Medicaid income rules hinge on your household’s MAGI and state limits, usually up to 138% of the federal poverty level for many adults.
You’re here to find the number. Good. Medicaid uses your household’s modified adjusted gross income (MAGI) and compares it to the federal poverty level (FPL). Most adults in states that expanded Medicaid qualify up to 138% of FPL after the standard 5-percentage-point disregard, while kids and pregnancy pathways often reach higher caps. The exact ceiling still depends on your state and eligibility group.
How Much Money Can You Make To Be On Medicaid: 2025 Limits By Household
Use the figures below as a fast benchmark. These reflect the 2025 FPL for the 48 contiguous states and D.C., plus the 138% FPL level that many adult applicants need to stay under. Alaska and Hawaii use higher FPLs, so their dollar amounts are higher.
| Household Size | 100% FPL | 138% FPL |
|---|---|---|
| 1 | $15,650 | $21,591 |
| 2 | $21,150 | $29,187 |
| 3 | $26,650 | $36,777 |
| 4 | $32,150 | $44,367 |
| 5 | $37,650 | $51,957 |
| 6 | $43,150 | $59,547 |
| 7 | $48,650 | $67,137 |
| 8 | $54,150 | $74,727 |
Reading the table: match your family size to the 138% column. If your MAGI sits at or below that number (and your state covers adults through the expansion group), you’re likely in range. Parents in some non-expansion states face much lower caps, while kids and pregnant people often qualify at higher percentages of FPL.
What Counts As Income For Medicaid (MAGI)
Medicaid financial checks for most children, pregnant people, parents/caretakers, and 19–64-year-old adults use MAGI. MAGI starts with your federal adjusted gross income, then adds back items like non-taxable Social Security benefits and tax-exempt interest. It’s household income, not just one person’s paycheck. If someone is claimed on your tax return, that person may be included in your Medicaid household.
The 5% FPL Disregard
There’s a built-in boost near the threshold. For MAGI-based groups, states apply a universal 5-percentage-point FPL disregard during the eligibility test. That’s why you’ll often hear “133%” yet see applications clear at “138%.” The disregard isn’t a coupon off your income; it’s a rule baked into the comparison against FPL.
Income Sources That Commonly Count
- Wages, salaries, tips
- Net self-employment income
- Unemployment compensation
- Taxable interest and dividends
- Taxable retirement income and pension withdrawals
- Alimony received (for divorces finalized before 2019, per IRS rules)
Items that don’t usually count toward MAGI include child support received and some disability benefits when not taxable. States follow federal MAGI rules for these categories, and edge cases can vary, so check your state’s application help if your situation is unusual.
State Differences You Need To Know
Medicaid is a federal-state partnership, so your state sets the specific cutoffs within federal guardrails. Many states cover adults up to 138% FPL. A few set lower caps for parents if they haven’t adopted the adult expansion. States also set higher limits for children and pregnancy coverage, often reaching 185%–250% FPL or more. A senior or a person with a disability may qualify through non-MAGI pathways with different income counting rules and, at times, asset tests.
Kids And Pregnancy Often Qualify At Higher FPL
Children’s Medicaid or CHIP frequently runs well above the adult cap. Pregnancy coverage also runs higher and includes postpartum coverage windows. If you’re near the line, still apply; many states have targeted categories designed to keep infants and children covered.
Alaska And Hawaii Use Higher Guideline Dollars
The same FPL percentages apply, but the dollar amounts for Alaska and Hawaii are higher. If you live in either state, check your state’s posted chart rather than the 48-state table above.
How To Estimate Your Eligibility In Minutes
If you like quick math, multiply the 100% FPL for your household size by 1.38. That’s your ballpark cap for adult expansion coverage. Then compare your projected yearly MAGI to that number. People often type the exact search: how much money can you make to be on medicaid? The simplest answer is “up to about 138% of FPL for many adults,” with higher caps for children and pregnancy coverage.
Monthly Vs. Annual Thinking
Applications ask for current income and may project the year. If your pay bounces around, estimate the year as best you can. Seasonal swings matter less if the annual total still lands under the limit.
Common Situations
- Multiple jobs or gig work: add taxable income from all sources to reach household MAGI.
- Recent raise or layoff: enter current income; you can report changes later if your situation shifts.
- Someone turns 19, 26, or moves in/out: household composition can change midyear; update your case so the record matches your tax household.
Use The Official Numbers While You Apply
The government publishes the FPL each year. Your state agency pulls these same figures when it runs eligibility. Here’s a helpful way to work through the math as you fill out the form:
- Find your household size on the current FPL table.
