Medicaid is one program on paper and fifty programs in practice. It's a federal-state partnership, which means Washington sets the floor and your state fills in most of what actually affects your family: who qualifies, what long-term care is covered, whether the state comes after your house later, and how you apply. This guide explains what changes from state to state, then sends you straight to a full guide for yours.

In This Guide

What's Federal, and What Each State Decides

Here's the thing most families don't realize until they're deep in it: Medicaid isn't run from Washington. The federal government sets the rules of the road, requires states to cover certain groups (like many children, pregnant women, and very low-income seniors), and pays for a big share of the cost. But each state runs its own program, gives it its own name, and makes a long list of its own choices within the federal lines.

The single choice that matters most is whether a state adopted the ACA Medicaid expansion, which opened Medicaid to most adults under 65 with income up to 138% of the federal poverty level. In 2026 the 138% ceiling works out to roughly $22,000 a year for one person and about $37,700 for a household of three, based on the year's federal poverty guidelines of $15,960 and $27,320.

As of 2026, 41 states including the District of Columbia have expanded, and 10 have not: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. If you're a working-age adult in a non-expansion state, you can earn too much for Medicaid and too little for Marketplace help at the same time, a squeeze known as the coverage gap. So the very first question is simple: did your state expand or not?

The Things That Change From State to State

Beyond expansion, a handful of dimensions decide how Medicaid actually works where you live. These are the things worth checking on your state's page.

  • Who qualifies, and the dollar limits. Federal law sets the framework, but states set the specific income and asset limits for seniors and people with disabilities, and they don't all match. Most cap countable assets low (your savings, not your home or car), but the exact numbers, and the rules for a married couple, are a state call.
  • Long-term care and staying at home. Every state covers nursing-home care for those who qualify, but the home and community-based programs that pay for care in your own home, run through what are called waivers, vary a lot: different names, different benefits, and often a waitlist. This is where families feel the state differences most.
  • Estate recovery. After a Medicaid recipient dies, federal law requires states to try to recoup certain long-term-care costs from the estate, but states can and do go beyond that federal minimum. What's protected, and how aggressively a state pursues it, differs. Our guide to Medicaid estate recovery walks through it.
  • How you apply, and to whom. Each state has its own Medicaid agency, its own online portal, and its own timelines. The application that's routine in one state can involve a different office and a different process next door.

None of this means you have to become an expert in all fifty. It means you check your own state, which is what the directory below is for.

Find Your State's Medicaid Guide

Pick your state for a full, eldercare-focused Medicaid guide: who qualifies, the income and asset limits, long-term-care options, estate recovery, and how to apply.

AlabamaView guide AlaskaView guide ArizonaView guide ArkansasView guide CaliforniaView guide ColoradoView guide ConnecticutView guide DelawareView guide FloridaView guide GeorgiaView guide HawaiiView guide IdahoView guide IllinoisView guide IndianaView guide IowaView guide KansasView guide KentuckyView guide LouisianaView guide MaineView guide MarylandView guide MassachusettsView guide MichiganView guide MinnesotaView guide MississippiView guide MissouriView guide MontanaView guide NebraskaView guide NevadaView guide New HampshireView guide New JerseyView guide New MexicoView guide New YorkView guide North CarolinaView guide North DakotaView guide OhioView guide OklahomaView guide OregonView guide PennsylvaniaView guide Rhode IslandView guide South CarolinaView guide South DakotaView guide TennesseeView guide TexasView guide UtahView guide VermontView guide VirginiaView guide WashingtonView guide West VirginiaView guide WisconsinView guide WyomingView guide
All 50 states

Frequently Asked Questions

Does Medicaid really vary by state?

Yes, quite a bit. Medicaid is a federal-state partnership: the federal government sets minimum rules and pays a share, but each state runs its own program and sets many of its own limits and options. That's why eligibility, covered services, and the application process differ depending on where you live.

Which states have not expanded Medicaid?

As of 2026, ten states have not adopted the ACA Medicaid expansion: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. In the other 40 states and DC, most adults under 65 can qualify with income up to 138% of the federal poverty level.

What are the Medicaid income limits in my state?

They depend on which pathway you're using (expansion adult, aged/blind/disabled, or long-term care) and on your state. The expansion pathway uses 138% of the federal poverty level, but the senior and long-term-care limits are set state by state. Your state's guide below has the specific numbers.

How do I find and apply to my state's Medicaid program?

Each state has its own Medicaid agency and online application portal, and the program often has its own name. Pick your state in the directory above for the agency, the portal, and the steps that apply where you live.

Learn More

MedicaidHow to Apply for Medicaid by State: Steps, Documents, and Where to ApplyApplying for Medicaid follows the same federal steps everywhere; the agency and portal are your state's. What to gather, how long it takes, and where to apply. MedicaidMedicaid Income Limits by State: Which Number Applies to YouMedicaid income limits depend on your pathway: expansion adults, aged and disabled, or nursing-home care. See the 2026 figures and your state's exact limits. MedicaidMedicaid Estate Recovery ExplainedMedicaid estate recovery explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting. MedicaidMedicaid Planning: How to Qualify Without Going BrokeSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidWhat a Medicaid Personal Needs Allowance CoversHow the Medicaid Personal Needs Allowance works in 2026: the $30 federal floor, state figures from $30 to $200, and how patient liability is calculated.

Find personalized help finding and applying to your state's Medicaid program at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.