Medicaid Income Limits 2026

Quick Answer

Quick answer: For 2026, if your state expanded Medicaid, adults under 65 generally qualify with household income below 138% of the federal poverty level, calculated using MAGI rules with no asset test. Aged, blind, and disabled pathways instead use SSI-based income and resource rules, which vary by state.

Key Takeaways

• Medicaid is a joint federal-state program, so income and resource limits vary by state and by eligibility group; there is no single national Medicaid income limit.
• For most children, pregnant women, parents, and adults, eligibility is based on Modified Adjusted Gross Income (MAGI), which uses no asset or resource test.
• In states that expanded Medicaid, adults under 65 may qualify with income below 138% of the federal poverty level.
• People who are 65 or older, blind, or disabled are usually evaluated under SSI-based methodologies, which do include resource limits that differ by state.
• Always confirm your numbers with your state Medicaid agency or HealthCare.gov, because state programs and pathways differ significantly.

Introduction

If you are trying to figure out the Medicaid income limits for 2026, the most important thing to understand first is that Medicaid does not work like a single national program with one income cutoff. Medicaid is a joint federal and state program that, together with the Children’s Health Insurance Program (CHIP), provides coverage to over 77.9 million Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. Each state runs its own Medicaid program within federal rules, which means the exact dollar figure that determines whether you qualify depends on your state, your household size, your age, and which eligibility group you fall into.

This guide walks through how income limits actually work in 2026. We focus on the figures that are set at the national level and published by federal agencies, because those are the anchors you can rely on no matter where you live: the federal poverty guidelines from the U.S. Department of Health and Human Services (HHS), the Supplemental Security Income (SSI) federal benefit amounts from the Social Security Administration (SSA), and the Medicare Savings Program limits published by Medicare. Where a number is genuinely state-specific, we say so and point you to the right place to confirm it, rather than guessing.

Because Medicaid eligibility decisions affect your health coverage and your finances, accuracy matters more here than almost anywhere else. Every figure in this article is drawn from an official .gov source, and a full list of those sources appears near the end. Use this page to understand the framework, then verify your specific situation with your state Medicaid agency. For a broader overview of the program, see our Medicaid 2026 guide.

Medicaid Eligibility by Group in 2026

Medicaid eligibility is organized into groups, and the rules for counting income and resources differ depending on which group applies to you. Federal law requires states to cover certain mandatory groups. Low-income families, qualified pregnant women and children, and individuals receiving SSI are examples of mandatory eligibility groups. States can also choose to cover additional optional groups. The single biggest dividing line for income rules is whether your group is evaluated under MAGI rules or under SSI-related rules.

MAGI adults, children, pregnant women, and parents

The Affordable Care Act established a methodology for determining income eligibility for Medicaid based on Modified Adjusted Gross Income, or MAGI. MAGI is the basis for determining Medicaid income eligibility for most children, pregnant women, parents, and adults. The MAGI-based methodology considers taxable income and tax filing relationships to determine financial eligibility. Crucially, the MAGI-based methodology does not allow for an asset or resource test, so MAGI Medicaid generally has no asset limit. That means for these groups, what you own, such as a car or money in a bank account, does not count against you; only your income matters.

Children’s eligibility was extended to at least 133% of the FPL in every state, and most states cover children at higher income levels. Pregnant women and parents or caretaker relatives are also evaluated under MAGI, though the income thresholds for each of these groups are set by the state and differ widely. This is why a parent might not qualify while their child does: states frequently set higher income limits for children and pregnant women than for adults. To see how household size changes the math, our guide on Medicaid eligibility by household size breaks it down further.

The expansion group: adults at or below 138% FPL

The Affordable Care Act created the opportunity for states to expand Medicaid to cover nearly all low-income adults under age 65. Under HealthCare.gov’s plain-language explanation, if your state has expanded Medicaid and your income is below 138% of the federal poverty level, you may qualify for Medicaid. The Affordable Care Act set the statutory expansion threshold at 133% of the FPL, and a standard income disregard effectively raises the cutoff to 138% of the FPL that you will see most agencies cite. Most states have chosen to expand coverage to adults, and those that have not yet expanded may choose to do so at any time. The expansion group is purely income-based; expansion Medicaid is income-based and does not impose an asset test.

