Medicaid is the largest source of free health coverage in the United States, covering over 75 million Americans as of 2026. Whether you qualify depends on your income, household size, state of residence, and whether your state expanded Medicaid under the Affordable Care Act. This guide explains the income thresholds, the categories of people who qualify, and exactly how to apply.
Quick Answer: In most expansion states, adults with household income at or below 138% of the Federal Poverty Level (roughly $22,025/year for one person in 2026) qualify for Medicaid. In non-expansion states, eligibility is limited to specific groups like children, pregnant women, and people with disabilities.
Check your eligibility now at CoveredUSA -- it takes 2 minutes.
2026 Medicaid Income Limits by Household Size
Medicaid eligibility is measured as a percentage of the Federal Poverty Level (FPL). The 2026 FPL guidelines were published by the Department of Health and Human Services (HHS) and apply to most benefit programs including Medicaid.
In the 41 states (plus Washington D.C.) that expanded Medicaid, the standard income limit for adults is 138% FPL. Here is what that looks like in dollar terms:
| Household Size | 100% FPL (Annual) | 138% FPL -- Medicaid Limit (Annual) | 138% FPL (Monthly) |
|---|
| 1 person | $15,960 | $22,025 | $1,835 |
| 2 people | $21,640 | $29,863 | $2,489 |
| 3 people | $27,320 | $37,702 | $3,142 |
| 4 people | $33,000 | $45,540 | $3,795 |
| 5 people | $38,680 | $53,378 | $4,448 |
| 6 people | $44,360 | $61,217 | $5,101 |
Figures are for the 48 contiguous states and D.C. Alaska and Hawaii have higher poverty guidelines due to higher cost of living.
The 138% threshold comes from the ACA's expansion provision. Federal law technically sets the limit at 133% FPL, but a built-in 5% income disregard raises the effective ceiling to 138%.
Expansion vs. Non-Expansion States
Whether your state expanded Medicaid is the single most important factor in determining if you qualify as a working-age adult.
Expansion states (41 states + D.C.): Any adult under 65 who earns at or below 138% FPL can qualify, regardless of whether they have children, a disability, or another qualifying status. Coverage is automatic if your income falls within the threshold.
Non-expansion states (10 states): Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming have not expanded Medicaid as of 2026. In these states, non-disabled adults without dependent children generally cannot qualify for Medicaid at any income level. Parents can qualify, but the income ceilings are extremely low -- as low as 17% FPL in Texas, which is roughly $273 per month for a family of three.
| State Type | Who Can Qualify | Income Ceiling |
|---|
| Expansion state | Any adult under 65 | 138% FPL |
| Non-expansion state (parents) | Parents with dependent children | 10% to 138% FPL (varies by state) |
| Non-expansion state (childless adults) | Generally not eligible | No pathway in most cases |
| Non-expansion state (disabled) | Adults with qualifying disability | Varies; often near 100% FPL |
If you live in a non-expansion state and earn less than 100% FPL, you may fall into the "coverage gap" -- you earn too little to receive ACA marketplace subsidies but do not qualify for Medicaid either. Around 1.5 million people were in this gap in 2025.
Who Qualifies Beyond Income: Special Categories
Even in non-expansion states, Medicaid covers several groups with specific eligibility rules. Income limits differ for each category.
Children (ages 0 to 18): Most states cover children at higher income thresholds than adults, often through the combination of Medicaid and CHIP (Children's Health Insurance Program). Many states extend coverage to children in households earning up to 200% to 300% FPL. In some states, CHIP covers children at up to 400% FPL.
Pregnant women: Pregnancy is a qualifying status in every state, including non-expansion states. Most states cover pregnant women at 185% to 200% FPL. Several states, including California and New York, have expanded pregnancy coverage to 213% or higher. After delivery, coverage typically continues for 12 months under a federal rule that took effect in 2022.
