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Medicaid Income Limits by State: Who Qualifies in 2026?

Medicaid Income Limits by State: Who Qualifies in 2026?
Published April 17, 2026

Medicaid income limits vary wildly by state. In states that expanded Medicaid under the Affordable Care Act, a single adult earning up to about $20,783 per year can qualify. In states that didn't expand, that same adult may not qualify at all, no matter how little they earn.

Below you'll find income eligibility rules for every state, how expansion status changes the picture, how to sign up, and what to do if you fall in the coverage gap. If you're trying to figure out whether you qualify for Medicaid or need marketplace insurance instead, start here.

How Medicaid Income Eligibility Works

Medicaid uses a measure called the Federal Poverty Level (FPL) to set income thresholds. The FPL is updated each year by the Department of Health and Human Services. For 2026, the FPL for a single person in the contiguous 48 states and DC is $15,060 per year. For a family of four, it is $31,200.

Your Medicaid eligibility is expressed as a percentage of the FPL. If the limit in your state is 138% FPL for adults, a single person can earn up to about $20,783 per year and still qualify.

Medicaid counts your Modified Adjusted Gross Income (MAGI), which is your adjusted gross income plus any tax-exempt interest and certain foreign income. Unlike some other programs, Medicaid under MAGI rules does not count assets like savings or home equity for most applicants. Only income matters.

Key point: Medicaid income limits are different for different groups. Adults, children, and pregnant women each have their own thresholds, and those thresholds vary by state.

Medicaid Expansion: Why Your State Matters

The single biggest factor in Medicaid eligibility is whether your state has expanded Medicaid. Under the ACA, states were given the option to extend Medicaid coverage to all adults with household incomes up to 138% of the FPL. As of early 2026, 40 states plus the District of Columbia have adopted expansion.

In expansion states, the rules are simple. If you are an adult under 65, not pregnant, and your income is at or below 138% FPL, you qualify. You do not need to have children or be disabled. No categorical test applies.

In the 10 states that have not expanded Medicaid, adults without dependent children generally cannot qualify at any income level. Parents may qualify, but only at far lower thresholds, sometimes as low as 18% or 25% of the FPL.

States That Have NOT Expanded Medicaid

These 10 states have not adopted Medicaid expansion as of 2026:

*Wisconsin is a special case. Wisconsin did not formally expand Medicaid under the ACA, but it covers adults up to 100% FPL through a state waiver. No coverage gap exists in Wisconsin, even though it is not technically an expansion state. The adult income limit is lower than in expansion states (100% FPL vs. 138% FPL).

If you live in a non-expansion state and earn too much for traditional Medicaid but too little for marketplace subsidies, you may fall into the coverage gap. That means no affordable insurance option is available to you.

2026 Medicaid Income Limits: Adults

The table below shows the Medicaid income limits for adults in selected states. In expansion states, the threshold is generally 138% FPL. In non-expansion states, the limit for parents is far lower, and childless adults typically do not qualify.

State Expansion? Adult Limit (% FPL) Annual Income (Single)
California Yes 138% $20,783
New York Yes 138% $20,783
Ohio Yes 138% $20,783
New Mexico Yes 138% $20,783
Wisconsin Partial* 100% $15,060
Texas No Parents only: ~18% ~$2,711 (parents)
Florida No Parents only: ~26% ~$3,916 (parents)
Georgia No Parents only: ~35% ~$5,271 (parents)

In expansion states not listed above, the adult income limit is the same: 138% FPL, or about $20,783 for a single person. The rules are uniform across all 40 expansion states.

Not Sure If You Qualify for Medicaid or Marketplace Coverage?

Enter your income and household size to see your options and estimated savings.

Check Your Subsidy

Medicaid Income Limits for Children (CHIP)

Children qualify for Medicaid and the Children's Health Insurance Program (CHIP) at much higher income levels than adults. Every state covers children in families with incomes up to at least 200% FPL, and many states go well above that.