Whether expansion is available to you depends entirely on your state. If you live in a state that has not expanded Medicaid, you may fall into a coverage gap where your income is too high for traditional Medicaid but you may still qualify for savings on a Marketplace plan. HealthCare.gov is the place to check what applies in your state.

SSI-related: aged, blind, and disabled

Some individuals are exempt from the MAGI-based income counting rules, including those whose eligibility is based on blindness, disability, or age (65 and older). For these groups, Medicaid eligibility for individuals 65 and older or who have blindness or a disability is generally determined using the income methodologies of the SSI program administered by the Social Security Administration. SSI is for people who have little or no income, little or no resources, and who have a disability, are blind, or are age 65 or older. Unlike MAGI Medicaid, SSI-related pathways do consider resources.

A handful of states, known as 209(b) states, use certain more restrictive criteria than SSI but still largely apply SSI methodologies. If you are aging into Medicare, have a disability, or are helping an older relative, these pathways are usually the ones that matter most. Our resources on Medicaid for seniors 2026 and Medicaid for disabled adults 2026 go deeper on how these rules play out in practice.

MAGI vs. SSI-related Medicaid at a glance

The table below summarizes the two main eligibility frameworks so you can quickly see which one applies to you and how the rules differ.

Feature	MAGI Medicaid	SSI-related Medicaid
Asset/resource test?	No asset or resource test	Yes; resource limits apply (vary by state)
Income basis	Modified Adjusted Gross Income (MAGI)	SSI income methodologies
Who it generally covers	Most children, pregnant women, parents, and adults	People who are 65 or older, blind, or have a disability
Expansion adults	Income below 138% FPL in expansion states	Not applicable

Note one important nuance: certain Medicaid eligibility groups do not require a separate income determination by the Medicaid agency at all. Coverage may be based on enrollment in another program, such as SSI. In many states, getting SSI automatically makes you eligible for Medicaid, which is one reason the SSI rules matter so much for older adults and people with disabilities.

Medicaid Income Limits and Amounts for 2026

Because most Medicaid income limits are tied to the federal poverty level and set by individual states, the most useful national anchors are the federal figures that the limits are built from. Here are the verifiable 2026 numbers, straight from federal agencies.

The 2026 federal poverty guidelines

The federal poverty guidelines are updated each year by HHS and are the foundation for MAGI Medicaid income limits. For 2026, the federal poverty guideline is $15,960 for a single person and $33,000 for a family of four in the 48 contiguous states and the District of Columbia. The poverty guidelines are higher in Alaska and Hawaii than in the 48 contiguous states. When a state says its Medicaid limit is, for example, 138% of the poverty level, it is applying that percentage to these annual figures for your household size. For a deeper look at how the guidelines themselves are built, see our federal poverty level 2026 explainer.

The expansion threshold: 138% FPL

In states that expanded Medicaid, adults under 65 may qualify with income below 138% of the federal poverty level. This is the single most cited Medicaid income figure, but remember it only applies in expansion states and only to the adult expansion group. It does not set the limit for children, pregnant women, the aged, the blind, or people with disabilities, all of whom may have different thresholds. For 2026, your 2026 income is used to check whether you are eligible for Medicaid and CHIP.

SSI federal benefit amounts

For the aged, blind, and disabled pathways tied to SSI, the SSI federal benefit rate is a key anchor. After a 2.8 percent cost-of-living increase that became effective January 2026, the 2026 monthly maximum federal SSI amounts are $994 for an eligible individual and $1,491 for an eligible individual with an eligible spouse. On the resource side, Many SSI-related Medicaid pathways commonly use resource limits such as $2,000 for an individual and $3,000 for a couple, but rules vary by state and program. For a full breakdown of the SSI program itself, see our SSI 2026 guide.

