Who Qualifies for Medicaid?
Medicaid eligibility is based on four main factors: income, household size, state of residence, and eligibility category. Unlike many programs, Medicaid has different income limits for different groups of people.
Children qualify in all 50 states, typically up to 138–317% FPL depending on state. Many states cover children up to 200% FPL or higher through CHIP.
Available in all 50 states, typically at 138–200% FPL. Coverage usually continues for 60 days after birth (12 months in many states).
In the 41 states that have expanded Medicaid, adults qualify up to 138% FPL. In the 10 non-expansion states, non-disabled adults without dependents generally don't qualify.
People who receive SSI are automatically eligible for Medicaid in most states. Others with disabilities may qualify based on income, typically at 100% FPL.
Seniors with low income and limited assets may qualify for full Medicaid or Medicare Savings Programs that help pay Medicare costs.
Parents and caretaker relatives of children can qualify in all states, though income limits vary widely — from as low as 10% FPL in some states to 138% FPL in expansion states.
Medicaid Income Limits 2026
Income limits vary by eligibility category. These are the federal baseline limits — your state may be more generous.
| Category | Income limit | Monthly limit (family of 4) | Available in |
|---|---|---|---|
| Adults (expansion states) | 138% FPL | $3,795/mo | 41 states + DC |
| Adults (non-expansion) | Varies (very low) | — | 10 states |
| Pregnant women | 138–200% FPL | $3,795–$5,500/mo | All 50 states |
| Children (Medicaid) | 138–317% FPL | $3,795+/mo | All 50 states |
| Children (CHIP) | 200–317% FPL | $5,500+/mo | All 50 states |
| Disabled (SSI recipients) | Automatic | — | Most states |
| Parents / caretakers | 10–138% FPL | Varies by state | All 50 states |
Medicaid Expansion States 2026
The ACA gave states the option to expand Medicaid to cover adults earning up to 138% FPL. As of 2026, 41 states plus DC have expanded. The following 10 states have not expanded:
If you live in a non-expansion state and are not pregnant, a child, disabled, or elderly, you likely won't qualify for Medicaid regardless of income. You may qualify for an ACA marketplace subsidy instead.
How to Apply for Medicaid
Find your state's exact income limits, program name, and application link using our state guides.
Find your state guide →You'll need: proof of identity, Social Security numbers, proof of income (pay stubs, tax returns), proof of residency, and immigration status if applicable.
Most states accept online applications at their Medicaid portal. You can also apply through Healthcare.gov, by calling 1-800-318-2596, or at your local Medicaid office.
Most states must process applications within 45 days (90 days for disability cases). If approved, coverage is often retroactive to the date of application or the month before.
Frequently Asked Questions
What is the income limit for Medicaid in 2026?
For adults in expansion states, the income limit is 138% FPL — $1,835/month for a single person and $3,795/month for a family of four. Children and pregnant women have higher limits that vary by state. Non-expansion states have much lower or no limits for non-disabled adults.
Can I get Medicaid if I have a job?
Yes. Having a job does not disqualify you from Medicaid. What matters is your household income relative to the federal poverty level. Many working adults and families qualify for Medicaid even with full-time employment if their income is below the threshold.
What is the difference between Medicaid and Medicare?
Medicaid is a need-based program for people with low income, regardless of age. Medicare is an age-based program for people 65 and older (and some younger people with disabilities), regardless of income. Some people qualify for both — called "dual eligible" — and get coverage from each program.
Does Medicaid cover dental and vision?
It depends on your state. Federal Medicaid rules require coverage for children (dental and vision are mandatory for kids under 21). For adults, dental and vision are optional — some states cover them, some don't. Check your state's Medicaid program for specifics.
Can undocumented immigrants get Medicaid?
Federal Medicaid funding is generally not available for undocumented immigrants, with an exception for emergency medical services. Some states use state-only funding to provide coverage for certain groups — particularly children and pregnant women — regardless of immigration status. Check your state's rules.
What if I'm denied Medicaid?
You have the right to appeal a denial. Your denial notice will include instructions on how to appeal and the deadline (usually 90 days). If you're denied because your income is too high, check whether you qualify for an ACA marketplace subsidy — people between 100–400% FPL may get significant premium tax credits.