Medicaid covers more than 80 million Americans, yet millions more go uninsured because they assume they earn too much to qualify. The income limit is not one number. Medicaid sets a different threshold depending on your state, your household size, which category you fit (adult, parent, child, pregnant, disabled), and whether your state has expanded under the Affordable Care Act. This guide gives you the 2026 numbers for every household size, explains the expansion versus non-expansion gap, and shows you how to apply.
The key concept to understand first is Modified Adjusted Gross Income, or MAGI. Since 2014, most working-age Medicaid enrollees are evaluated on MAGI, not assets. That means the government counts your taxable income, not your savings account. If you have a car, a house, or a retirement account, those do not count against you in MAGI-based Medicaid. What counts is your wages, self-employment income, alimony, and most other taxable income sources in 2026.
Direct answer: How much can you make and still get Medicaid in 2026?
It depends on your state. See Medicaid income limits by state for precise figures. Adults in the 41 Medicaid expansion states (including DC) can earn up to 138% FPL, which is $22,025 per year for one person or $45,540 for a family of four in 2026. Adults in the 10 non-expansion states face much lower limits, often below 50% FPL for parents and effectively zero for childless adults. Children qualify at higher levels through CHIP.
Medicaid income limits by household size 2026 (expansion states)
Medicaid expansion states use 138% of the Federal Poverty Level as their adult income ceiling. The 2026 FPL was published by HHS ASPE on January 13, 2026 and applies to all Medicaid determinations made after that date. The table below shows the 138% FPL threshold for household sizes 1 through 8 plus the per-additional-person increment in 2026.
Monthly limits matter for people with variable incomes. To get the monthly limit, divide the annual figure by 12. For a single adult in an expansion state, the 2026 monthly income limit is approximately $1,835. For a family of four, the monthly limit is approximately $3,795. Medicaid uses MAGI (Modified Adjusted Gross Income) to count income, so pre-tax contributions to a 401(k) or HSA reduce your countable income and may help you qualify.
Medicaid expansion vs. non-expansion: the coverage gap explained
Medicaid expansion was created by the ACA in 2010 and allowed any state to extend Medicaid to adults earning up to 138% FPL, with the federal government paying 90% of the cost. As of 2026, 41 states (including DC) have adopted expansion. The 10 states that have not are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.
Wisconsin is a partial exception. BadgerCare Plus (Wisconsin's Medicaid program) covers adults up to 100% FPL, higher than most non-expansion states, but still below the 138% FPL that full expansion states offer. Childless adults in Wisconsin without a disability still face very low thresholds under traditional Medicaid categories.
Adults in the ACA coverage gap earn between 0% and 100% FPL but live in non-expansion states. They earn too much for traditional Medicaid (which may require near-zero income for childless adults) but too little for ACA marketplace subsidies (which start at 100% FPL). The ACA subsidy cliff returned on January 1, 2026 when enhanced premium tax credits from the American Rescue Plan expired, meaning people in the coverage gap have fewer options than at any point since 2021.
Income limits for special categories: children, pregnant women, and seniors
Children qualify for Medicaid and CHIP at higher income levels than adults. In most states, children qualify for Medicaid up to 138% FPL and for CHIP up to 200% to 300% FPL. Some states like New York and California cover children at up to 400% FPL through separate CHIP programs. Income eligibility for children has never depended on whether the state expanded adult Medicaid.
Pregnant women qualify for Medicaid at higher income thresholds in all 50 states. Most states cover pregnant women up to 138% to 215% FPL. States with separate Medicaid pregnancy programs often cover up to 200% FPL and some reach 250% FPL. Coverage for pregnancy typically includes prenatal care, labor and delivery, and 12 months of postpartum care under the ARP extended postpartum option, which most states have adopted.
Adults age 65 and older with Medicare are a separate category. Most seniors qualify for Medicare first. Medicaid then acts as secondary coverage for dual-eligible adults who meet both Medicare and Medicaid income requirements. For dual-eligible seniors, the relevant income limits are much lower (often around 100% FPL for full Medicaid benefits), but a range of Medicare Savings Programs offers help with Part B premiums, deductibles, and cost-sharing even at incomes up to 135% FPL.
What counts as income for Medicaid (MAGI rules)
MAGI stands for Modified Adjusted Gross Income. For the full breakdown, see what counts as income for Medicaid. Medicaid adopted MAGI-based counting for most working-age adults starting in 2014 under the ACA. MAGI counts taxable income before deductions. The following DOES count toward your 2026 Medicaid income limit: wages and salaries, self-employment net income, tips, alimony received (for agreements finalized before 2019), Social Security benefits that are taxable, unemployment compensation, and rental income.
The following does NOT count as income under MAGI for Medicaid in 2026: child support received, Supplemental Security Income (SSI), veterans benefits, gifts, inheritances, life insurance proceeds, workers compensation, and foster care payments. Retirement account withdrawals (Roth IRA distributions) and non-taxable Social Security benefits also do not count. Pre-tax 401(k) contributions reduce your MAGI, which is why a small pre-tax retirement contribution can sometimes push a household below the eligibility line.
Is your state a Medicaid expansion state? How to check
As of 2026, 41 states and DC have expanded Medicaid. The 10 non-expansion states are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. If you live in one of the other 40 states or DC, the 138% FPL limits in the household size table above apply to you as an adult.
Wisconsin deserves special mention. BadgerCare Plus covers parents and childless adults up to 100% FPL ($15,960 for an individual in 2026), which is more generous than most non-expansion states but still below the 138% FPL threshold of full expansion states. Wisconsin has a Medicaid program by a different name, and residents should apply through access.wisconsin.gov rather than Healthcare.gov.
