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Medicaid Income Eligibility
Medicaid is a health insurance program that provides coverage to low-income individuals and families. To be eligible for Medicaid, you must meet certain income and asset requirements. The income limits for Medicaid vary from state to state, but there are some general guidelines that apply to all states.
- Gross Income: Your gross income is the total amount of money you earn before taxes or other deductions.
- Modified Adjusted Gross Income (MAGI): Your MAGI is your gross income minus certain deductions and adjustments, such as unreimbursed medical expenses and certain types of income that are not taxed.
- Federal Poverty Level (FPL): The FPL is a measure of poverty that is used to determine eligibility for many government programs, including Medicaid. The FPL is set by the federal government and is adjusted each year based on the cost of living.
In general, you are eligible for Medicaid if your MAGI is below a certain percentage of the FPL. The percentage varies from state to state, but it is typically between 133% and 150% of the FPL. This means that if your MAGI is below this percentage, you may be eligible for Medicaid.
In some states, there are different income limits for different types of Medicaid coverage. For example, there may be a lower income limit for children than there is for adults. There may also be different income limits for pregnant women and people with disabilities.
If you are not sure whether you are eligible for Medicaid, you can contact your state Medicaid office or visit the Medicaid website for more information.
| State | MAGI Limit |
|---|---|
| Alabama | 133% of FPL |
| Alaska | 133% of FPL |
| Arizona | 133% of FPL |
| Arkansas | 138% of FPL |
| California | 138% of FPL |
Federal Poverty Level (FPL)
Medicaid eligibility is based on income, and those with income at or below a certain percentage of the Federal Poverty Level (FPL) may qualify for Medicaid coverage. The FPL is a measure of poverty established by the U.S. government, and it is used to determine eligibility for various government programs, including Medicaid.
The FPL is updated annually, and the current income limits for Medicaid eligibility are as follows:
- For individuals, the income limit is 138% of the FPL.
- For families of two, the income limit is 138% of the FPL.
- For families of three, the income limit is 148% of the FPL.
- For families of four, the income limit is 158% of the FPL.
- For families of five, the income limit is 168% of the FPL.
- For families of six, the income limit is 178% of the FPL.
- For families of seven, the income limit is 188% of the FPL.
- For families of eight or more, the income limit is 198% of the FPL.
For example, if the FPL for a family of four is $30,000, the income limit for Medicaid eligibility for that family would be $47,400 (158% of $30,000).
In addition to income, there are other factors that can affect Medicaid eligibility, such as age, disability, and pregnancy. For more information on Medicaid eligibility, please visit the Medicaid website.
| Family Size | Income Limit (% of FPL) |
|---|---|
| 1 | 138% |
| 2 | 138% |
| 3 | 148% |
| 4 | 158% |
| 5 | 168% |
| 6 | 178% |
| 7 | 188% |
| 8 or more | 198% |
Modified Adjusted Gross Income (MAGI)
Medicaid income limits are based on your Modified Adjusted Gross Income (MAGI). MAGI is your adjusted gross income (AGI) plus certain other types of income, such as tax-exempt interest and nontaxable Social Security benefits.
To calculate your MAGI, start with your AGI. You can find your AGI on line 8b of your federal income tax return.
Then, add the following types of income to your AGI:
- Tax-exempt interest
- Nontaxable Social Security benefits
- Certain other types of income, such as gambling winnings and prizes
Once you have calculated your MAGI, you can compare it to the Medicaid income limits in your state. If your MAGI is below the limit, you may be eligible for Medicaid.