Medicare Savings Program limits

If you have Medicare and limited income, the Medicare Savings Programs (MSPs) are a form of Medicaid help that pays Medicare premiums and, in some cases, other costs. Eligibility for the Medicare Savings Programs is determined using SSI methodologies. There are three main programs, each with its own 2026 monthly income and resource limits. The Qualified Medicare Beneficiary (QMB) program has a monthly income limit of $1,350 for an individual and $1,824 for a married couple, with resource limits of $9,950 (individual) and $14,910 (married couple). The Specified Low-Income Medicare Beneficiary (SLMB) program has a monthly income limit of $1,616 for an individual and $2,184 for a married couple, with resource limits of $9,950 (individual) and $14,910 (married couple). The Qualifying Individual (QI) program has a monthly income limit of $1,816 for an individual and $2,455 for a married couple, with resource limits of $9,950 (individual) and $14,910 (married couple).

2026 eligibility snapshot: national anchors

Program / anchor	2026 monthly income limit	2026 resource limit
Expansion Medicaid (adults under 65, expansion states)	Below 138% FPL	No asset test
SSI federal benefit rate (individual)	$994	$2,000 (commonly used; varies by state)
SSI federal benefit rate (individual with eligible spouse)	$1,491	$3,000 (commonly used; varies by state)
QMB (individual / married)	$1,350 / $1,824	$9,950 / $14,910
SLMB (individual / married)	$1,616 / $2,184	$9,950 / $14,910
QI (individual / married)	$1,816 / $2,455	$9,950 / $14,910

These are national reference points. Your state’s actual income limits for MAGI groups will be expressed as a percentage of the poverty guidelines above and will differ from the SSI and MSP figures, which are their own separate programs. If you are dual-eligible for both Medicare and Medicaid, our guide on Medicaid and Medicare dual eligibility explains how the two programs work together.

How to Apply for Medicaid in 2026

You can apply for Medicaid in two main ways: directly through your state Medicaid agency, or through the Health Insurance Marketplace at HealthCare.gov. Because a single application can screen you for Medicaid, CHIP, and Marketplace savings at once, many people start at HealthCare.gov and are routed to their state if they appear to qualify for Medicaid. There is no single open enrollment window for Medicaid; you can apply at any time of year.

To be eligible, you generally must be a resident of the state where you apply and either a U.S. citizen or a qualified non-citizen, such as a lawful permanent resident. Some eligibility groups are also limited by age, or by pregnancy or parenting status. When you apply, be ready to document your income, household size, and, for SSI-related pathways, your resources.

One feature worth knowing about is retroactive coverage. Once you are determined eligible, benefits may also be covered retroactively for up to three months prior to the month of application, if you would have been eligible during that period. This can help if you had medical bills before you applied. For a step-by-step walkthrough, see our guide on how to apply for Medicaid 2026, and once you are enrolled, our Medicaid renewal process 2026 guide explains how to keep your coverage active.

Common Mistakes to Avoid

Medicaid eligibility is full of details that trip people up. Here are the most common mistakes that lead to confusion or wrongful denials.

• Assuming there is one national income limit. There is not. Limits vary by state and by eligibility group. The 138% FPL figure applies only to the adult expansion group in states that expanded Medicaid.
• Assuming every Medicaid pathway has an asset test. The MAGI-based methodology does not allow for an asset or resource test, so for most children, pregnant women, parents, and adults, what you own does not count. Asset limits generally apply only to SSI-related pathways.
• Confusing MAGI with the income on your tax return. MAGI is its own calculation. It is your AGI plus untaxed foreign income, non-taxable Social Security benefits, and tax-exempt interest, but not Supplemental Security Income. It is not a single line on your tax form.
• Not applying because you think you earn too much. Because children and pregnant women often have higher limits, and because expansion states cover adults up to 138% FPL, many people who assume they are ineligible actually qualify. Applying is free.
• Mixing up SSI program limits with Medicaid income limits. The SSI federal benefit rate and the Medicare Savings Program limits are their own thresholds and are not the same as a state’s MAGI Medicaid income limits.
• Forgetting about spend-down options. If your income is slightly too high, your state may have a medically needy or spend-down program. Our Medicaid spend-down programs guide explains how that works.

State Variations You Need to Know

This point deserves its own section because it is the single most important thing to remember: Medicaid is state-run, and the rules vary by state. Medicaid is a joint federal and state program, and while federal law requires states to cover certain mandatory groups, states have wide latitude over income thresholds, optional coverage groups, and how some pathways are administered.

