Can Grandparents Raising Grandchildren Get Medicaid for Themselves?

Grandparents raising grandchildren can often get Medicaid for themselves, not just for the kids, by qualifying as a "caretaker relative" of a grandchild who lives with them. Federal rules name grandparents as caretaker relatives, and every state must cover parents and caretaker relatives whose household income falls under the limit the state sets. The rule is written around who you are to the child and who is raising them, so legal custody or guardianship isn't among its conditions, and the group has no asset test. Income is the real gate, and that limit depends heavily on where you live.1,2,3

In This Guide

• Who Counts as a Caretaker Relative for Medicaid?
• Why Caretaker Relative Medicaid Has No Asset Test
• Whose Income Counts in Your Household
• The Income Limit: Why Your State Matters Most
• Medicaid for Grandparents 65 or Older, or Already on Medicare
• If You're Covered in the Adult Group Instead
• What About Your Grandchild's Coverage?
• How Grandparents Apply for Medicaid as a Caretaker Relative
• Frequently Asked Questions
• Learn More

Who Counts as a Caretaker Relative for Medicaid?

Medicaid has a mandatory coverage group for parents and other caretaker relatives, set out in 42 CFR 435.110. "Mandatory" means every state has to cover it. Who belongs in it comes from the definition at 42 CFR 435.4: a caretaker relative is a relative of a dependent child by blood, adoption, or marriage, with whom the child is living, who assumes primary responsibility for the child's care. The regulation lists the child's grandfather and grandmother by name, alongside parents, siblings, aunts, uncles, and several other relatives.2,1

That definition comes down to three conditions, and it helps to take them one at a time:

1. You're related to the child. A grandparent qualifies by blood, adoption, or marriage, and so does the spouse of a listed relative, "even after the marriage is terminated by death or divorce."1
2. The child lives with you. The definition is written around a relative the child is living with.1
3. You've taken on primary responsibility for the child's care. Claiming the child as a tax dependent can show this, but the regulation says it "may, but is not required to," be shown that way.1

Legal custody and court-appointed guardianship are not among the conditions the federal definition states. When the Centers for Medicare & Medicaid Services (CMS) adopted this definition in 2012, it described caretaker relatives as "in essence, standing in the shoes of a parent to assume primary responsibility to care for a child." CMS also declined to stretch the term to relatives with "only temporary or fleeting custody of the child (such as in the provision of day care or babysitting)." So a grandparent who has stepped in to raise a grandchild fits the description, while a grandparent who watches the kids after school while a parent raises them does not.1

Your grandchild has to be a "dependent child"

The second half of the test is about the child. Under 42 CFR 435.4, a caretaker relative is caring for a "dependent child," and the child has to meet two criteria. The first criterion for a Medicaid "dependent child" is age: under 18, or, if your state has chosen this option, 18 and a full-time secondary school student expected to finish before turning 19.1

The second is called deprivation of parental support. The child must be deprived of a parent's support because at least one parent has died, is absent from the home, has a physical or mental incapacity, or is unemployed (working under 100 hours a month, or a higher number of hours your state sets). The deprivation requirement applies unless your state has dropped it in its State plan. When a grandchild lives with you because a parent has died or isn't living in the home, that is one of the reasons the regulation lists.1

Why Caretaker Relative Medicaid Has No Asset Test

The parent and caretaker relative group is one of the groups whose financial eligibility is figured with Modified Adjusted Gross Income, or MAGI, an income-tax-based method. For MAGI groups, federal law says a state "shall not apply any assets or resources test," and the regulation at 42 CFR 435.603(g) says the agency "must not" apply one.3

In practice, that means the state looks at your income, not at what you own. A paid-off house, a car, or retirement savings you've built up over decades aren't measured against an asset limit in this group. That's different from the Medicaid routes where age 65 or older is a condition of eligibility, or where eligibility rests on being blind or disabled, and it's different from Medicaid that comes with Supplemental Security Income (SSI), which our guide on whether SSI qualifies you for Medicaid explains. The MAGI no-asset-test rule doesn't reach those routes, so which group your state tests you in matters.3

