Medicaid Eligibility in Michigan: Income Limits & How to Apply
Medicaid Eligibility in Michigan
Michigan expanded its Medicaid program under the Affordable Care Act, opening Healthy Michigan Plan to adults aged 19-64 whose income falls at or below 138% of the federal poverty level. In 2026, that works out to roughly $21,597 for one person or $44,367 for a family of four.
Key threshold: If your income is below $21,597 (individual) or $44,367 (family of 4), you likely qualify for Healthy Michigan Plan with free or very low-cost coverage. No premiums, no deductibles.
Under Michigan'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 Healthy Michigan Plan
If you're a Michigan resident trying to understand your healthcare options, you'll want to know about the Healthy Michigan Plan, the state's Medicaid program, and how it connects with the HealthCare.gov marketplace. The Healthy Michigan Plan provides health care benefits to Michigan residents aged 19-64 with incomes up to 138% of the Federal Poverty Level (FPL). For 2025, this means an individual earning around $20,000 annually or a family of four with an income of about $37,000 would likely qualify. Other groups, including children, pregnant women, seniors, and individuals with disabilities, also have specific Medicaid pathways with different income thresholds. For instance, children up to age 18 can qualify with household incomes up to 217% FPL, and pregnant women up to 200% FPL. Michigan's Medicaid and Children's Health Insurance Program (CHIP) covered approximately 2.35 million people in 2023, with 1.1 million low-income adults covered by the Healthy Michigan Plan. The state's overall uninsured rate was 4.4% in 2023, lower than the national average.
If your income is slightly above the Healthy Michigan Plan's cutoff, you might still find affordable coverage through HealthCare.gov, the federal marketplace. Here, you could qualify for subsidies that significantly lower your monthly premiums. For example, Michigan's benchmark Silver plan averages around $401 per month, which is lower than the national average. With subsidies, many Michiganders have found plans for less than $10 per month. However, it's important to be aware that enhanced federal subsidies are currently scheduled to end after 2025, which could lead to higher premiums in 2026 if not extended. If your income changes throughout the year, it's crucial to update your information with the marketplace, as this could shift your eligibility between Medicaid and subsidized marketplace plans. During recent Medicaid redeterminations, many people lost coverage, but you can reapply for the Healthy Michigan Plan or explore marketplace options at any time if your circumstances change.
The Healthy Michigan Plan offers comprehensive benefits with little to no cost-sharing. Covered services generally include preventive care, doctor visits, hospital and emergency services, prescription medications, mental health, and substance use disorder treatment. Michigan also has unique programs and waivers, such as the MI Choice Waiver Program, which provides home and community-based services for seniors and individuals with disabilities who would otherwise need nursing home care. Telehealth services are also covered under the Healthy Michigan Plan, improving access to care, especially for those who might face transportation challenges.
When navigating Michigan's healthcare system, be mindful of potential processing delays for applications and ensure you have all necessary documentation. While the Healthy Michigan Plan does not have an asset test for most adult applicants, certain other Medicaid programs, particularly for long-term care, do have asset limits. For example, a single individual applying for some long-term care Medicaid programs may have an asset limit of $2,000. Managed care plans are widely used in Michigan Medicaid, and you'll typically choose a plan after being approved for coverage. If you were impacted by recent Medicaid unwinding, you can reapply through MI Bridges or by calling the application helpline at 1-855-276-4627.
Michigan Medicaid Income Limits 2026
The following table shows the key income thresholds for Michigan 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 Healthy Michigan Plan. If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.
Michigan's benchmark premium of $401/month falls below the national average of roughly $525. For residents transitioning from Medicaid to marketplace coverage, the cost difference is less dramatic than in many states.
Marketplace Insurance in Michigan
Michigan residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Michigan costs approximately $401/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 Michigan 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.
Michigan participates in the federal marketplace at HealthCare.gov. During the application, your income is evaluated for both Medicaid eligibility and marketplace subsidy amounts simultaneously.
Michigan adopted Medicaid expansion, bringing Healthy Michigan Plan coverage to low-income adults who previously had no affordable option. The transition between Medicaid and marketplace coverage is handled through HealthCare.gov.
How to Apply for Healthy Michigan Plan
- Start online at HealthCare.gov — the application automatically screens for Healthy Michigan Plan eligibility based on your household income.
- Go through the state directly — Michigan's Medicaid office accepts applications year-round with no enrollment window.
- Get phone support — Michigan's Medicaid hotline can walk you through the process and verify eligibility.
- In-person options — Local social services offices and community health navigators can assist with your application.
Have the following ready: recent pay stubs or tax returns, proof that you live in Michigan, Social Security numbers for everyone in your household, and details on any existing health insurance.
Calculate Your Subsidy in Michigan
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Michigan.
Check Your Eligibility →Frequently Asked Questions
What is the income limit for Medicaid in Michigan?
In 2026, the Medicaid income limit in Michigan 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.
Has Michigan expanded Medicaid under the ACA?
Yes, Michigan has expanded Medicaid under the ACA. Adults aged 19-64 earning up to 138% of the federal poverty level qualify for Healthy Michigan Plan.
Am I eligible for health insurance subsidies in Michigan?
Yes. Michigan 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 HealthCare.gov.
What is the Michigan Medicaid program called?
Michigan's Medicaid program is known as Healthy Michigan Plan. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and adults up to 138% FPL.
How do I keep my health insurance if I lose Medicaid in Michigan?
If your Healthy Michigan Plan 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 HealthCare.gov. 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 Michigan?
Yes. Medicaid eligibility in Michigan 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 Healthy Michigan Plan even if you work full-time. Many Healthy Michigan Plan enrollees are working adults.
What's the difference between Medicaid and marketplace insurance in Michigan?
Medicaid (Healthy Michigan Plan) provides free or very low-cost coverage with no premiums. Marketplace plans in Michigan average $401/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
- Indiana Medicaid Eligibility — Expansion state
- Ohio Medicaid Eligibility — Expansion state
- Wisconsin Medicaid Eligibility — Non-expansion state