People with disabilities: Adults who receive SSI (Supplemental Security Income) are automatically eligible for Medicaid in most states. Others with a qualifying disability may qualify at income levels at or near 100% FPL, regardless of age. Processing time for disability-based applications can take up to 90 days.
Adults 65 and older: Medicaid also covers Medicare recipients who have limited income and assets through Medicare Savings Programs (MSPs). These programs can pay Medicare premiums, deductibles, and copayments. Income limits for MSPs range from 100% to 135% FPL depending on the specific program tier.
Immigrants and citizenship status: Medicaid requires applicants to be U.S. citizens or meet qualified immigration status. Undocumented immigrants do not qualify for full Medicaid coverage under federal rules, though a growing number of states (including California, Illinois, and New York) have used state funds to extend coverage to undocumented adults.
Income That Counts (and What Does Not)
Medicaid uses a standard called MAGI (Modified Adjusted Gross Income) for most applicants under 65. MAGI-based income includes wages, salaries, self-employment income, taxable Social Security benefits, capital gains, and most other taxable income.
What does NOT count toward Medicaid income:
- Child support received
- Veterans' disability payments (in most states)
- Worker's compensation
- Gifts or inheritances
- The first 5% of FPL (built-in income disregard)
For adults 65 and older applying for long-term care Medicaid or Medicare Savings Programs, states use non-MAGI rules that also consider assets (bank accounts, property, investments). Asset limits are typically $2,000 for a single person and $3,000 for a couple in most states, though some states have eliminated asset tests entirely.
Medicaid vs. CHIP: What Is the Difference?
Both programs are administered jointly by the federal government and states, but they serve different populations and have different funding structures.
| Feature | Medicaid | CHIP |
|---|
| Who it covers | Low-income adults, children, pregnant women, disabled | Children in households above Medicaid limits |
| Age limit | None (varies by category) | Under 19 in most states |
| Typical income ceiling | 138% FPL (expansion states) | 200% to 400% FPL for children |
| Cost to enrollee | Usually free | Small premiums or copays in some states |
| Application | Same process as Medicaid | Same application |
In practice, when you apply for Medicaid with children in your household, the system automatically screens them for CHIP coverage if their income is too high for Medicaid but still low enough for CHIP.
How to Apply for Medicaid in 2026: Step-by-Step
Applying for Medicaid is free and does not require a broker or paid service. There are several ways to apply, and the process typically takes a few days to a few weeks.
Step 1: Check your eligibility first. Before spending time on an application, run a quick eligibility check. The free screener at CoveredUSA takes about 2 minutes and tells you which programs you likely qualify for based on your income and household. This helps you decide whether to apply for Medicaid, an ACA marketplace plan, or both.
Step 2: Gather your documents. You will need:
- Proof of identity (driver's license, state ID, passport, or birth certificate)
- Social Security numbers for all household members applying
- Proof of income for all household members (recent pay stubs, tax return, or employer letter)
- Proof of residency (utility bill, lease, or bank statement with your address)
- Proof of immigration status if you are not a U.S. citizen
Step 3: Choose your application method. You can apply:
- Online through your state's Medicaid website or HealthCare.gov
- By phone through your state Medicaid agency
- In person at your local Medicaid or social services office
- By mail using a printed paper application
Step 4: Submit your application. Complete all required fields and attach your documents. Incomplete applications can delay processing. If you apply through HealthCare.gov and appear to qualify for Medicaid, the system will forward your information to your state Medicaid agency automatically.
Step 5: Wait for a determination. State agencies have up to 45 days to process standard Medicaid applications. If your eligibility involves a disability, processing can take up to 90 days. You will receive a written notice with the decision.
Step 6: Enroll in a plan (if required). In states that run Medicaid through managed care organizations (MCOs), you will need to choose a health plan after approval. You usually have 30 to 60 days to select a plan, or the state will assign one automatically.
