Find Out if You're Eligible for Medicaid
In most states, you can get Medicaid if you make less than $21,597 per year as a single person or $44,367 per year as a family of four.
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But in some states, you need to have a low income and meet other requirements, like being pregnant or having a disability. You also usually have to be a U.S. citizen or a permanent resident to get Medicaid.
How to qualify for Medicaid
In most states, a single person earning $21,597 or less per year or a family of four with an annual income of $44,367 or lower is eligible for Medicaid.
Because the cost of living is higher in Alaska and Hawaii, you can make more and still get Medicaid. In AK, single adults can get Medicaid if they make up to $26,979 per year. In Hawaii, the income limit is $24,826 per year.
But in states that haven't expanded their Medicaid programs, the income limit is much lower. Adults without children often don't even qualify unless they meet another requirement, like being pregnant or having a disability.
2025 Medicaid income limits by state
State | Individual income limit | Parents in a family of four |
|---|---|---|
| Alabama | N/A | $5,787 |
| Alaska | $26,979 | $55,462 |
| Arizona | $21,597 | $44,367 |
| Arkansas | $21,597 | $44,367 |
| California | $21,597 | $44,367 |
Source: KFF. Info is current as of Feb. 2025 and does not include info for waiver programs. Income limits are annual.
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Medicaid changes in 2025
Medicaid rules may rapidly change in 2025. The federal government is looking for ways to cut Medicaid spending. One potential change is that Medicaid will require some recipients to show that they're working.
If you're on Medicaid, stay up to date with the potential changes to the program. Your state Medicaid office should be able to help you understand how any changes affect you and your eligibility for coverage.
Medicaid expansion by state
Medicaid uses the federal poverty level (FPL) as a baseline to determine eligibility. The Affordable Care Act gave states the option to expand coverage to anyone earning up to 138% of the poverty level. Forty states and Washington, D.C., have expanded their Medicaid programs, which means you only have to have to meet the income requirements to qualify.
States without expanded Medicaid
In 10 states, you can only get Medicaid if you have a low income and you meet other requirements, like being blind or pregnant.
- Alabama
- Florida
- Georgia
- Kansas
- Mississippi
- South Carolina
- Tennessee
- Texas
- Wisconsin
- Wyoming
Each state has some control over their Medicaid requirements. For example, parents in South Carolina can make more money and get Medicaid than parents in Florida or Texas. If you live in a state that hasn't expanded Medicaid, you should work with your state's Medicaid office to find out if you're eligible.
Who else can get Medicaid?
Parents, children, people with disabilities, pregnant women and senior citizens with low incomes can get Medicaid in every state, even if a state hasn't expanded its Medicaid program.
Families and children
Families with children qualify for Medicaid depending on income. Coverage typically ends after the child turns 19, although, in some cases, it may extend up to age 21.
Children in foster care at the age of 18 can get free Medicaid coverage until they turn 26.
Children can also get Medicaid even if their families have higher income limits. For example, parents with two kids in Connecticut have to make less than $44,367 per year to get Medicaid for themselves. But the same family could make up to $64,622 per year and get coverage for their children.
Income limits for Children's Medicaid for a family of four
Children 0-1
Children 1-5
Children 6-18
State | Income limit |
|---|---|
| Alabama | $46,939 |
| Alaska | $71,136 |
| Arizona | $48,868 |
| Arkansas | $47,261 |
| California | $66,872 |
Source: KFF. Info is current as of Jan. 2025 and does not include eligibility for the Children's Health Insurance Program (CHIP). Income limits are annual.
Children 0-1
State | Income limit |
|---|---|
| Alabama | $46,939 |
| Alaska | $71,136 |
| Arizona | $48,868 |
| Arkansas | $47,261 |
| California | $66,872 |
Source: KFF. Info is current as of Jan. 2025 and does not include eligibility for the Children's Health Insurance Program (CHIP). Income limits are annual.
Children 1-5
State | Income limit |
|---|---|
| Alabama | $46,939 |
| Alaska | $71,136 |
| Arizona | $46,939 |
| Arkansas | $47,261 |
| California | $45,653 |
Source: KFF. Info is current as of Jan. 2025 and does not include eligibility for the Children's Health Insurance Program (CHIP). Income limits are annual.
Children 6-18
State | Income limit |
|---|---|
| Alabama | $46,939 |
| Alaska | $71,136 |
| Arizona | $44,367 |
| Arkansas | $47,261 |
| California | $42,760 |
Source: KFF. Info is current as of Jan. 2025 and does not include eligibility for the Children's Health Insurance Program (CHIP). Income limits are annual.