KFF maintains a current map of expansion status at kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions. If you are unsure whether your state has expanded, that map is the most reliable real-time source. Expansion status matters because it determines whether you qualify as an adult at 138% FPL or whether you must fit a narrower traditional category.
Common reasons Medicaid applications get denied and how to appeal
Income slightly over the limit is the most common denial reason in expansion states. If your income fluctuates month to month (self-employment, seasonal work, gig work), you can project forward and use an annual income estimate rather than a single month. If you have a major income change (job loss, hours cut, a medical leave), report it immediately because Medicaid coverage can start the first day of the month you became eligible, not the date you reported the change.
Missing documents are the second most common reason for denial. The state cannot approve your application without verifying your income and identity. If you receive a request for additional information (often called a Request for Information or RFI letter), you typically have 10 to 30 days to respond before the application is closed. You can reopen a closed application in most states without starting from scratch if you submit the missing documents within 90 days.
If your application is denied, you have the right to a fair hearing. Request one in writing within 90 days of the denial notice. You may also request continuation of benefits during the appeal period if you were previously enrolled. Medicaid fair hearings are decided by an administrative law judge at the state level, not by the agency that denied your claim. Many denials based on income documentation errors are overturned at the fair hearing stage.
Medicaid coverage: what it includes once you qualify
Medicaid is a comprehensive health insurance program jointly funded by the federal government and states. Once enrolled, most beneficiaries pay little or nothing for covered services. Federal law requires all Medicaid programs to cover physician services, hospital inpatient and outpatient care, lab tests and X-rays, family planning services, rural health clinic services, and home health services. Expansion-state plans must also cover all 10 ACA Essential Health Benefits, including mental health, substance use treatment, preventive care, and maternity services.
Dental, vision, and hearing coverage vary by state because these are optional Medicaid benefits at the federal level. Dental coverage for adults ranges from none (a handful of states) to comprehensive (most states offer at least emergency dental, and many offer preventive and restorative dental). Children always receive comprehensive dental, vision, and hearing coverage through the EPSDT benefit, regardless of what the adult benefit package includes. If dental or vision matters to your household, check your specific state's benefit package at Medicaid.gov or call your state Medicaid office.
Frequently Asked Questions
What is the Medicaid income limit for a family of 4 in 2026?
In an expansion state, a family of 4 can earn up to $45,540 per year in 2026 and still qualify for Medicaid. That is 138% of the 2026 Federal Poverty Level of $33,000 for a family of four. In non-expansion states, the limit for parents is typically much lower, often ranging from 17% to 44% FPL depending on the state. Texas, Florida, and Georgia are among the 10 non-expansion states with the strictest income limits.
Can I work and still get Medicaid in 2026?
Yes. Working does not disqualify you from Medicaid. In expansion states, adults can earn up to $22,025 per year (individual) or $45,540 per year (family of four) and still qualify. MAGI, the income counting method Medicaid uses, is based on taxable income. Pre-tax 401(k) contributions and health savings account contributions reduce your countable income, which may help you stay within the limit.
What counts as income for Medicaid?
Medicaid uses MAGI (Modified Adjusted Gross Income) for most working-age adults in 2026. What counts: wages, self-employment net income, tips, alimony received (pre-2019 agreements), taxable Social Security benefits, unemployment compensation, and rental income. What does not count: child support received, SSI, veterans benefits, gifts, inheritances, workers compensation, and non-taxable Social Security. Pre-tax retirement contributions reduce your MAGI.
What is the income limit for a single person on Medicaid in 2026?
In an expansion state, a single adult can earn up to $22,025 per year in 2026 (138% of the 2026 FPL of $15,960) and still qualify for Medicaid. Monthly, that is approximately $1,835. In non-expansion states, the limit for childless adults is effectively zero in most cases because childless adults without a disability typically do not qualify for traditional Medicaid at any income.
Is my state a Medicaid expansion state?
As of 2026, 41 states and DC have expanded Medicaid. The 10 non-expansion states are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. Wisconsin is a partial exception: BadgerCare Plus covers adults up to 100% FPL ($15,960 for an individual in 2026). The KFF expansion map at kff.org/medicaid shows current status for every state.
What is the Medicaid income limit for pregnancy in 2026?
Most states cover pregnant women at higher income thresholds than regular Medicaid for adults. The limit ranges from 138% FPL to 215% FPL depending on the state, which translates to $22,025 to roughly $34,000 per year for a single pregnant woman in 2026. Some states go higher. Coverage includes prenatal care, labor and delivery, and up to 12 months of postpartum care in states that have adopted the extended postpartum option.
Can childless adults get Medicaid in non-expansion states?
Rarely, at any income level. In the 10 non-expansion states, traditional Medicaid is built around categorical eligibility: pregnant women, children, parents of dependent children, people with disabilities, and seniors. Childless adults who are not pregnant or disabled typically do not qualify for Medicaid in non-expansion states regardless of how low their income is. This is the core of the coverage gap affecting millions of adults.
How does CHIP differ from Medicaid income limits?
CHIP (Children's Health Insurance Program) covers children in households that earn too much for Medicaid but not enough for ACA marketplace subsidies. In most states, CHIP covers children up to 200% to 300% FPL. For example, in a state where Medicaid for children stops at 138% FPL ($37,702 for a family of 3 in 2026), CHIP would cover children in that same family up to roughly $54,640 to $82,000 depending on the state's CHIP income ceiling. CHIP costs are lower than marketplace plans but there are small premiums and copays.