Whose Income Counts in Your Household

Because MAGI rules borrow from the tax system, the people counted in your household depend mostly on how you file taxes, and household income is generally the MAGI-based income of the people in that household. Here's how it works for a grandparent:7,3

• If you file a tax return and claim your grandchild as a dependent, your household for Medicaid generally includes you and the grandchild you claim.8
• If you don't file taxes and no one claims you, non-filer rules apply. A grandchild isn't your "child" under these rules, which cover only natural, adopted, and step children, so a non-filing grandparent's household doesn't include the grandchild. With no spouse or children of your own living with you, that's a household of one.8
• If you're married and living with your spouse, each of you is included in the other's household, whether or not you file jointly. The caretaker group also covers the spouse of a caretaker relative who lives with them, as long as household income is within the limit.7,2

You don't have to file a federal tax return to apply. CMS states that people applying for Medicaid or the Children's Health Insurance Program (CHIP) don't need to file taxes or be claimed as someone's dependent. Because state income limits are set by household size, though, which household rule applies to you can change the dollar limit you're measured against.7

The Income Limit: Why Your State Matters Most

The federal rule sets a floor and a ceiling, and each state picks its own standard in between. The federal floor for the parent and caretaker relative group's income standard is the state's old cash-welfare income standard under Aid to Families with Dependent Children (AFDC) as of May 1, 1988, converted to a MAGI-equivalent figure. That is why the limit for this group can be very low in some states: it is tied to decades-old welfare levels, not to a percentage of today's poverty line.2

The other thing that shapes your options is whether your state adopted the Affordable Care Act (ACA) Medicaid expansion. As of 2026, 41 states including the District of Columbia have adopted the ACA Medicaid expansion; 10 states have not: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. In an expansion state, a grandparent whose income is above the caretaker limit may still qualify in the adult group, which reaches 138% of the federal poverty level.4,3

Three places show how wide the range is:

Texas Medicaid adds a condition of its own: the Texas Health and Human Services Commission says the child you're caring for must already have Medicaid and live with you. That rule comes from Texas's program, so don't assume another state works the same way. The Texas chart counts income before taxes, and Texas lists grandparents among the related caretakers who can qualify.4

In New Jersey Medicaid, the caretaker standard is low, but because the state expanded, a grandparent above it can be covered in the adult group instead. The District's Department of Health Care Finance (DHCF) cut its caretaker standard from 216% to 133% of the poverty level effective January 1, 2026, and DC's category explicitly includes a grandfather or grandmother of a dependent child.4,9

These three are examples, not a full list. To find the number for your state and household size, use our guide to Medicaid income limits by state, or go straight to Texas, New Jersey, or DC.

Medicaid for Grandparents 65 or Older, or Already on Medicare

You may have heard that turning 65 moves you onto the rules for older applicants, with an asset limit. For a caretaker relative, it doesn't work that way. Turning 65 does not by itself end MAGI-based Medicaid eligibility. Under 42 CFR 435.603(j)(2), people 65 and older are taken off MAGI methods only "when age is a condition of eligibility" for the group being tested, and the caretaker group sets no upper age limit. A grandparent 65 or older who is evaluated as a caretaker relative stays on MAGI rules, with no asset test. CMS made this choice on purpose in its 2012 rule, after comments about "elderly parents and caretaker relatives over the age 65."5

Medicare works the same way. Being eligible for or enrolled in Medicare does not, by itself, take a caretaker relative out of the parent and caretaker relative group or off MAGI rules. The federal rule for this group sets no Medicare condition. The adult expansion group is different: it's limited to people under 65 who aren't entitled to or enrolled in Medicare Part A or B. So if you're on Medicare, the caretaker group can still be open to you even though the adult group isn't.6

