Medicaid Income Limits 2026: What You Can Earn & Still Qualify

There is no single Medicaid income limit, and looking up the wrong one is an easy mistake to make. Medicaid runs three separate eligibility tracks, each with its own income rule and its own dollar figure: roughly $1,835 a month for working-age adults in states that expanded Medicaid, a $994-a-month SSI yardstick for the aged and disabled, and, in states that use one, a long-term-care limit keyed to $2,982 a month, 300% of the SSI rate.1,2,3 Which number decides your case depends on your age, whether you have Medicare, whether you need nursing-home-level care, and then on your state. This guide sorts you into the right track, then sends you to your state's exact figures.

In This Guide

• Key Takeaways
• Which Medicaid Income Limit Applies in Your State?
• The MAGI Income Limits: Adults, Parents, and Children
• Turning 65 Can Change Which Limit Applies
• Over the Aged, Blind, and Disabled Limit? Medicare Savings Programs Are Next
• What Counts as Income, and Who Counts as Your Household
• Being Over the Long-Term-Care Limit Is Not the End
• Why Medicaid Income Limits Change from State to State
• Find Your State's Income Limits
• Frequently Asked Questions
• Learn More

Which Medicaid Income Limit Applies in Your State?

Three questions sort you into one of the three tracks. Answer them in order, and stop at your first yes.

1. Do you need nursing-home-level care, either in a facility or through a home-based waiver? This is a clinical determination your state makes, not a figure you can calculate. If yes, you are on the institutional track. If your state uses a special income level, your figure is that level, keyed to $2,982 a month; if it runs a medically-needy spend-down instead, see the long-term-care section below.3,8
2. Are you 65 or older, or entitled to or enrolled in Medicare? If yes, you are on the aged, blind, and disabled track. Your yardstick is the SSI benefit rate, $994 a month for an individual.3 If your income is above that, do not stop reading here: the Medicare Savings Programs covered below reach well past it.7
3. Otherwise you are on the MAGI track, the one that covers working-age adults, parents, pregnant applicants, and children. In a state that expanded Medicaid, the adult ceiling is 138% of the federal poverty level, roughly $1,835 a month for one person.1,2

Here is what each track looks like side by side in 2026, for a single applicant:

Where those dollar figures come from, and what sits behind each track:

1. Working-age adults (the MAGI, or modified-adjusted-gross-income, pathway). In an expansion state the ceiling is 138% of poverty: roughly $22,000 a year for one person in 2026, or about $37,700 for a household of three, against poverty guidelines of $15,960 and $27,320 for the 48 contiguous states and the District of Columbia.1,2 Alaska and Hawaii run higher guidelines, so the ceiling there is higher.9

2. Aged, blind, or disabled (the ABD pathway). The 2026 SSI federal benefit rate is $994 a month for an individual and $1,491 for a couple, and ABD Medicaid is anchored to the SSI program, though the structure differs by state.3,4 The exact figure and its asset limit are state decisions, and being over the figure is not a dead end.7

3. Long-term care and nursing homes (the institutional pathway). The federal benchmark is 300% of the SSI rate, $2,982 a month in 2026, but federal rules write it as a limit on federal matching funds rather than as an income limit every state publishes, so your state's own figure is the one that applies: Washington's is $2,982, while Idaho lists $3,002.3 In states that treat it as a hard cap, you can still qualify by routing income through a Qualified Income Trust, commonly called a Miller trust.5 Our guide to Medicaid planning walks through meeting the limit.

