Medicaid Income Limits 2026

The Short Answer: There Is No Single National Limit

Medicaid is a joint federal-state program, so income limits are set by pathway and by state. What federal sources publish are the anchors those limits are built from: the 2026 HHS poverty guidelines and the Medicare Savings Program standards. In expansion states, adults under 65 generally qualify with household income at or below an effective 138% of the federal poverty level (FPL), calculated under MAGI rules with no asset test. Children are covered to at least 133% of FPL in every state, and most states go higher. Overview: Medicaid 2026 guide.

2026 Federal Poverty Guidelines and the 138% Line

The 2026 guidelines were published in the Federal Register on January 15, 2026, and a CMS bulletin dated January 23, 2026 directed states to update their standards to the 2026 figures. The 138% column is computed from the official FPL amounts — it is not a separately published table — and a few states use different thresholds. Some early-2026 determinations may briefly have reflected 2025 values ($15,650 for one person; $32,150 for four); those are 2025 figures, not the current basis.

Alaska and Hawaii use higher guidelines. Why 138% and not 133%? The statute sets the expansion line at 133% of FPL, and a required 5-percentage-point disregard makes the effective threshold 138%. More: Federal Poverty Level 2026 and eligibility by household size.

MAGI vs. Non-MAGI: Which Rules Apply to You

Most children, pregnant people, parents, and adults are evaluated under MAGI, which counts taxable income and tax relationships and, by federal rule, applies no asset or resource test. People who are 65 or older, blind, or disabled are generally evaluated under SSI income methodologies, which typically include a resource test: the federal SSI limits are $2,000 (individual) and $3,000 (couple), with exclusions such as your home and one vehicle. State application of non-MAGI standards varies — 209(b) states may be more restrictive, and medically needy standards are state-set. Details: Medicaid asset limits 2026.

2026 Medicare Savings Program Limits

If you have Medicare and limited income, the Medicare Savings Programs pay Medicare premiums and, under QMB, cost sharing. The 2026 monthly income limits below apply in the 48 states and DC and include the standard $20 disregard; Alaska and Hawaii are higher, and some states use more generous standards.

QI requires annual reapplication and is not available to people who otherwise qualify for Medicaid. See Medicaid and Medicare dual eligibility.

Over the Limit? Options Vary by State

You may still have routes to coverage: a medically needy spend-down (36 states and DC operate spend-down programs), a Medicaid Buy-In for working people with disabilities, or another eligibility group in non-expansion states, where adults may otherwise face a coverage gap. Applying is free, and one application through HealthCare.gov or your state agency screens Medicaid, CHIP, and Marketplace savings at once. Steps: how to apply for Medicaid 2026.

Looking Ahead: January 1, 2027

Upcoming federal changes dated January 1, 2027 — six-month renewals for expansion adults, a community engagement requirement for certain expansion adults, and shorter retroactive coverage for new applications — change how often and how eligibility is checked, not the 138%-of-FPL income formula above. Details: renewal process guide.

Sources

• HHS/ASPE — 2026 Poverty Guidelines
• CMS — Informational Bulletin, Jan 23, 2026
• Medicaid.gov — Eligibility Policy
• eCFR — 42 CFR 435.603
• SSA — Understanding SSI: Resources
• Medicare.gov — Medicare Savings Programs
• CMS — Informational Bulletin, Dec 9, 2025 (2026 MSP resource standards)
• Federal Register — CMS-2454-IFC (June 3, 2026)
• HealthCare.gov — Getting Medicaid & CHIP

Last fact-check: July 29, 2026

Editorial status: Independent subject-matter review has not been completed.