Step 7: Keep your information current. Medicaid requires annual renewal. You will be asked to confirm your income and household size each year. Income changes during the year should be reported to your state Medicaid agency, as they can affect your eligibility.
What Medicaid Covers
Medicaid provides comprehensive health coverage that typically includes:
- Doctor visits and preventive care
- Hospital care (inpatient and outpatient)
- Emergency services
- Prescription drugs
- Mental health and substance use disorder treatment
- Lab tests and imaging
- Maternity and newborn care
- Dental and vision (coverage varies by state -- adults often have limited dental)
- Long-term care and nursing home coverage (for eligible adults)
Most Medicaid enrollees pay no premiums and minimal or no copayments for covered services. Some states charge small copays for non-emergency use of emergency rooms.
What If You Do Not Qualify for Medicaid?
If your income is above the Medicaid threshold, you may still qualify for low-cost coverage through the ACA marketplace. Households earning between 100% and 400% FPL can receive premium tax credits that reduce monthly premiums significantly -- sometimes to $0 for the lowest-cost plans.
See the ACA income limits page for a full breakdown of subsidy thresholds by household size.
If you are 65 or older or have a qualifying disability, Medicare may be the right program for you. See the Medicare eligibility guide for details on how to qualify.
For a comprehensive look at Medicaid income thresholds in your state, visit the Medicaid income limits page.
Frequently Asked Questions
Do I qualify for Medicaid if I am unemployed in 2026?
Yes, as long as your income falls within your state's Medicaid limits. Unemployment benefits count as income under MAGI rules. If you lose your job and your total household income drops to or below 138% FPL (in expansion states), you will likely qualify. You can apply at any time -- Medicaid has no open enrollment period.
Can I get Medicaid if I have a job?
Yes. Many working adults qualify for Medicaid, especially in expansion states. If your employer offers health insurance but you cannot afford the premiums, you may still qualify for Medicaid based on your gross household income. Having a job does not disqualify you.
What if my income changes during the year?
Report income changes to your state Medicaid agency as soon as possible. A drop in income could make you newly eligible. An increase could make you ineligible, in which case you would have a Special Enrollment Period to sign up for marketplace coverage.
Does Medicaid cover dental and vision for adults?
It depends on your state. Federal rules require dental and vision coverage for children on Medicaid. For adults, dental and vision are optional benefits that states can choose to include or exclude. About half of all states offer some level of adult dental coverage. Vision coverage for adults is also available in many states but may be limited to basic exams.
Can I have Medicaid and Medicare at the same time?
Yes. People who have both are called "dual eligibles." This is common among adults 65 and older with low incomes and people under 65 with disabilities. Medicaid can help pay Medicare premiums, deductibles, and cost-sharing through Medicare Savings Programs.
How long does Medicaid approval take?
Standard applications take up to 45 days. Applications involving a disability determination can take up to 90 days. If you have an immediate medical need, tell the caseworker -- some states can expedite review for urgent situations.
Is there an asset limit for Medicaid in 2026?
For most working-age adults applying under MAGI-based rules, there is no asset test. Asset limits apply mainly to long-term care Medicaid (nursing home coverage) and some Medicare Savings Programs. Those limits are typically $2,000 for individuals and $3,000 for couples, though several states have eliminated asset tests entirely.
What happens if I miss the Medicaid renewal deadline?
If you miss your renewal, your Medicaid coverage may be terminated. You typically have a grace period to respond. If coverage is terminated, you can reapply at any time -- Medicaid applications are accepted year-round. You will also have a Special Enrollment Period for marketplace coverage if Medicaid ends.
Check If You Qualify Now
Eligibility rules vary by state, and reading tables only gets you so far. The fastest way to know if you qualify is to run a free screener. CoveredUSA's tool asks about 10 questions and shows you which programs you likely qualify for -- including Medicaid, CHIP, Medicare, and ACA marketplace plans.
Check your eligibility now at CoveredUSA -- it takes 2 minutes.
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