One overlap is worth naming. If you are under 65 with a disability but not yet entitled to or enrolled in Medicare, the expansion adult group can still apply unless an eligibility group the statute lists before it already covers you, because it is written around age and Medicare status, not disability.1 That matters: the MAGI groups apply no asset test and the ABD track does. The exceptions to the MAGI rules are purpose-limited, too. Being disabled, being over 65, or applying for a Medicare Savings Program does not move you out of MAGI for every purpose; the same person evaluated for a MAGI group is still determined under MAGI, with no asset test.6

The MAGI Income Limits: Adults, Parents, and Children

The MAGI track covers working-age adults, children, pregnant applicants, and parents or caretaker relatives.6 Federal law sets the adult and child limits as percentages of the poverty level, and the children's figure is a floor states may exceed but not go below; parents are the exception, as you will see.1,10,11

The new adult group: 133% on paper, 138% in practice. The ACA created the new adult group at Section 1902(a)(10)(A)(i)(VIII) of the Social Security Act for individuals under 65 who are not pregnant and not entitled to or enrolled in Medicare, with income at or below 133% of the federal poverty line. The figure families actually see quoted is 138%, and both are correct: 42 CFR 435.603(d)(4) requires the state to subtract 5 percentage points of the poverty level, so the effective ceiling is 138% FPL. That subtraction is not a 5-point uplift you can apply to any group you like; the regulation limits it to the MAGI group with the highest income standard, so 138% is this group's effective ceiling where it is the highest MAGI standard in play.1 The group covers adults 19 and older (children under 19 have their own mandatory group) whether or not they have children at home.1,10 It exists only in the 41 states, including DC, that adopted the expansion.12

One condition for parents. Under 42 CFR 435.119(c), a state may not cover a parent or other caretaker relative living with a dependent child under 19 through the expansion group unless that child has Medicaid, CHIP, or other minimum essential coverage. Expect to be asked about your child's coverage, and enroll the child first if they are not covered.1

A community-engagement condition arrives for this group after December 2026. Under section 71119 of the 2025 budget-reconciliation law (Public Law 119-21), states must make community engagement a condition of eligibility for the expansion adult group beginning no later than the first day of the first quarter after December 31, 2026, and may start earlier. It is broader than "work": 80 hours a month of work, community service, or a work program, half-time enrollment in school, any combination totaling 80 hours, or monthly income of at least the federal minimum wage times 80 hours all satisfy it. And nine categories of people are excluded outright, among them the parent, guardian, caretaker relative, or family caregiver of a dependent child 13 or under or of a disabled person; anyone medically frail or with special medical needs, expressly including a person who is blind or disabled, has a substance use disorder or disabling mental disorder, or has a serious or complex medical condition; a veteran with a total disability rating; an Indian, Urban Indian, or California Indian; a person in a drug or alcohol treatment program; someone complying with TANF work requirements, or in a SNAP household and not exempt from SNAP's work requirement; and a person who is pregnant or receiving postpartum coverage. Do not stop applying on the assumption that the requirement reaches you.1

Parents and caretaker relatives: the trap in the rules. Parents and other caretaker relatives are a federally mandatory group, but they are mandatory only at the state's old cash-welfare standard, not at a percent of the poverty level. Under 42 CFR 435.110, the minimum standard a state must use is its AFDC income standard in effect on May 1, 1988, converted to a MAGI equivalent. That 1988 floor is the least a state may offer, not the number to check: the maximum is the higher of the state's section 1931 effective income level as of March 23, 2010 or December 31, 2013 converted to a MAGI equivalent, or its July 16, 1996 AFDC standard raised by no more than the CPI increase since, and a state may use methodologies less restrictive than its 1996 plan's.11 So look up your own state's published parent standard. What holds everywhere is that this is a state-set dollar standard rather than a poverty-level percentage, which is why, in a non-expansion state, a working parent is measured against that state standard rather than the "138%" number, which is not available to them.11 If you are a grandparent raising grandchildren, see how the parent and caretaker relative group can cover you.