Medicaid Income Limits by State
Medicaid income limits vary by state. The following table shows the Medicaid income limits for all 50 states and the District of Columbia.
| State | Medicaid Income Limit |
|---|---|
| Alabama | $17,655 for individuals and $35,310 for families of four |
| Alaska | $27,180 for individuals and $54,360 for families of four |
| Arizona | $18,754 for individuals and $37,508 for families of four |
| Arkansas | $17,655 for individuals and $35,310 for families of four |
| California | $17,655 for individuals and $35,310 for families of four |
Medicaid Income Limits and Eligibility
Medicaid offers health coverage to eligible low-income individuals and families. The income limits to qualify for Medicaid vary from state to state, but generally fall below the federal poverty level (FPL). The FPL is a measure of poverty used by the U.S. government to determine eligibility for various social programs. In 2023, the federal poverty level for a family of four is $36,650. Many states have expanded Medicaid eligibility under the Affordable Care Act (ACA), allowing more people to qualify.
Medicaid Expansion
In 2014, the ACA expanded Medicaid eligibility to all adults with incomes up to 138% of the FPL. However, the expansion was optional, and many states chose not to expand. As of 2023, 38 states and the District of Columbia have expanded Medicaid.
In states that have expanded Medicaid, income limits are more generous, and more people are eligible for coverage. For example, in California, an individual with an income up to 138% of the FPL is eligible for Medicaid. In Texas, which has not expanded Medicaid, an individual must have an income at or below 133% of the FPL to qualify.
Medicaid Income Limits by State
The following table shows the Medicaid income limits for each state, as of 2023. Keep in mind that these limits are subject to change, so it’s important to check with your state’s Medicaid agency for the most accurate and up-to-date information.
| State | Medicaid Income Limit |
|---|---|
| Alabama | 138% of FPL |
| Alaska | 138% of FPL |
| Arizona | 138% of FPL |
| Arkansas | 138% of FPL |
| California | 138% of FPL |
| Colorado | 138% of FPL |
| Connecticut | 138% of FPL |
| Delaware | 138% of FPL |
| District of Columbia | 138% of FPL |
| Florida | 138% of FPL |
| Georgia | 138% of FPL |
| Hawaii | 138% of FPL |
| Idaho | 138% of FPL |
| Illinois | 138% of FPL |
| Indiana | 138% of FPL |
| Iowa | 138% of FPL |
| Kansas | 138% of FPL |
| Kentucky | 138% of FPL |
| Louisiana | 138% of FPL |
| Maine | 138% of FPL |
| Maryland | 138% of FPL |
| Massachusetts | 138% of FPL |
| Michigan | 138% of FPL |
| Minnesota | 138% of FPL |
| Mississippi | 138% of FPL |
| Missouri | 138% of FPL |
| Montana | 138% of FPL |
| Nebraska | 138% of FPL |
| Nevada | 138% of FPL |
| New Hampshire | 138% of FPL |
| New Jersey | 138% of FPL |
| New Mexico | 138% of FPL |
| New York | 138% of FPL |
| North Carolina | 138% of FPL |
| North Dakota | 138% of FPL |
| Ohio | 138% of FPL |
| Oklahoma | 138% of FPL |
| Oregon | 138% of FPL |
| Pennsylvania | 138% of FPL |
| Rhode Island | 138% of FPL |
| South Carolina | 138% of FPL |
| South Dakota | 138% of FPL |
| Tennessee | 138% of FPL |
| Texas | 133% of FPL |
| Utah | 138% of FPL |
| Vermont | 138% of FPL |
| Virginia | 138% of FPL |
| Washington | 138% of FPL |
| West Virginia | 138% of FPL |
| Wisconsin | 138% of FPL |
| Wyoming | 138% of FPL |
It’s important to note that Medicaid eligibility is not just based on income. Other factors like age, disability, and family size can also affect your eligibility. If you’re not sure if you qualify for Medicaid, contact your state’s Medicaid agency for more information.
Alright folks, that pretty much covers the basics of income limits for Medicaid. I know it can be confusing, but don’t fret. If you’re still feeling a tad lost, the internet has a wealth of resources that can help you understand your options. And if you’re still struggling, don’t be shy to reach out to your local Medicaid office. They’re there to help! Thanks for taking the time to read this article. If you have any more questions, feel free to drop me a line. Until next time, keep smiling and stay healthy!