Medicaid Income Limit Calculator

Medicaid covers more than 80 million Americans, yet income eligibility rules vary so dramatically by state, household type, and program category that even experienced healthcare navigators frequently need to verify thresholds before advising clients. A single adult in one state may qualify at 138% of the federal poverty level under ACA Medicaid expansion while their counterpart in a non-expansion state faces a limit as low as 18% FPL for working adults without dependent children. According to KFF Health Policy, more than 40% of uninsured adults in non-expansion states would qualify for Medicaid if their state had expanded coverage, making the eligibility calculation not just an administrative task but a consequential one. The calculation uses Modified Adjusted Gross Income (MAGI) methodology for most non-elderly adults and children, which differs from standard MAGI used in tax filings in several ways that catch applicants and caseworkers off guard. This calculator applies current-year income limits by state, household category, and family size to produce an accurate eligibility determination.

This calculator determines Medicaid income eligibility based on state, household size, age group (adult, child, pregnant, elderly/disabled), and monthly income. It uses 2026 federal poverty level figures and state-specific expansion status. For MAGI-based categories (under 65, non-disabled), it calculates MAGI household income as a percentage of FPL. For aged, blind, and disabled categories, it applies the SSI-linked income methodology. The tool outputs whether the household is likely eligible, which Medicaid program category applies, and whether they should also check CHIP eligibility for children.