Children: a 133% floor, which states may exceed. Coverage of children under 19 is federally mandatory under 42 CFR 435.118, and the minimum standard a state must use is 133% FPL for the applicable family size. One exception raises that floor, and it reaches infants under 1 only: a state that had established a higher infant standard, up to 185% FPL, as of December 19, 1989, or had authorizing legislation as of July 1, 1989, must use that higher level. The maximum is the higher of 133% FPL, the state's highest effective level for that age group as of March 23, 2010 or December 31, 2013 converted to a MAGI equivalent, or, for infants, 185% FPL, so the 185% infant ceiling is available to any state, not only the ones that elected it before 1989. Within that maximum a state may set its children's standard higher.10 And once a child is determined eligible, federal law guarantees 12 months of continuous eligibility in both Medicaid and CHIP, so a mid-year raise does not end the child's coverage before that period runs out.6

No asset test on this track. Federal law bars a state from applying any asset or resource test to the MAGI groups: expansion adults, children, pregnant applicants, and parents or caretaker relatives.6 Savings, a car, and a retirement account do not count against you here. That is the central break between this track and the ABD and long-term-care pathways, which the statute expressly excepts from the rule, leaving them free to apply a resource test.6

Turning 65 Can Change Which Limit Applies

This transition is easy to miss: turning 65 can end Medicaid eligibility even though nothing about the person's income changed.

The new adult group is written for individuals under 65 who are not pregnant and not entitled to or enrolled in Medicare, at an effective ceiling of 138% FPL, and because it is a MAGI group it applies no asset test.1,6 For one person in 2026 that is roughly $1,835 a month, 138% of the $15,960 poverty guideline for the 48 contiguous states and DC.2 Alaska and Hawaii run higher.9

On the 65th birthday that pathway closes, and the same person is generally assessed on the SSI-related aged, blind, and disabled track instead, the track the statute expressly excepts from the MAGI no-asset-test rule.6 Two things change at once:

• The income yardstick drops. It becomes the SSI federal benefit rate of $994 a month for an individual rather than 138% of the poverty level.3
• A resource test appears. The MAGI groups are barred from applying one; the ABD track is not.6

So a 64-year-old covered at $1,600 a month with $10,000 in savings can, in a state applying the SSI resource standard, be over both tests at 65: the income standard drops below their income, and an asset test that never applied appears.1,3,6 Neither their income nor their savings moved.

Two cautions before you act on this.

The $2,000 asset limit is a default, not a national rule. The SSI resource standard is $2,000 for an individual and $3,000 for a couple, and it counts only countable resources: the home you live in and one vehicle used for transportation are not counted against it.3 Most states follow SSI's rules for the aged, blind, and disabled, which is why $2,000 is the default.4 Several states set theirs higher: Illinois allows $17,500 for AABD Medical, raised from $2,000 in May 2023.13,14 New York's non-MAGI resource limit is $33,038 for a single applicant.15 California's AB 116 reinstated a non-MAGI Medi-Cal asset test no sooner than January 1, 2026, after the state eliminated it in 2024; the limit is $130,000 for one person ($195,000 for two) only through June 30, 2027, and drops to $21,000 for one person ($31,000 for two) starting July 1, 2027. SSI-linked Medi-Cal stays at SSI's $2,000 limit.2 Missouri's single-applicant resource limit is $6,220.50.15 Nebraska uses $4,000.16 If you read "$2,000" on a national chart and assume it is your number, you may be spending down money you did not have to spend. Check your state's page.

Age is not the only trigger. The new adult group also excludes anyone entitled to or enrolled in Medicare, so a person under 65 who reaches Medicare through disability leaves the 138% no-asset-test group the same way, at whatever age that happens.1 Both routes land on the ABD track, which is where your state's rules start governing the answer.

Over the Aged, Blind, and Disabled Limit? Medicare Savings Programs Are Next

Take a concrete case. You are 65 or older, your Social Security check is $1,400 a month, and the ABD yardstick is $994.3,7 You are over the limit, and a chart that shows only that figure stops there.

