Medicaid income limits vary from state to state and are based on a percentage of the federal poverty level (FPL). In general, adults with incomes below 138% of the FPL are eligible for Medicaid, while children under 19 with household incomes below 206% of the FPL are typically eligible. Some states have expanded Medicaid eligibility to adults with incomes up to 100% of the FPL. To determine if you are eligible for Medicaid, you will need to apply through your state’s Medicaid agency. You can find more information about Medicaid income limits and eligibility requirements on the Medicaid website or by contacting your state’s Medicaid office.
Medicaid and Income Eligibility
Medicaid is a government-sponsored health insurance program that provides medical assistance to low-income individuals and families. To be eligible for Medicaid, you must meet certain income and asset limits. The income limits vary from state to state, but there are some general guidelines that apply to everyone.
Income Guidelines
In general, the income limit for Medicaid is 138% of the federal poverty level (FPL). This means that if your income is below 138% of the FPL, you may be eligible for Medicaid. The FPL is adjusted each year, so the income limits for Medicaid also change each year.
The following table shows the income limits for Medicaid in 2023:
| Family Size | Income Limit |
|---|---|
| 1 | $19,320 |
| 2 | $26,160 |
| 3 | $32,990 |
| 4 | $39,750 |
| 5 | $46,530 |
| 6 | $53,310 |
| 7 | $60,090 |
| 8 | $66,870 |
If your income is above the limit for your family size, you may still be eligible for Medicaid if you have certain expenses that reduce your income, such as child care costs or medical bills.
Other Eligibility Requirements
In addition to meeting the income requirements, you must also meet other eligibility requirements to qualify for Medicaid. These requirements may vary from state to state, but they typically include:
- Being a citizen or legal resident of the United States
- Being a child, pregnant woman, parent, or disabled person
- Having a low income and few assets
If you think you may be eligible for Medicaid, you can apply through your state’s Medicaid agency. You can find more information about Medicaid and how to apply on the Medicaid website.
Federal Poverty Level (FPL)
Medicaid eligibility is based on income and household size. The Federal Poverty Level (FPL) is a measure of poverty used to determine eligibility for various government programs, including Medicaid. The FPL is updated each year by the U.S. Department of Health and Human Services (HHS). To be eligible for Medicaid, your income must be below a certain percentage of the FPL.
- For individuals, the income limit is 138% of the FPL.
- For families, the income limit is 138% of the FPL for the family size.
The following table shows the FPL for 2023 for individuals and families of various sizes:
| Family Size | FPL |
|---|---|
| 1 | $13,590 |
| 2 | $18,310 |
| 3 | $23,030 |
| 4 | $27,750 |
| 5 | $32,470 |
| 6 | $37,190 |
| 7 | $41,910 |
| 8 | $46,630 |
If your income is below the FPL, you may be eligible for Medicaid. However, the specific eligibility criteria vary from state to state. Some states have expanded Medicaid eligibility to include people with incomes up to 100% of the FPL. Other states have not expanded Medicaid eligibility. To find out if you are eligible for Medicaid in your state, contact your state Medicaid office.
MAGI and Medicaid Eligibility
Medicaid income limits vary from state to state. In general, you can qualify for Medicaid if your household income is below certain limits relative to the federal poverty level (FPL). Adjusted gross income (AGI) alone does not determine Medicaid eligibility. Instead, the Modified Adjusted Gross Income (MAGI) is the basis for determining your eligibility for Medicaid and several other health insurance assistance programs.
MAGI is generally calculated by starting with AGI and making a few adjustments, including:
- Adding tax-exempt interest income
- Adding nontaxable Social Security benefits
- Subtracting the foreign earned income exclusion
- Subtracting the foreign housing exclusion or deduction
- Subtracting certain student financial aid
Your MAGI can be higher than your AGI. However, in most cases, it is the same or lower than your AGI.
Medicaid eligibility uses a percentage of the federal poverty level (FPL) to determine the income cutoff for coverage. This percentage varies from state to state, but it is generally between 133% and 150% of FPL. In some cases, states may use a higher percentage for certain groups of people, such as children, pregnant women, or people with disabilities. The states can also choose to expand Medicaid eligibility to cover more people, with higher income levels, than the federal government requires.
For example, in 2023, the federal poverty level (FPL) for a household of four is $27,750. This means that a family of four with a MAGI of $36,975 or less ($27,750 x 133%) would be eligible for Medicaid in a state that uses the 133% FPL threshold.
In some states, Medicaid eligibility may also depend on other factors, such as age, disability, pregnancy, or whether you have children. Medicaid rules can be complicated, and the specific rules can vary widely by state. However, if you’re not sure whether you qualify, you can contact your state Medicaid office or visit the Medicaid.gov website for more information.
Here is a table summarizing the Medicaid income limits for some states in 2023. Note that these limits are subject to change, so it is important to check with your state Medicaid office to confirm the most up-to-date information.
| State | Medicaid Income Limit for a Family of Four |
|---|---|
| Alabama | $36,975 |
| California | $54,300 |
| Florida | $36,975 |
| Illinois | $54,300 |
| New York | $54,300 |
| Texas | $36,975 |
Modified Adjusted Gross Income
Medicaid is a government-sponsored health insurance program that provides coverage to low-income individuals and families. The income limits for Medicaid vary from state to state, but they are generally based on a modified adjusted gross income (MAGI). MAGI is calculated in a similar way to adjusted gross income (AGI) for federal income tax purposes, but there are some important differences.
- Social Security benefits are not included in MAGI.
- Certain deductions and credits are not allowed in calculating MAGI.
- The income of all members of a household is counted in determining MAGI.
The table below shows the MAGI limits for Medicaid eligibility in each state for 2023. The limits are based on the federal poverty level (FPL), which is also used to determine eligibility for other government programs.
| State | MAGI Limit for Medicaid Eligibility |
|---|---|
| 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 | 138% 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 |
In addition to MAGI, there are other factors that can affect Medicaid eligibility, such as age, disability, and pregnancy. For more information on Medicaid eligibility, please visit the website of your state’s Medicaid agency.
Hey folks, thanks for taking the time to learn about the income limits for Medicaid. I know it can be a lot to take in, but I hope this article has shed some light on the subject. If you have any further questions, please don’t hesitate to reach out to your local Medicaid office. And don’t forget to check back in later for more informative articles like this one. We’ll be here, ready to keep you in the know. In the meantime, take care and stay healthy!