Medicaid Income Limits 2026: Calculator + 50-State Chart

Category	2026 income limit	Income methodology
Expansion-state adult	138% FPL ($1,835/mo single)	MAGI
Children (Medicaid + CHIP)	200% to 405% FPL	MAGI
Pregnant women	185% to 405% FPL (median 205%)	MAGI (unborn counts)
Aged, blind, disabled (ABD)	$994/mo single, $1,491/mo couple	Non-MAGI (SSI rules)
Long-term care / HCBS waivers	$2,982/mo (300% SSI)	Non-MAGI + $2,000 asset cap
Medicare Savings Programs (QMB)	100% FPL ($1,330/mo single)	Non-MAGI + asset test

Married couples applying for nursing home Medicaid get special “spousal impoverishment” protections. The at-home spouse (called the “community spouse”) can keep between $2,643.75 and $4,066.50 per month in income (MMMNA range) and up to $162,660 in countable assets (CSRA maximum) in 2026, without those resources being counted against the applicant (CMS, 2026). See our guides to Medicare Savings Programs and Extra Help for Medicare Part D for related dual-eligible thresholds.

What is the maximum income for New York Medicaid in 2026?

New York Medicaid covers adults up to 138 percent of the federal poverty level under the state’s standard MAGI Medicaid program: $1,835 per month for a single adult and $3,142 per month for a family of 3 in 2026. New York also runs the Essential Plan (EP), a Basic Health Program that extends near-free coverage to adults with incomes between 138 and 200 percent FPL, or up to $2,660 per month for a single adult. The EP ceiling was rolled back from 250 percent to 200 percent FPL effective July 1, 2026 under the federal reconciliation law (HR1) (NY State of Health, April 2026).

Section 1931 parents in New York use a dollar-threshold rule adjusted annually by the CPI-U, which historically runs a few percentage points above the standard 138 percent MAGI floor. Practically speaking, if your NY household of 3 earns under about $3,140 per month, you qualify for full Medicaid; if you fall between that and $4,555 per month (200 percent FPL for a family of 3), you qualify for the Essential Plan. Apply at nystateofhealth.ny.gov.

What is the maximum income for Louisiana Medicaid in 2026?

Louisiana Medicaid covers adults up to 138 percent of the federal poverty level under Louisiana Healthy adults, the state’s ACA expansion program adopted in 2016 under Governor John Bel Edwards. For 2026, that ceiling is $1,835 per month for a single adult, $2,489 for a couple, and $3,795 for a family of 4. Children up to 217 percent FPL are covered by LaCHIP, and pregnant women up to 138 percent FPL are covered under standard Medicaid (Louisiana Department of Health, 2026).

Louisiana’s expansion group covers roughly 785,000 adults, which is one of the higher enrollment counts per capita in the South (KFF Louisiana Medicaid fact sheet, 2025). The program covers a full benefit package including primary care, hospitalization, mental health, prescription drugs, and dental. Apply through LADHH self-service portal or by calling 888-342-6207. Approval typically takes 30 to 45 days.

What is the highest income to qualify for Medicaid in Georgia?

Georgia has not adopted the ACA Medicaid expansion, so adult Medicaid income limits sit far below 138 percent FPL. For parents and caretakers, the cap is 35 to 38 percent of FPL in 2026, roughly $528 per month for a family of 3. Childless non-elderly adults are ineligible for regular Medicaid at any income (KFF, 2026).

Georgia’s Pathways to Coverage program, launched July 2023 under an 1115 waiver, covers adults with incomes up to 100 percent FPL ($1,330 per month for a single adult in 2026) but requires 80 hours of qualifying work, education, or volunteer activity per month. Enrollment has been modest, with roughly 8,000 adults covered as of June 2025, far below the state’s 47,000 first-year projection (Georgia Budget and Policy Institute, 2026). Children in Georgia qualify for standard Medicaid up to 205 percent FPL and PeachCare (CHIP) up to 247 percent FPL. Apply at Georgia Gateway.

What is the maximum income for Michigan Medicaid in 2026?

Michigan Medicaid covers adults through the Healthy Michigan Plan, the state’s ACA expansion adopted in 2014. The cap is 138 percent of the federal poverty level, or $1,835 per month for a single adult and $3,795 per month for a family of 4 in 2026. Children under age 19 are covered up to 217 percent FPL through MIChild, and pregnant women are covered up to 195 percent FPL (Michigan Department of Health and Human Services, 2026).

Michigan enforces a 5-year lookback for long-term care Medicaid, meaning any asset transfers made within 60 months of applying can trigger a penalty period. The state’s medically needy program uses a monthly MNIL of about $525 for a single adult, which triggers the spend-down for applicants over the standard income cap. Apply at MI Bridges or call your local MDHHS office.

MAGI vs non-MAGI: what counts as income for Medicaid?

Medicaid uses two different income tests depending on the coverage category. For adults, children, and pregnant women, states apply Modified Adjusted Gross Income (MAGI), the same tax-based formula the ACA marketplace uses. For seniors, disabled adults, and long-term care applicants, states apply the older SSI-based rules with different disregards and asset limits (Medicaid.gov, 2026).

What counts as income under MAGI

MAGI Medicaid counts wages, self-employment income, Social Security benefits (including the portion not taxed), unemployment, alimony from pre-2019 divorces, and most retirement withdrawals. It excludes SSI, child support received, most veterans’ benefits, workers’ compensation, and gifts. There is no asset test for MAGI groups. Only current monthly income counts, not projected annual income.