The biggest state-level variable is whether your state expanded Medicaid. Most states have chosen to expand coverage to adults under 65 up to 138% FPL, but some have not, and those that have not may choose to do so at any time. In non-expansion states, low-income adults without dependent children frequently cannot qualify for Medicaid regardless of how low their income is.

States also differ on income limits for children, pregnant women, and parents, on whether they operate a medically needy spend-down program, and on the precise resource rules for SSI-related groups. A handful of states, known as 209(b) states, use certain more restrictive criteria than SSI. Because of all this variation, no national chart can tell you your exact limit. Always confirm with your state Medicaid agency. If asset rules are your main concern, our Medicaid asset limits 2026 guide covers how resource tests differ across states and programs, and our Medicaid buy-in programs guide explains options for working people with disabilities whose income exceeds standard limits.

Official Sources

For the most accurate and current information, always rely on these official government sources rather than third-party charts:

• Medicaid.gov eligibility policy — the federal rules on MAGI, SSI-related eligibility, and mandatory groups.
• Medicare.gov Medicare Savings Programs — 2026 income and resource limits for QMB, SLMB, and QI.
• Social Security Administration — SSI — SSI eligibility, federal benefit amounts, and resource limits.
• HealthCare.gov — apply for Medicaid, CHIP, and Marketplace coverage, and check the 138% FPL expansion rule.
• HHS poverty guidelines — the 2026 federal poverty guidelines used to calculate income limits.

People Also Ask

What is the Medicaid income limit for 2026?

There is no single national limit. In states that expanded Medicaid, adults under 65 may qualify with income below 138% of the 2026 federal poverty level. Limits for children, pregnant women, and SSI-related groups differ by state and pathway, so confirm your specific limit with your state Medicaid agency.

Does Medicaid have an asset limit in 2026?

It depends on your pathway. The MAGI-based methodology used for most children, pregnant women, parents, and adults does not allow for an asset or resource test. SSI-related pathways for people who are aged, blind, or disabled do consider resources, with limits that vary by state and program.

What is the difference between MAGI and SSI-related Medicaid?

MAGI Medicaid uses Modified Adjusted Gross Income and has no asset test; it covers most children, pregnant women, parents, and adults. SSI-related Medicaid uses the income methodologies of the SSI program and applies resource limits; it generally covers people who are 65 or older, blind, or have a disability.

What are the 2026 SSI amounts?

According to the Social Security Administration, the 2026 monthly maximum federal SSI amounts are $994 for an eligible individual and $1,491 for an eligible individual with an eligible spouse. These reflect a 2.8 percent cost-of-living increase effective January 2026. Some states supplement these federal amounts.

How do I apply for Medicaid in 2026?

You can apply through your state Medicaid agency or through HealthCare.gov, which screens for Medicaid, CHIP, and Marketplace savings with one application. You can apply at any time of year. Once approved, benefits may be covered retroactively for up to three months before the month of application if you were eligible then.

Conclusion

The phrase “Medicaid income limit 2026” suggests one number, but the reality is a framework that depends on your state, your household, your age, and your eligibility group. The figures you can rely on nationally are the ones published by federal agencies: the 2026 poverty guidelines of $15,960 for an individual and $33,000 for a family of four, the 138% FPL cutoff for the adult expansion group in expansion states, the 2026 SSI amounts of $994 and $1,491, and the Medicare Savings Program limits for QMB, SLMB, and QI.

Just as important as the numbers are the principles: MAGI Medicaid generally has no asset test, expansion Medicaid is income-based, not all groups have asset limits, and the rules vary meaningfully from state to state. If you are unsure whether you qualify, do not rule yourself out. Apply through HealthCare.gov or your state Medicaid agency, confirm your figures with the official sources listed above, and use spend-down or buy-in options if your income is slightly over the line. Compared with the choices you make about Medicare, summarized in our Medicare vs. Medicaid guide, Medicaid eligibility rewards checking carefully and applying even when you are unsure.

Reviewed by the Guru Gazette Editorial Review Team · Last reviewed June 2026 · Fact-checked June 2026. Every figure is verified against official .gov sources; see our Fact-Checking Policy.