If you make too much to get Medicaid for your children, you might still be able to get coverage from the Children’s Health Insurance Program (CHIP). The two programs are very similar, but the Children's Health Insurance Program lets you make more and still get coverage for your kids.
When you get Medicaid for your children, your coverage will pay for certain types of health care, including:
- Vaccines
- Routine checkups
- Prescription medications
Pregnant women
Pregnant women who have low incomes can get Medicaid. However, how much you can make depends on where you can live. For example, if you live in Washington, D.C., you can make twice as much as you could in Arizona and still get Medicaid. Talk to your state's Medicaid office to find out if you qualify.
For Medicaid eligibility, pregnant women are usually counted as two people, or more if they're having twins or triplets. Essentially, a pregnant woman is counted as herself plus the number of babies she's going to have.
So if a woman is pregnant with a single baby, she's usually counted as two people for eligibility purposes. If she's pregnant with twins, she usually counts as three people. This could change by state, though, so check your specific state rules.
In nearly every state, Medicaid pays for postpartum care for a year after you give birth. In Wisconsin, Medicaid pays for postpartum care for three months after you have your baby.
In Arkansas, a bill to extend postpartum care was passed through the state House of Representatives but failed in the state Senate. Currently, Arkansas Medicaid only covers postpartum care for two months after birth.
After Medicaid coverage ends, you can sign up for private health insurance through HealthCare.gov or your state’s health insurance exchange. You don't have to wait for open enrollment because you will have what's called a "special enrollment period" that lasts for 60 days from the end of your Medicaid coverage.
The Children's Health Insurance Program (CHIP) is an option for pregnant women in some states, even if they make too much for Medicaid.
Covered services include:
- Prenatal doctor visits
- Prenatal vitamins
- Labor and delivery
- Postpartum checkups
People with certain disabilities
Medicaid is an option for people with certain disabilities such as traumatic brain injuries, cerebral palsy and schizophrenia. Check with your state Medicaid department for a full list.
In many states, if you get disability payments through the Social Security Administration, you will also qualify for Medicaid.
Seniors age 65 and up
If you're over 65 and you get Supplemental Security Income (SSI) payments, you’re automatically able to get Medicaid. You might even be able to get Medicaid along with Medicare. This is called "dual eligibility."
When you get medical care, Medicare will almost always be your primary coverage. Medicare pays first and then Medicaid will pay for some or all of the remaining costs, assuming the medical care is covered. For example, neither Medicare nor Medicaid will cover cosmetic procedures like a facelift.
How to apply for Medicaid
You can apply for Medicaid through your state’s Medicaid website.
If you're applying for a policy on HealthCare.gov, you'll automatically be checked for Medicaid eligibility. If you qualify for Medicaid, your state Medicaid office will contact you to sign up.
- Check with HealthCare.gov or your state if you can get Medicaid.
- Get your info and docs ready. This includes your birth certificate, driver’s license, pay stubs, bank statements, rental agreement and Medicare card, if you have Medicare.
- Fill out and submit an application for Medicaid through your state’s online portal or by mail to your state's Medicaid office.
Many states have unique names for their Medicaid and CHIP programs. For example, in California Medicaid is called Medi-Cal.
You can sign up for Medicaid anytime, as long as you qualify. That's because, unlike health insurance, Medicaid doesn't have an "open enrollment period."
Frequently asked questions
What is the primary eligibility requirement for Medicaid?
To get Medicaid in most states, you have to make less than $21,597 per year if you're single or $44,367 per year if you're part of a family of four. In a few states, you also have to meet other requirements, like being blind or having another disability.
How much does Medicaid cost per month?
Medicaid is free for many people. But in some states, depending on the Medicaid program you are on, you might have to pay a cheap monthly rate. Some Medicaid programs also require you to pay a small share of your medical bill. For example, in Florida, you have to pay up to $2 when you go to a doctor's office and up to $7.50 for each prescription medication you get.
What disqualifies a person from Medicaid?
The main thing that disqualifies you from Medicaid is your income. If you're single and make more than $21,597 per year, you won't be able to get Medicaid in most states. Some states have lower income limits, which means you have to make even less to qualify. In those states, you also have to meet another requirement, like being a parent or having a disability.
Sources
Info about Medicaid eligibility is from the Medicaid website. Federal poverty level (FPL) guidelines for the state-by-state Medicaid requirements are from KFF.
Other sources include the Florida Legislature, HealthCare.gov, InsureKidsNow.gov, the Medicaid and CHIP Payment and Access Commission (MACPAC), Medicaid.gov, the National Collaborative for Infants and Toddlers (NCIT), the Social Security Administration (SSA), the Texas Department of Health and Human Services and the U.S. Government Accountability Office.
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