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Do I qualify for Medicaid? Here's how to tell
4 min readReviewed by CoverageCo’s licensed agents
Key takeaways
- Four things decide it: income, household size, your state, and who's applying.
- Expansion states cover most adults to about 138% of the poverty level.
- Children and pregnant women qualify at higher income levels.
- An estimate gets you close; a licensed agent confirms it.
The four things that decide it
Medicaid eligibility usually comes down to four factors working together:
- Income — measured as a percentage of the federal poverty level (using MAGI, close to tax-return income).
- Household size — the limit rises with each additional person.
- Your state — expansion states cover more adults than non-expansion states.
- Who's applying — children, pregnant women, parents, seniors, and people with disabilities have different rules.
The fastest way to know
Because those four factors interact, two people with the same paycheck can get different answers depending on their state and family. Rather than guess, run your actual numbers for your state and household — then have a licensed agent confirm it and, if you don't qualify, show you what you do.
Medicaid eligibility estimator
See what you may qualify for.
Answer three quick questions for a free estimate. If you don’t qualify for Medicaid, we’ll help you find what you do — in one call.
This is a general estimate based only on what you enter — not a determination of eligibility, an application, or an offer of coverage. Only your state Medicaid agency can determine Medicaid eligibility. CoverageCo is a licensed insurance agency, not a government agency.
Common questions
What disqualifies you from Medicaid?
Most often, having income above your state's limit for your household size and category. In states that didn't expand Medicaid, adults without dependent children may not qualify at any income. Assets can matter for some pathways (like long-term care) but not for most MAGI-based coverage.
How do I check if I qualify?
Run your income and household size against your state's limits, or use an eligibility estimator to get close. Because the rules vary by state and who's applying, a licensed agent can confirm your result and handle enrollment.
Keep reading
Medicaid income limits, explained
Medicaid income limits are set as a percentage of the federal poverty level and vary by state, household size, and who's applying. Here's how they actually work.
How to apply for Medicaid: a step-by-step guide
Applying for Medicaid is free and can be done through your state. Here's what you'll need, how to apply, and what to do if you're found ineligible.
Medicaid vs. the Marketplace: which one are you eligible for?
Medicaid and Marketplace coverage serve different income levels. Here's how to tell which one you qualify for — and what to do if you're near the line.
If Medicaid isn’t a fit
Many people just over the Medicaid line qualify for Marketplace coverage with financial help that lowers the monthly cost.
Reviewed by CoverageCo’s licensed insurance agents · Last updated August 2026. Sources: Medicaid.gov; HealthCare.gov and state Health Insurance Marketplaces; KFF; HHS federal poverty guidelines. This article is general information, not a determination of eligibility.
Important disclosures
The Coverage Company (“CoverageCo”) is a private, licensed insurance agency. This website is not Medicaid, Medicare, HealthCare.gov, or any federal or state government program, and is not affiliated with, endorsed by, or connected to any government agency.
The eligibility estimator and any figures shown are for general education only. They are based on the limited information you provide and published federal poverty guidelines, are not guaranteed to be current, and are not a determination of eligibility, an application, or an offer of coverage. Only your state Medicaid agency can determine Medicaid eligibility. If you contact us, a state-licensed insurance agent may help you review private coverage options; enrollment in any plan is subject to eligibility and the plan’s terms.