What counts under non-MAGI (ABD, long-term care)

Non-MAGI Medicaid counts nearly all cash income received in the month of application, including all Social Security payments and pensions. It applies a $20 general income disregard and, for earned income, a $65 disregard plus half of remaining earnings. Unlike MAGI, non-MAGI groups face a $2,000 individual asset limit ($3,000 couple in most states) and a five-year look-back on asset transfers for long-term care applicants.

Who auto-qualifies for Medicaid without an income check?

Roughly 7.4 million people are enrolled in Medicaid without going through a standard income application because federal or state law extends automatic eligibility to specific groups (Medicaid.gov, 2026). Knowing the auto-qualify paths saves months of paperwork for people who are already eligible without realizing it.

SSI recipients auto-qualify in most states through “SSI 1634” agreements delegating Medicaid enrollment to the Social Security Administration. A handful of states require SSI recipients to file a separate state Medicaid application but almost always approve them. Our SSI income limit guide walks through the underlying eligibility.

Deemed newborns (babies born to a Medicaid-enrolled mother) receive automatic Medicaid for the first year with no application. Former foster youth qualify automatically from age 18 through 26 in every state, with no income limit, under a 2014 ACA provision. Children receiving federal adoption assistance also auto-qualify. Certain Medicare Savings Program recipients qualify for Medicaid drug and cost-sharing help without a separate income screen.

What is medically needy Medicaid (spend-down)?

Thirty-four jurisdictions (33 states plus DC) operate a “medically needy” or “spend-down” program that lets applicants qualify by subtracting medical bills from their income until it falls below the state’s medically needy income limit (MNIL). KFF’s April 2026 tracker lists 34 total, though only 32 states cover older-adult and disabled populations through this pathway. The MNIL is typically much lower than the standard Medicaid cap, often between 25% and 100% FPL (KFF, 2026).

Here is how the math works. Say your monthly income is $2,500 and your state’s MNIL is $500. You have a $2,000 spend-down. If you incur $2,000 or more in medical bills during a set budget period (usually one to six months), Medicaid covers the rest. Bills you owe count even if they are unpaid, and past unpaid medical debt often counts toward the current period.

States that offer medically needy include NY, NJ, PA, IL, MI, FL, GA, NC, KY, LA, MD, DC, WI, IN, MN, MA, and many others. Texas, Arizona, Missouri, and most southern non-expansion states do not offer it, which is why many over-income seniors in those states end up on private pay for long-term care until they run down assets to qualify.

How do I apply for Medicaid in 2026?

You can apply four ways, and 2026 processing times average 30 to 45 days for MAGI cases and 45 to 90 days for ABD cases (Medicaid.gov, 2026). Federal law requires states to make an eligibility determination within 45 days for most applications and 90 days for disability-based applications. Delays beyond those windows create appeal rights.

Method one: apply through Healthcare.gov. The federal marketplace forwards your application to your state Medicaid agency if your income appears to qualify. This works for MAGI groups only, not seniors or long-term care. Method two: apply directly on your state Medicaid agency website (search “[your state] Medicaid apply”). Method three: mail or fax the state’s paper application to the address listed on the state site. Method four: apply in person at a county Department of Social Services office.

Have these documents ready: photo ID, Social Security numbers for everyone in the household, proof of income (recent pay stubs, tax return, benefit letters), proof of residency (utility bill, lease), and immigration documents if applicable. For ABD applications, add bank statements for the last 60 months, deed and vehicle titles, life insurance policies, and any trust documents. Our Medicaid program page has state-by-state application links.

What if I am denied Medicaid?

Every Medicaid applicant has the right to a fair hearing if denied, terminated, or reduced. Federal regulations at 42 CFR 431.220 require states to grant a hearing on request, and the deadline to file is usually 90 days from the denial notice date. If you file within 10 days of a termination notice, your coverage continues during the appeal.

Start by reading the denial notice carefully. It must state the specific rule cited, the income or asset finding, and the appeal deadline. Common reversible errors include: the state counted income that should be excluded (SSI, VA aid and attendance, child support received), miscounted household size, missed a disability determination, or failed to consider spend-down.

Request the hearing in writing (email counts in most states) and reference the case number and denial date. Bring documentation to the hearing: bank statements showing the true monthly income, doctor’s statements for disability claims, marriage or custody papers to prove household composition, and a written summary of your position. Free legal help is available through Legal Aid, the National Health Law Program, and state SHIP counselors for seniors.

What is the bottom line on 2026 Medicaid income limits?

The single most important number in Medicaid is 138% FPL, which sets the adult income limit at $1,835 per month or $22,025 per year for a single person in 40 states plus DC. Children, pregnant women, and disabled applicants use different limits that are usually higher (children, pregnancy) or built on SSI rules (disability, long-term care). Ten non-expansion states still leave a coverage gap that traps roughly 1.2 million adults with no path to affordable coverage (KFF, July 2026).

State agencies update dollar figures each spring after HHS releases the new poverty guidelines in January. If you are near the income cap, apply anyway; states must screen you for every eligibility category, and a denial in one category may still yield approval in another (pregnancy, disability, medically needy). Related guides: TANF income limits and CHIP income limits.