- Check the category that fits you (adult, parent, child, pregnancy).
- Compare your annual MAGI to the % FPL cap for that category.
- If you’re near the line, submit the application anyway. The system applies the 5% disregard for MAGI groups and checks every category you may fit.
For reference during your application, the annual HHS poverty guideline update explains the dollar thresholds, and the Medicaid eligibility policy page outlines how MAGI works for most groups.
Where The 138% Number Comes From
Federal law sets a base adult standard of 133% FPL for the expansion group, and the universal 5-percentage-point disregard pushes the effective test to 138%. That’s why many charts and explainers round to 138% when describing the adult cap.
| Eligibility Pathway | Typical % Of FPL | What That Means In Practice |
|---|---|---|
| Adults (Expansion States) | Up to 138% | Many 19–64-year-olds qualify at or below this level after the 5% disregard. |
| Parents/Caretakers | State-set (often lower if no expansion) | Some non-expansion states set caps far below 100% FPL; expansion states may map parents to the adult group. |
| Pregnancy Coverage | About 138%–200%+ (state-set) | Higher caps during pregnancy and postpartum; exact level depends on state. |
| Children (Medicaid/CHIP) | About 160%–250%+ (state-set) | Kids often remain eligible at higher FPL levels through Medicaid or CHIP. |
| Aged/Blind/Disabled (Non-MAGI) | Varies by program | Different rules may include asset tests; income treatment isn’t MAGI-based. |
Worked Examples Using The 2025 Table
Single Adult, Expansion State
You earn $21,000 from a salaried job. For a one-person household, 138% FPL is $21,591. You’re under the cap, so you’re likely eligible.
Family Of Four, Mixed Income
One parent earns $36,000, the other brings in $7,000 of gig income. Total MAGI is $43,000. For a four-person household, the 138% line is $44,367. The adults may qualify; kids likely qualify through Medicaid or CHIP even if the adults miss, since children’s caps run higher.
Parent In A Non-Expansion State
Your household has three people and $28,000 in MAGI. In a non-expansion state, the parent pathway could sit far below 138% FPL. You might miss as a parent, but a child may still qualify at a higher cap. If your state later adopts the adult expansion, the 138% line would apply.
How To Apply With Confidence
File online, by phone, or in person with your state Medicaid agency. Bring pay stubs or self-employment records if asked. If your income is irregular, you can submit a projection for the year and provide updates if things change.
- Report changes fast: new job, hours cut, someone moves in or out, pregnancy, or a birthday that shifts age category.
- Ask for a fair hearing: if you’re denied and you believe the income test was off, you can appeal.
- Don’t self-deny: if you sit near the threshold, apply anyway; the system checks every category you might fit.
Got A Tricky File? Tips For Edges And Exceptions
Self-Employment And Side Gigs
Use net self-employment income after business expenses that the tax code allows. Keep simple logs for mileage, supplies, and platform fees so your projection matches your tax file.
College Students And Young Adults
If a student is claimed as a tax dependent, MAGI often flows through the parents’ household. If not claimed and filing taxes alone, the student may be a household of one.
Mixed-Status Families
Medicaid checks immigration status for the person applying. U.S.-born kids in mixed-status homes can qualify even if a parent is ineligible. Income is still measured at the household level.
When Non-MAGI Rules Apply
People who qualify due to age or disability may have different income rules and, sometimes, resource checks. If that’s your situation, review the non-MAGI path with your state agency and ask about Medicaid with Medicare (dual eligibility) if you’re 65+ on Medicare.
Answering The Exact Search Question
Many readers ask the same thing in plain words: how much money can you make to be on medicaid? Use 138% of FPL as a quick adult target in expansion states, use the higher caps for kids and pregnancy where your state sets them, and check the latest state chart if you’re a parent in a non-expansion state.
Quick Checklist Before You Apply
- Pick your household size using your tax household.
- Scan the 2025 FPL table and find the matching 138% figure (or higher cap for kids/pregnancy).
- Estimate yearly MAGI from all taxable sources.
- Apply online or with your state office and upload docs if asked.
- Set a reminder to report any major income or household changes within the required window.
How Much Money Can You Make To Be On Medicaid? Final Word
Use the 138% adult line as your quick screen, keep in mind that kids and pregnancy categories often sit higher, and remember that states set the exact figures inside federal rules. If your income is close, apply. The system will run the 5% disregard and every category that fits your family.