That is the wrong place to stop. Full Medicaid is not the only thing Medicaid runs for people on Medicare. The Medicare Savings Programs are state-run, Medicaid-administered programs that help people with limited income and resources pay Medicare costs, and their ceilings are percentages of the federal poverty level that sit well above the SSI benefit rate.7,3 There are four, and the first three are in the table below:

For a married couple the ceilings are about $1,824, $2,184, and $2,455. These published dollar figures already build in the $20 SSI general income exclusion on top of the poverty-level percentage. A fourth program, QDWI (Qualified Disabled and Working Individual), pays the Part A premium for certain working people with disabilities who lost premium-free Part A.7 The $1,400-a-month retiree above, over the limit for full Medicaid, sits inside the SLMB range.7

Four details decide what these are worth to you:

• QMB carries a billing protection. Federal law bars Medicare providers and suppliers, pharmacies included, from billing a QMB enrollee for Medicare cost-sharing: Part A and Part B deductibles, coinsurance, and copayments. A bill for that cost-sharing is improper billing, not a debt you owe. Two charges fall outside it: a small Medicaid copayment, if one applies, and drug-plan copays, which Extra Help caps at $12.65 per covered drug in 2026.7
• QI is first-come, first-served, exclusive, and annual. It is paid out of a capped annual federal allocation to each state, with preference to people who had QI in the last month of the previous year, and it is only for people who do not qualify for any other Medicaid coverage, so applying early in the year matters here as it does not for QMB or SLMB. You must also apply every year: selection in one year does not entitle you to continued assistance in the next.7
• QMB, SLMB, and QI turn on Extra Help automatically, the Part D Low-Income Subsidy, so an approval reaches your prescription costs and not just your premiums. QDWI, the fourth program, does not carry it.7
• The resource test is far more forgiving than the $2,000 standard governing full ABD Medicaid: $9,950 for an individual and $14,910 for a couple in 2026. Those are the federal standard, not an absolute cutoff, and states can effectively raise them by disregarding certain resources, some to the point of eliminating the resources test outright.7,3

As with every number here, your state can be more generous. Massachusetts eliminated the MSP asset test effective March 1, 2024 and runs its tiers at 190% of poverty for QMB, above 190% through 210% for SLMB, and above 210% through 225% for QI.15 Income ceilings are higher in Alaska and Hawaii, and any state can effectively raise both the income and the resource limits by disregarding certain amounts, so treat the figures above as the federal shape, apply even if you are somewhat over them, and confirm with your state.7 Our guide to Medicare Savings Programs by state carries each state's thresholds and how to apply.

An MSP pays your Medicare costs rather than making you fully eligible for Medicaid, so it is not the only door. If your state runs a medically-needy program, the spend-down described two sections down is the other, and it is not reserved for nursing-home applicants: the District of Columbia, for one, runs community Medicaid spend-down on a one-month budget period.8 Massachusetts sets its medically-needy limit at $522 a month for a single person at home.15 A senior over $994 and still in their own house can reach for both.

What Counts as Income, and Who Counts as Your Household

A percentage only becomes a dollar figure once you know how many people are in your household and which of your money counts. Both answers follow the same track split as the limits themselves, and the two tracks use different rulebooks.

On the MAGI track, eligibility is determined using modified adjusted gross income, the tax-based measure, and no asset or resource test may be applied at all.6 Household size and composition follow federal income-tax filing relationships, the "tax household." Under 42 CFR 435.603(f)(1), a person who expects to file and does not expect to be claimed as a dependent has a household of the taxpayer plus everyone they expect to claim as a tax dependent; under 435.603(f)(4) a married couple living together are each in the other's household whether or not they file jointly. CMS says a Medicaid and CHIP household is generally the same as a tax household, sometimes adding a spouse who lives with you but is not on your return, or, for a pregnant applicant, the child or children she is carrying.17 If you file a joint return with two dependents, your household is four, and four is what sets your dollar ceiling.

Three situations use no tax household at all, per CMS: someone who does not expect to file and will not be claimed as a dependent; a tax dependent claimed by a non-parent or non-custodial parent; and children living with two parents or step-parents who do not file jointly. Non-filer rules apply instead: under 42 CFR 435.603(f)(3) the household is the individual plus, only if living with them, a spouse, their children under the age the state specifies, and, for a person under that age, their parents and siblings under that age. You do not have to file a federal return, or be claimed on someone else's, to apply.17

On the aged, blind, and disabled track, income is measured using the SSI program's methodology rather than the MAGI calculation, the household rules are the non-MAGI rules rather than your tax household, and a resource test applies.3,17,4 The same family can therefore be counted differently depending on which pathway applies.

