverty Level (FPL) as the measuring stick. The FPL is a number set by the federal government each year based on household size. Your income is compared to this number as a percentage.
In most states that expanded Medicaid under the Affordable Care Act, adults qualify if their income is at or below 138% of the FPL.
| Household Size | 100% FPL (2026) | 138% FPL — Medicaid limit | Monthly limit |
|---|---|---|---|
| 1 person | $15,060 | $20,783 | $1,732 |
| 2 people | $20,440 | $28,207 | $2,351 |
| 3 people | $25,820 | $35,632 | $2,969 |
| 4 people | $31,200 | $43,056 | $3,588 |
| 5 people | $36,580 | $50,480 | $4,207 |
| 6 people | $41,960 | $57,904 | $4,825 |
Does every state have the same limit?
No. This is the most important thing to understand about Medicaid. The 138% FPL rule applies in states that chose to expand Medicaid under the Affordable Care Act. As of 2026, 40 states plus Washington D.C. have expanded Medicaid.
In the remaining 10 non-expansion states, the income limits are much lower — sometimes as low as 17–35% FPL for adults without children. In those states, many low-income adults fall into a "coverage gap" where they earn too much for Medicaid but too little for marketplace subsidies.
Non-expansion states (lower income limits apply):
Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming have not expanded Medicaid. If you live in one of these states, your income limit may be significantly lower.
Special groups with different limits
Even within expansion states, certain groups of people have different income rules:
- Pregnant women — most states allow income up to 185–200% FPL
- Children (CHIP) — typically covered up to 200–300% FPL
- Elderly adults (65+) — income and asset limits apply differently
- People with disabilities — may qualify under different SSI-related rules
- Parents and caretakers — limits vary widely by state
What counts as income for Medicaid?
Medicaid uses MAGI (Modified Adjusted Gross Income) to count your income. This includes:
- Wages and salary
- Self-employment income
- Unemployment benefits
- Social Security income (in most cases)
- Alimony received
It does not count things like child support received, gifts, or Supplemental Security Income (SSI).
How to apply for Medicaid in 2026
Find your state's Medicaid office
Go to Medicaid.gov and click "Get Medicaid" to find your state's official application portal. Every state has its own application system.
Apply online, by phone, or in person
Most states let you apply online. You can also call your state's Medicaid helpline or visit your local Department of Social Services office. It is completely free to apply.
Gather your documents
You'll typically need proof of identity (ID or passport), proof of income (pay stubs or tax return), proof of residency, and Social Security numbers for household members.
Wait for a decision
Most states must process your application within 45 days. If approved, coverage can be backdated to the month you applied or even the month before.
Frequently asked questions
Can I get Medicaid if I'm working?
Yes. Having a job does not disqualify you. What matters is your total income. Many working Americans with low wages qualify for Medicaid.
What if I'm denied — can I appeal?
Yes. If your application is denied, you have the right to appeal the decision. The denial letter will explain how to appeal. You can also apply again if your income or household situation changes.
Do assets (savings, car, house) affect eligibility?
For most non-elderly adults, asset limits no longer apply under the expanded Medicaid rules — only income is counted. However, for elderly applicants applying for long-term care Medicaid, asset limits do still apply.
What does Medicaid cover?
Medicaid covers doctor visits, emergency room care, hospital stays, prescriptions, lab tests, mental health services, and substance use treatment. Most states also cover dental, vision, and hearing services.