If you have Medicare and also qualify for full Medicaid, you're what CMS calls a dually eligible person. CMS sorts people with both into categories, including "full-benefit" ones, where Medicaid's full benefits sit alongside Medicare. For how the two programs work together, see our guide to Medicare and Medicaid dual eligibility.10

Separately, every state must cover the four Medicare Savings Programs (QMB, SLMB, QI, and QDWI), which help with Medicare costs. If you're evaluated for one of them, your state uses non-MAGI financial methods only for that determination, so applying for help with Medicare costs doesn't by itself move your caretaker-group case off MAGI. Our Medicare Savings Programs by state guide has each state's limits.11,6

One boundary is worth knowing. Under 42 CFR 435.603(j)(4), MAGI methods aren't applied when someone requests coverage of long-term care services and supports, such as nursing home care, under a group that covers long-term care services MAGI-eligible people don't get. That evaluation uses a different set of financial methods, and the MAGI no-asset-test rule doesn't reach it. If that's the kind of care you need, ask your state Medicaid office which rules apply before you plan around the caretaker group.6,3

If You're Covered in the Adult Group Instead

In an expansion state, a grandparent under 65 whose income is above the caretaker limit may be enrolled in the adult group rather than the caretaker group. Two rules apply there that don't apply in the caretaker group, and both are worth understanding before you're surprised by a letter.3

First, under 42 CFR 435.119(c), a state may not cover a parent or caretaker relative living with a dependent child in the adult group unless the child is getting Medicaid or CHIP or has other minimum essential coverage. Expect to be asked about your grandchild's coverage.3

Second, section 71119 of the 2025 federal budget reconciliation law (H.R. 1, Public Law 119-21) created a Medicaid community engagement (work) requirement. States must apply the Medicaid community engagement requirement no later than January 1, 2027, unless CMS grants a temporary good-faith exemption, which can't run past December 31, 2028. CMS says only people eligible for or enrolled in the adult group can be subject to it, so people covered through other Medicaid groups, including the parent and caretaker relative group, are not.12,13

Within the adult group, a caretaker relative who lives with and has primary responsibility for a "dependent child" is excluded from the requirement. For this rule, 42 CFR 435.554 defines a dependent child as a child 13 years of age or under; the exclusion also covers a caretaker relative of an individual with a disability. That's a different age line from the under-18 definition that decides who's a caretaker relative. A grandparent in the adult group whose only grandchild at home is 14 or older, and not disabled, isn't excluded from the work requirement as a caretaker relative. For people the requirement does reach, any one of several activities meets it, including 80 hours a month of work, community service, or a work program, or half-time enrollment in an educational program.13

What About Your Grandchild's Coverage?

Your grandchild's own Medicaid or CHIP eligibility is figured separately from yours: in CMS's example of a grandfather who claims his 15-year-old grandson, the grandfather's household includes both of them, but the grandson's household includes only himself, and a child's own MAGI income always counts toward the child's eligibility. If a child welfare agency placed the child with you, the Administration for Community Living's grandparents advisory council says they should automatically enroll the child in Medicaid.8

Our guide for grandparents raising grandchildren covers the child's coverage and other support in detail.

How Grandparents Apply for Medicaid as a Caretaker Relative

You apply through your state Medicaid agency, the same way anyone applies for Medicaid; our guide on how to apply for Medicaid by state lists where to apply in each state. When you fill out the application, say clearly that you're a grandparent raising a grandchild who lives with you, so the agency knows to consider the parent and caretaker relative group.

Before you start, it helps to have a few things gathered:

• Your income for the month, and that of anyone else in your household, such as a spouse who lives with you.
• How you file taxes, and whether you plan to claim your grandchild as a dependent, since that shapes who counts in your household.7
• Your grandchild's current health coverage, if any. In Texas, the child must already have Medicaid, and in the adult group in any state, the agency will ask about it.4,3

Your state may ask you to show your relationship to the child and that the child lives with you. If you're not sure what your state accepts, ask the caseworker before you gather paperwork.

Learn More

Find personalized help checking whether you qualify as a caretaker relative in your state 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.