Does Social Security count as income? Yes. The answer follows from the SSI rules the ABD track borrows.4 Under that methodology a Social Security retirement or disability benefit is unearned income, reduced only by the $20 general income exclusion.18 Mom's $1,600 monthly benefit therefore counts as $1,580 against the standard rather than as nothing, which is exactly why a retiree with a benefit like that sits above the $994 ABD figure and should look at the Medicare Savings Programs above rather than full Medicaid.3,7 Past that general rule, the further income exclusions and the countable-resource rules are set state by state, and a 209(b) state may apply a rule stricter than SSI's, so confirm what counts on your state's guide or with your state agency rather than assuming a national chart applies to you.4

The long-term-care track adds a second test that has nothing to do with money. Meeting the income limit does not by itself open the institutional pathway: you must also need nursing-home-level care, which is a clinical determination rather than a figure you can calculate.3,15 How your state assesses it, and who performs the assessment, is covered on your state's guide.

Being Over the Long-Term-Care Limit Is Not the End

The $2,982 figure, 300% of the SSI benefit rate, is easy to read as a hard wall.3 Whether your state's limit actually is one depends on which financial-eligibility regime your state runs.

In an income-cap state, the cap is real, and a trust is the way through. Florida shows how it works: for its Institutional Care Program and its home- and community-based waiver programs, a single applicant's gross income, after the deductions the rule allows, cannot exceed 300% of the SSI benefit rate, $2,982 in 2026. An applicant over that limit may qualify by establishing a Qualified Income Trust, which holds only the applicant's income and must pay the state what remains at death, up to the Medicaid paid on their behalf.19

In a medically-needy state, there is no such cap, and no trust is needed. New York runs a medically-needy income standard rather than a fixed dollar cap: its Medicaid Income Level is $1,836 a month for a single applicant, and the state's own standards chart directs an applicant whose income is above that level to spend down to it.15 Massachusetts is likewise not an income-cap state; its medically-needy income limit is $522 a month for one person in the community, and no Miller trust is required.15

What "spending down" actually means. Not writing a check to the state. The agency deducts from your countable income, which is not the gross figure on a benefit statement, the medical expenses you have incurred that no third party will pay, and once those expenses equal the amount by which that countable income exceeds the standard, coverage begins for that period.8 The arithmetic runs over a budget period of no more than six months, and the length is your state's call: the District of Columbia, for example, uses one month for community Medicaid and six months for long-term care.8 Massachusetts shows the shape of it: excess income over the $522 medically-needy limit is multiplied by six to set the deductible, so a person at $1,000 a month carries $478 of excess and a $2,868 deductible to meet before MassHealth starts paying.15 The bills you already owe are what get you there, which is why a spend-down reaches people who could never write that check.

So the same retiree with the same $3,200-a-month pension is told to set up a trust in Florida and to spend down in New York, while a Massachusetts nursing-home resident faces no income limit at all and instead pays income toward the cost of care.19,15 Being over the special income level means different things in different places, and it does not by itself mean "you do not qualify."

If you are married, your spouse keeps an income allowance. Under the spousal-impoverishment rules at 42 U.S.C. 1396r-5, the at-home spouse's own income is not counted against the spouse in care.15 If it falls short of the Minimum Monthly Maintenance Needs Allowance, $2,705.00 a month (July 1, 2026 through June 30, 2027; Alaska $3,381.25; Hawaii $3,111.25) plus any excess-shelter allowance, part of the institutionalized spouse's income can be set aside to close the gap. That standard tops out at $4,066.50 a month unless a fair hearing finds exceptional circumstances causing significant financial duress.20,15 Your state elects a resource standard between $32,532 and $162,660, and a fair hearing or court order can protect more.20 The minimum allowance runs July to June, so a chart from earlier in the year may be out of date.20

Two rules come up alongside this question and are not income rules at all, so they live where they belong. Giving assets away before applying can trigger a penalty period under Medicaid's 60-month look-back (California departs from it: from January 1, 2026 Medi-Cal uses a 30-month look-back for nursing-facility care, counting only transfers made on or after that date), which our Medicaid planning guide covers.21 And once you qualify, an institutionalized resident keeps a personal needs allowance of at least $30 a month ($60 for an institutionalized couple whose incomes are counted together), a federal floor a state may set above, explained in our personal needs allowance guide.6 Neither one changes which income limit applies to you.

