Medicaid Eligibility in Maryland: Income Limits & How to Apply
Medicaid Eligibility in Maryland
Maryland has expanded Medicaid under the Affordable Care Act. This means adults aged 19-64 with household income at or below 138% of the federal poverty level (FPL) qualify for Maryland Medicaid. This is approximately $21,597 per year for an individual or $44,367 per year for a family of four in 2026.
Key threshold: If your income is below $21,597 (individual) or $44,367 (family of 4), you likely qualify for Maryland Medicaid with free or very low-cost coverage. No premiums, no deductibles.
Under Maryland's expanded program, coverage extends to:
- Adults aged 19-64 with income up to 138% FPL
- Children in families with income up to 200-300% FPL (varies by age)
- Pregnant women with income up to 185-200% FPL
- Seniors and people with disabilities who meet income and asset requirements
About Maryland Medicaid
If you're a Maryland resident trying to understand your health coverage options, you've come to the right place. Maryland Medicaid, also known as Medical Assistance, is a crucial program that provides free or low-cost health care to many individuals and families across the state. You qualify for Maryland Medicaid if your income is up to 138% of the Federal Poverty Level (FPL). For example, as of February 2026, an adult in a one-person household could qualify with a monthly income up to approximately $1,835, while a family of four could qualify with a monthly income up to around $3,795. Children in Maryland have higher income limits, with eligibility extending up to 322% FPL, and pregnant individuals up to 264% FPL. This program is widely used, with approximately 1.5 million Marylanders enrolled in Medicaid in 2024, representing about 24% of the state's population. This demonstrates that it's a real and functioning program that supports a significant portion of the state's residents.
If your income is slightly above the Maryland Medicaid cutoff, you won't be left without options. You can transition to health coverage through the Maryland Health Connection, the state's official marketplace. Here, you may be eligible for significant subsidies that lower your monthly premium. For instance, the benchmark Silver plan in Maryland is around $435 per month, which is lower than the national average. With subsidies, your actual payment could be much less. For example, a 40-year-old in Baltimore City earning $20,000 a year could pay as little as $4 per month for a lowest-cost Silver plan, and a 27-year-old earning $20,000 could pay $0. It's important to remember that your income can fluctuate, and if it changes, you might shift between Medicaid and marketplace subsidies. Maryland recently went through a "Medicaid unwinding" period after the COVID-19 public health emergency, where many people had their eligibility redetermined. If you lost coverage during this time, you can reapply for Medicaid or explore marketplace options at any time.
Maryland Medicaid provides comprehensive benefits with little to no cost-sharing for most services. Your managed care organization (MCO) covers doctor visits, pregnancy care, prescription drugs, hospital and emergency services, mental health care, and substance use disorder treatment, among others. Children's dental and vision care are also included. Maryland also has several unique waiver programs, such as the Community Options Waiver, which provides home and community-based services for elderly and disabled individuals at risk of nursing home placement. Additionally, Maryland has been proactive in expanding telehealth services, with no geographic restrictions for telehealth and reimbursement for both audio-visual and audio-only visits. The state has also modernized its remote patient monitoring coverage, making it easier for providers to offer these services.
When navigating Maryland Medicaid, be aware of a few key things. While there are no asset limits for most Modified Adjusted Gross Income (MAGI) based Medicaid categories, some programs for seniors and individuals with disabilities may have asset limits. During the recent unwinding period, some individuals lost coverage due to administrative reasons, such as not receiving or understanding renewal notices. Always ensure the Maryland Department of Health has your current contact information. If you need to choose a Managed Care Organization (MCO), be aware that issues can arise; for example, one of Maryland's largest MCOs recently had its accreditation suspended, impacting new enrollments and giving current members a 60-day window to switch plans. Your concrete action step is to visit Maryland Health Connection online or call them to apply for coverage or update your information.
Maryland Medicaid Income Limits 2026
The following table shows the key income thresholds for Maryland in 2026:
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,650 | $21,597 | $62,600 |
| 2 | $21,150 | $29,187 | $84,600 |
| 3 | $26,650 | $36,777 | $106,600 |
| 4 | $32,150 | $44,367 | $128,600 |
| 5 | $37,650 | $51,957 | $150,600 |
| 6 | $43,150 | $59,547 | $172,600 |
If your household income falls below the 138% FPL column, you qualify for Maryland Medicaid. If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.