State Children's Limit (% FPL) Family of 4 Income
New York 405% $126,360
Illinois 317% $98,904
California 266% $82,992
Washington 312% $97,344
Texas 201% $62,712
Florida 210% $65,520

Even in states that have not expanded Medicaid for adults, children's coverage is broad. If your family earns too much for adult Medicaid, your children may still qualify for Medicaid or CHIP.

Medicaid Income Limits for Pregnant Women

Pregnant women have a separate Medicaid eligibility category with higher income limits than other adults. Most states cover pregnant women at 185% to 200% FPL or above. Some go much higher:

Medicaid coverage for pregnant women typically includes prenatal care, labor and delivery, postpartum care for at least 60 days after birth, and newborn coverage. Many states now extend postpartum coverage to 12 months.

The Coverage Gap: When You Earn Too Little for Subsidies

In the 10 non-expansion states, there is a gap in the system. Marketplace subsidies are designed for people earning between 100% and 400% FPL (or higher, if enhanced subsidies are in effect). Traditional Medicaid in these states covers parents only at very low incomes and generally excludes childless adults entirely.

People earning below 100% FPL but above their state's Medicaid limit have no affordable coverage option. The coverage gap affects an estimated 1.5 million Americans. Most live in Texas and Florida, the two states with the largest uninsured populations.

If you are in the coverage gap: You cannot be penalized for lacking insurance. You may qualify for community health centers, hospital charity care programs, or state-funded programs that operate outside of Medicaid. Check your state's health department website for local resources.

For a full comparison of your options, see our guide on Medicaid vs. marketplace insurance.

FPL Income Thresholds by Household Size (2026)

The Federal Poverty Level varies based on how many people are in your household. Here are the 2026 FPL figures for the contiguous 48 states and DC, along with what 138% FPL (the standard Medicaid expansion threshold) works out to:

Household Size 100% FPL 138% FPL
1 $15,060 $20,783
2 $20,440 $28,207
3 $25,820 $35,632
4 $31,200 $43,056
5 $36,580 $50,480
6 $41,960 $57,905

Alaska and Hawaii note: These states use higher FPL figures. In Alaska, the 2026 FPL for a single person is $18,810. In Hawaii, it is $17,310. Their Medicaid income limits are adjusted accordingly.

Medicaid Eligibility by State: Full Directory

Select your state below to see detailed Medicaid income limits, eligibility rules, and application instructions specific to where you live:

How to Sign Up for Medicaid

Unlike marketplace insurance, Medicaid does not have a limited enrollment period. You can apply any time of year. Here is how the process works:

Step 1: Check Your Eligibility

Before you apply, confirm that your income falls within your state's Medicaid limits. Use the state directory above or our subsidy calculator to get a quick estimate based on your income and household size.

Step 2: Gather Your Documents

You will typically need:

Step 3: Apply

You can apply through any of these channels:

Step 4: Wait for a Determination

Most states process Medicaid applications within 45 days (90 days for disability-based applications). If approved, coverage can start as early as the date you applied. In some cases, Medicaid can cover medical bills from up to three months before your application date.

Find Out What Coverage You Qualify For

Our free calculator shows whether you are eligible for Medicaid, marketplace subsidies, or both.

Check Your Subsidy

What Medicaid Covers

All state Medicaid programs must cover a set of mandatory benefits, including:

Many states also cover dental care, vision, and hearing services for adults, though these are optional benefits that vary by state.

Cost-sharing on Medicaid is minimal. Most enrollees pay no premiums. Copays, when they exist, run $1 to $4 per service. Federal law caps Medicaid copays at 5% of household income.

Medicaid vs. Marketplace Insurance: Which Should You Choose?

If your income puts you near the Medicaid eligibility line, you need to weigh the trade-offs between Medicaid and a marketplace plan:

For a detailed comparison, see our full guide: Medicaid vs. Marketplace Insurance: Which One Are You Eligible For?

The Bottom Line

Medicaid income limits depend on where you live. In the 40 expansion states, adults qualify with incomes up to 138% FPL, about $20,783 per year for a single person. Children qualify at much higher incomes in every state. Pregnant women have their own expanded thresholds.

The fastest way to check is to visit your state's eligibility page above or run your numbers through our calculator. You can apply for Medicaid any time of year. There is no enrollment window to miss.