Why Medicaid Income Limits Change from State to State

Federal law sets the framework; states fill in the specifics, which is why the same person can qualify in one state and not the next.

The biggest divide is expansion. As of 2026, 41 states including the District of Columbia adopted the ACA Medicaid expansion, and 10 states did not: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.12 In a non-expansion state, the working-age-adult pathway is absent, so a low-income adult who would qualify next door may not qualify at all. In nine of those ten states, adults below the poverty level can fall into a coverage gap: too much income for Medicaid, too little for Marketplace premium subsidies.12 If that describes you, do not stop at the chart. A non-expansion state is not the same as no route to Medicaid: CMS flags several of these states as running a section 1115 demonstration covering some additional low-income adults, though in CMS's words that coverage can carry eligibility and benefit limits, reach only part of a state, and run under an enrollment cap. Georgia's Pathways to Coverage demonstration, for one, reaches 100% of poverty for parents and childless adults who meet a work requirement.12 Check whether another mandatory pathway reaches you first, as a parent or caretaker relative at your state's standard, or on the basis of disability, and then apply anyway: only the agency can make the determination, and our guide to applying for Medicaid by state has the route for yours. One timing rule applies to every track on this page, not just to this group: Medicaid's retroactive eligibility can pay covered bills furnished in or after the third month before the month you apply, if you would have been eligible when you received the care. Three months is the federal outer boundary; the exact effective date inside it is your state's plan choice, and a section 1115 demonstration can shorten the window, so confirm yours. For applications filed on or after January 1, 2027 the federal window shrinks to two months for most enrollees and to one month for the expansion adult group, so waiting to file can cost you coverage you were already entitled to.6

Wisconsin is the exception. It has not adopted the expansion, but it covers low-income adults below the poverty level under a section 1115 demonstration, so it has no coverage gap. The flip side is that Medicaid is still unavailable in Wisconsin to an adult with income between 100% and 138% of poverty.12 A childless adult in Wisconsin and a childless adult in Mississippi are in genuinely different situations.

The aged-and-disabled limit varies for a more technical reason. In most states, known as 1634 states, the state has an agreement with the Social Security Administration to make its Medicaid eligibility determinations, so an SSI award generally enrolls you in Medicaid with no separate Medicaid application. That route has a condition: SSA decides Medicaid only for SSI recipients who also meet certain citizenship or immigration-status requirements, and it refers anyone who may not meet them to the state, which is a referral, not a Medicaid denial. In another group of states, Medicaid uses the same SSI eligibility criteria but the state makes the determination itself, so you have to file a separate Medicaid application. Those two differ in how you apply rather than in the number you are measured against. The third group, the "209(b)" states, is the one that can move the number: they apply at least one eligibility criterion stricter than SSI's, such as a lower income or resource standard or a stricter definition of disability, so some SSI recipients do not qualify there on the state's ordinary standard. The option is bounded, and the bound protects you: a 209(b) state's requirements may be no more restrictive than those in its Medicaid plan on January 1, 1972, and it must let you deduct incurred medical expenses from income through a spend-down to reach the eligibility level. Being over the limit in a 209(b) state is never the end of the inquiry.4 Read alongside the income-cap and medically-needy split above, that gives three structural choices which together decide your number: a hard income cap you need a trust to cross, a medically-needy standard you spend down to, and a 209(b) rule stricter than SSI's.4,8 States mix them, which is why two states quoting the same federal percentage land families in different places, and why your state's page is the one that counts.

States also set their own asset limits and the rules for a married couple, especially when one spouse needs long-term care. Those, too, live on your state's guide.

Learn More

Find personalized help figuring out which Medicaid pathway and income limit applies to your family 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.