At $435/month for a benchmark Silver plan, Maryland has some of the more affordable marketplace premiums in the country. Residents just above the Medicaid threshold often pay very little out of pocket after subsidies.
Marketplace Insurance in Maryland
Maryland residents who do not qualify for Medicaid can purchase private health insurance through Maryland Health Connection. The average benchmark (second-lowest cost Silver) plan in Maryland costs approximately $435/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Maryland might pay after subsidies:
| Income Level | Annual Income | Expected Contribution | Estimated Monthly Premium |
|---|---|---|---|
| 150% FPL | $23,475 | 4.01% of income | ~$78/mo |
| 200% FPL | $31,300 | 6.52% of income | ~$170/mo |
| 250% FPL | $39,125 | 8.33% of income | ~$272/mo |
| 300% FPL | $46,950 | 9.83% of income | ~$385/mo |
| 400% FPL | $62,600 | 9.83% of income | ~$513/mo |
These are estimates for an individual. Actual premiums depend on your age, household size, tobacco use, and the specific plan you choose. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays.
Unlike most states, Maryland runs its own insurance marketplace through Maryland Health Connection. Residents shop for plans and apply for subsidies through this state-run platform rather than HealthCare.gov.
Maryland's Medicaid program goes beyond the ACA's minimum requirements. Maryland Medicaid includes comprehensive benefits, and the state's investment in its own marketplace reflects a broader commitment to accessible healthcare coverage.
How to Apply for Maryland Medicaid
- Online application — Start at Maryland Health Connection. Your Medicaid eligibility is checked automatically when you enter your income details.
- State Medicaid office — Apply directly through Maryland's Medicaid agency at any time during the year. Unlike marketplace insurance, Medicaid has no enrollment deadline.
- Phone assistance — Call Maryland's Medicaid helpline for guided help completing your application.
- In-person help — Visit your county human services office or a local navigator for face-to-face support.
Gather your documents before applying: proof of income (W-2s, pay stubs, or tax returns), proof of Maryland residency, Social Security numbers for all household members, and any current insurance information.
Calculate Your Subsidy in Maryland
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Maryland.
Check Your Eligibility →Frequently Asked Questions
How much can I earn and still qualify for Maryland Medicaid?
In 2026, the Medicaid income limit in Maryland is 138% of the federal poverty level: $21,597 per year for an individual, $29,187 for a household of 2, $36,777 for 3, and $44,367 for a family of 4.
Does Maryland have Medicaid expansion?
Yes, Maryland has expanded Medicaid under the ACA. Adults aged 19-64 earning up to 138% of the federal poverty level qualify for Maryland Medicaid.
Can I get ACA subsidies in Maryland?
Yes. Maryland residents with household income between 100% and 400% FPL ($15,650 to $62,600 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through Maryland Health Connection.
What is the Maryland Medicaid program called?
Maryland's Medicaid program is known as Maryland Medicaid. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and adults up to 138% FPL.
What should I do if my Maryland Medicaid coverage is ending?
If your Maryland Medicaid coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through Maryland Health Connection. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
Does working disqualify me from Medicaid in Maryland?
Yes. Medicaid eligibility in Maryland is based on your Modified Adjusted Gross Income (MAGI), not your employment status. If your household income is at or below 138% FPL ($21,597 for an individual), you qualify for Maryland Medicaid even if you work full-time. Many Maryland Medicaid enrollees are working adults.
What's the difference between Medicaid and marketplace insurance in Maryland?
Medicaid (Maryland Medicaid) provides free or very low-cost coverage with no premiums. Marketplace plans in Maryland average $435/month before subsidies — relatively affordable compared to other states. If you're right at the Medicaid income boundary, subsidized marketplace Silver plans with cost-sharing reductions can offer solid coverage.
Medicaid Eligibility in Nearby States
- Delaware Medicaid Eligibility — Expansion state
- Pennsylvania Medicaid Eligibility — Expansion state
- Virginia Medicaid Eligibility — Expansion state
- West Virginia Medicaid Eligibility — Expansion state