How Much Is Medicaid a Month? Income Limits vs. Premiums (2026)

People asking "how much is Medicaid a month" are usually asking two different things. Either they mean: "How much can I earn and still qualify?" — which is the income limit. Or they mean: "What will Medicaid actually charge me each month?" — which is the premium. These have completely different answers. For most enrollees, the second answer is $0, full stop. But whether you clear the first question depends on your state and household size. Here is both, sorted.

Question 1: How much can I earn? The 2026 income limits

Standard Medicaid for adults under 65 uses a single income test: your household's Modified Adjusted Gross Income (MAGI) compared to the Federal Poverty Level. For 2026, the threshold is 138% FPL in the 40 states (plus DC) that have expanded Medicaid under the ACA.

Income below that line? You likely qualify. Income above it? You may still qualify for a subsidized marketplace plan — and our subsidy calculator can show you exactly what that would cost. The income limits above apply in expansion states. If your state has not expanded Medicaid, adult eligibility rules are narrower and vary significantly; check your specific state's page in our Medicaid eligibility guide.

One important clarification: MAGI Medicaid has no asset test. Your savings, bank balances, and second car are not counted — only your income is checked. If you're worried about savings affecting your eligibility, see our detailed breakdown in Medicaid asset limits for 2026. The $2,000 figure that circulates online applies to a different pathway entirely.

Question 2: What will I pay? The premium answer

For the large majority of Medicaid enrollees, the monthly premium is $0. Federal law — specifically, the Medicaid statute governing "cost sharing" — prohibits states from charging premiums to enrollees with incomes below 150% of the Federal Poverty Level, unless the state holds an approved Section 1115 demonstration waiver.

As of 2026, New Hampshire is the only expansion state actively charging premiums to standard adult enrollees under a Section 1115 waiver. New Hampshire's Granite Advantage program charges $60–$100/month for enrollees above 100% FPL. Notably, a 2025 federal budget law (the OBBBA) schedules a nationwide ban on all Medicaid expansion premiums by October 1, 2028 — so even this exception is time-limited. If you're in New Hampshire, check your current premium tier through the state's EASY portal.

Every other expansion state: $0 monthly premium for standard adult Medicaid. That is the rule, not the exception.

When Medicaid programs do charge: three situations

Three programs within the broader Medicaid system carry monthly costs. The confusion between them and standard Medicaid is what drives most "how much does it cost?" searches.

CHIP — Children's Health Insurance Program

CHIP covers children whose family income is above the Medicaid limit but below roughly 200–300% FPL (the threshold varies by state). It is administered alongside Medicaid but operates under different rules — and it charges premiums. The federal rules cap total family cost-sharing at 5% of household income per year. In practice, typical 2026 CHIP premiums run $15–$20/month on the low end, up to $60–$80/month for higher-income families, scaled by income bracket. For a full breakdown of CHIP eligibility and what your state charges, see CHIP eligibility for 2026.

Medicaid Buy-In — working people with disabilities

Medicaid Buy-In programs allow people with disabilities who work (and who would otherwise lose Medicaid coverage as their income rises) to stay enrolled by paying a monthly premium. These programs exist in 47 states, with income thresholds typically up to 250% FPL. The median monthly premium across states is approximately $25/month, though the range is wide — some states use a flat fee, others use sliding-scale calculations. If you're a working adult with a disability, Buy-In may be the pathway that keeps your Medicaid intact as your income grows.

Copayments — not premiums, but worth knowing

Standard MAGI Medicaid charges no monthly premium, but may charge small copayments at the point of service. Federal rules cap these at modest amounts: typically $4/visit for doctor's offices, $8 for non-emergency emergency room visits, and $4 for generic prescriptions. Many states have eliminated copays entirely for enrollees below 100% FPL. These are not monthly bills — they're usage-based, and they cannot be charged for children, pregnant individuals, emergency services, or preventive care.

How to know which rule applies to you

The premium you'd pay — or not pay — depends entirely on which pathway you're entering Medicaid through. Three questions sort it out:

• Are you an adult under 65 without a disability determination? You're on MAGI Medicaid. Monthly premium: $0 (except NH). Your only question is whether your income is under the state limit.
• Is this coverage for a child above the state Medicaid income limit? That's CHIP, not Medicaid. Expect $15–$80/month depending on income and state.
• Do you have a disability and earn above the standard Medicaid income limit? Look into Medicaid Buy-In. Monthly cost is roughly $25/month at the median, scaled by income.

If you're comparing Medicaid to a marketplace plan because your income is near the eligibility line — or above it — the cost comparison gets more specific. A marketplace plan with premium tax credits can cost $0–$150/month depending on income and plan selection; Medicaid is $0 if you qualify. Our Medicaid vs. Marketplace comparison walks through when each one is the better choice, and the subsidy calculator runs the exact numbers for your household. If your income is near the ACA threshold and you're tracking how subsidies interact with income, the explainer on what MAGI means for Medicaid is worth reading first.

Frequently asked questions

This article reflects Medicaid rules and Federal Poverty Level figures as of September 2026. State rules and waiver programs change — confirm current income limits and premium requirements with your state Medicaid agency or at HealthCare.gov. This is general information, not personalized legal or financial advice.