The numbers
Medicaid income limits, explained
5 min readReviewed by CoverageCo’s licensed agents
Key takeaways
- Limits are a percentage of the federal poverty level, which rises with household size.
- Expansion states cover most adults to about 138% of FPL.
- Kids and pregnant women usually have higher limits than other adults.
- Medicaid counts “MAGI” income — close to your tax-return income, not your take-home pay.
How the limit is built
Medicaid limits start from the federal poverty level, a number the government updates each year that goes up with household size. Your state then sets its eligibility as a percentage of that number — for adults in expansion states, that's about 138%.
Because the poverty level rises with each additional person, a family of four can earn considerably more than a single person and still qualify. That's why “the Medicaid limit” isn't a single dollar figure — it depends on how many people are in your household.
What income counts
For most people, Medicaid uses “MAGI” — modified adjusted gross income — which is close to the income on your federal tax return, not your after-tax take-home pay. Some income sources are counted and some aren't, which is one reason people are surprised by the result.
Because of that, the only reliable way to know your status is to run your actual numbers for your state and household — an estimate gets you close, and a licensed agent can confirm it.
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 is the income limit for Medicaid?
There's no single number — it's a percentage of the federal poverty level that rises with household size and varies by state. In expansion states, most adults qualify up to about 138% of the poverty level; children and pregnant women often qualify at higher limits.
Does Medicaid look at gross or net income?
Most Medicaid eligibility uses MAGI, which is based on your adjusted gross income (close to your tax-return income), not your take-home pay after deductions. Certain income types are excluded, so it's worth checking your specific situation.
Keep reading
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.
The Medicaid coverage gap, explained
In states that didn't expand Medicaid, some adults earn too much for Medicaid but too little for Marketplace help. Here's what the gap is and how to get covered anyway.
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.