Medicaid Eligibility Income Chart 2026: Why the Limit Changes by State

Information checked: 2026-09-09 · Maintenance label: State/local variable

Search for a Medicaid eligibility income chart and you will find dozens of tables, many of them contradicting each other. They are not all wrong. They are describing different states.

Medicaid is a joint federal and state programme. Federal law sets a floor and a framework; states decide a great deal above that floor. So a single national income chart cannot exist in the way people expect.

This guide explains what is federally fixed, what your state decides, and how to find the number that actually applies to you.

Key takeaway

Eligibility for most non-elderly applicants is calculated using Modified Adjusted Gross Income. Federal law let states extend eligibility to adults at or below 133% of the federal poverty level, and children are covered to at least 133% in every state, with most states going higher. Because expansion was a state option and states have further options above the floor, the limit that applies to you is a state number, not a national one.

Table of contents

• How income is measured
• What federal law fixes
• Why your neighbour's answer does not apply to you
• Finding your actual number
• If your income is above the limit
• Frequently asked questions
• Summary

How income is measured

The Affordable Care Act established Modified Adjusted Gross Income as the primary method for determining financial eligibility. The same methodology is used for Medicaid, CHIP and premium tax credits, and it takes account of taxable income and tax filing relationships.

Two implications are worth internalising before you compare yourself to any chart. First, MAGI is not the same as the number on your payslip. Second, who counts as part of your household follows tax filing relationships, so the household size you assume may not be the household size the agency uses.

What federal law fixes

A few things do not vary:

• Mandatory eligibility groups. States must cover certain groups, including low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income.
• A children's floor. Eligibility for children was extended to at least 133% of the federal poverty level in every state, and most states cover children at higher income levels.
• An adult expansion option. The Affordable Care Act created the opportunity for states to extend eligibility to adults with income at or below 133% of the federal poverty level.

That last one is the origin of most of the confusion, because it was an option rather than a requirement.

Check your own stateMedicaid.gov eligibility ›Income limits are set state by state. Start here, then open your own state's Medicaid agency for the figure that actually applies to you.

Why your neighbour's answer does not apply to you

Most states have chosen to expand coverage to adults. States that have not yet expanded may choose to do so at any time. States also have additional options and may choose to cover other groups beyond the mandatory ones.

Variable	Who decides	Effect on your limit
Adult expansion adopted	Your state	Determines whether a low-income adult without children has a pathway at all
Coverage level for children	Your state, above the federal floor	Many states cover children well above 133% FPL
Optional groups covered	Your state	Adds pathways that do not exist elsewhere
Household composition	Federal MAGI rules	Changes the poverty level figure your income is compared against

So a chart labelled “Medicaid income limits” without a state name attached is not usable for a decision.

Finding your actual number

1. Identify your state and whether it has adopted the adult expansion.
2. Work out your household as the MAGI rules define it, which follows tax filing relationships.
3. Find the current federal poverty level figure for that household size.
4. Apply your state's percentage threshold for your specific category, which differs for children, pregnant applicants, parents and other adults.
5. Apply through your state's own Medicaid agency, which makes the determination.

If you are close to a threshold, apply anyway. The determination is made by the agency against its own rules, and the categories are more numerous than the summary charts suggest.

Check your own stateMedicaid.gov eligibility ›Income limits are set state by state. Start here, then open your own state's Medicaid agency for the figure that actually applies to you.

If your income is above the limit

Two things worth knowing rather than giving up. Medicaid and CHIP applications are accepted year-round, not only during an enrolment period. And an income above the Medicaid threshold may place you in the range where Marketplace premium tax credits apply instead, which is a different programme with its own rules.

Children frequently qualify at higher income levels than adults in the same household, so a household above the adult threshold should still check the children's pathway.

Frequently asked questions

Is there one national Medicaid income limit?

No. Federal law sets floors and a framework; states set the operative limits above that, and adult expansion was a state option.

What is the difference between 133% and 138%?

The statutory expansion figure is 133% of the federal poverty level. Many published charts show 138% because of how income disregards are applied in practice. Use your state agency's own figure for a decision.

Does MAGI include everything I earn?

MAGI is a tax-based measure that considers taxable income and tax filing relationships. It is not simply gross pay, and household composition follows tax rules.

Can I apply outside an enrolment period?

Yes. Medicaid and CHIP applications are accepted throughout the year.

My income is slightly over. Should I still apply?

Yes. Categories are more numerous than summary charts show, and the determination is made by your state agency against its own rules.

Summary

The number you are looking for is a state number. National charts describe a framework, not your eligibility.

Work out your MAGI household, find your state's threshold for your specific category, and apply through the state agency. Children often qualify where adults in the same household do not.