How Much Money Can You Make To Get On Medicaid? | Income Map

Medicaid looks at your household’s modified adjusted gross income (MAGI) against a percentage of the federal poverty level (FPL). The cutoffs differ by state and by group: adults, parents, kids, pregnant people, and people who qualify through disability or long-term care. This guide shows the math, the ranges, and where to check the latest numbers.

How Much Money Can You Make To Get On Medicaid? Income Rules Explained

People often ask, “How Much Money Can You Make To Get On Medicaid?” because the answer hinges on group and state. The baseline for many groups is 138% of FPL (the 133% standard plus a 5% disregard). Expansion states use this for adults 19–64. Other groups use different bands. Parents in non-expansion states can face lower cutoffs. Kids and pregnant people usually have higher ceilings through Medicaid or CHIP. People who qualify through disability or long-term care follow different rules that aren’t MAGI-based.

2025 FPL Math At A Glance

The table below uses the 2025 poverty guidelines for the 48 contiguous states and D.C. to show 100% and 138% FPL annual income levels. Alaska and Hawaii use separate figures.

Household Size	100% FPL (Annual)	138% FPL (Annual)
1	$15,060	$20,783
2	$20,440	$28,207
3	$25,820	$35,632
4	$31,200	$43,056
5	$36,580	$50,480
6	$41,960	$57,905
7	$47,340	$65,329
8	$52,720	$72,754

MAGI, Household, And What Counts

MAGI uses tax-based rules. It starts with adjusted gross income, then adds items like non-taxable Social Security and tax-exempt interest. Who counts in your household follows tax filing relationships in most cases. This keeps rules aligned across Medicaid, CHIP, and Marketplace aid.

How Much Money To Get On Medicaid: State-By-State Reality

Medicaid is a state-run program with federal rules. That blend means ranges. Adults in expansion states qualify up to 138% FPL. In non-expansion states, parents can face lower bands tied to FPL; some single adults may only qualify through a disability path. Kids can qualify at higher levels through Medicaid or CHIP. Pregnant people often qualify at higher FPL levels as well, with extended postpartum coverage in many states.

Where To Check The Official Numbers

The best route is two stops. First, confirm the current poverty guideline table for your household size, then match your state’s program limits. You can view the HHS poverty guidelines, then read your state’s rules starting from Medicaid eligibility policy. Both pages point to the rules.

How Income Limits Work By Group

Adults, 19–64

In expansion states, adults qualify up to 138% FPL. The five-percent disregard is already baked into that number. If your annual MAGI is below the 138% line for your household size, you’re in range to apply. Go by annual income unless your state asks for a current monthly snapshot during processing.

Parents And Caregivers

States set their own cutoffs. Some match 138% FPL. Others set lower bands tied to FPL for parents of minor children. If your state hasn’t expanded, parents can see tighter bands than adults in expansion states.

Kids And Teens (Medicaid Or CHIP)

States usually set higher limits for children through Medicaid and CHIP. Some reach 200% FPL and beyond. If a child’s income or family MAGI sits above Medicaid levels, CHIP can still be a path. Some CHIP programs charge small premiums or copays, capped at a small share of income.

Pregnant People

States often use higher FPL bands during pregnancy. Coverage can extend through a set postpartum window. Income counting rules follow MAGI, and many states grant fast-track enrollment for prenatal care.

People Who Qualify Through Disability

These pathways are not MAGI-based. SSI-related rules and state options apply. Income and assets are counted under different methods, and the test can include resource caps. States publish separate pages for these groups.

Long-Term Care And Waivers

Institutional and home-and-community-based services use special rules. Many states tie nursing facility eligibility to 300% of the SSI federal benefit rate, with separate asset tests. There are also rules for how much income a spouse at home can keep.

How Much Money Can You Make To Get On Medicaid? Real-World Checks

Use the table up top to gauge the band for adults in expansion states. Then look at your group. Parents, kids, and pregnant people often have different bands. People using disability or long-term care routes follow non-MAGI tests. If your income sits near a line, apply anyway. States verify with the latest data, and changes mid-year can shift your status.

Monthly Vs. Annual Income

MAGI uses annual income, but states often screen with monthly figures to see if you qualify right now. A job change, seasonal work, or a gap can move you below a line on a monthly view even when your annual figure looks higher. Report changes fast so the agency can adjust.

Household Size Pitfalls

Household counts are where people slip. The general rule tracks tax filing: you, your spouse if filing jointly, and your tax dependents. Some special cases apply, like a pregnant person counting as two in many states. Read your state page and match your filing plan when you apply.

Income Items That Often Surprise Applicants

• Non-taxable Social Security counts under MAGI.
• Tax-exempt interest counts.
• Child support received doesn’t count for MAGI groups.
• Self-employment uses net income after business expenses.
• Alimony counts only if it is taxable under your tax year’s rules.

If You’re Over The Limit

Check your child’s CHIP band. Then check Marketplace aid. Above the Medicaid cutoff, premium tax credits start at 100% FPL in many states and can run well above that range. A zero-premium plan may show up once the credits apply. If income later drops, you can switch to Medicaid when eligible.

Sample Scenarios To Match Your Situation

Single Adult In An Expansion State

You live alone and estimate MAGI at $20,000. For a household of one, 138% FPL is $20,783. You fall under the line, so you can apply as an adult in an expansion state.

Two-Parent Family, One Child

Household size is three. Your combined MAGI is $36,000. The 138% FPL line for three is $35,632. You’re a bit over the adult band in expansion states. Your child may still qualify through Medicaid or CHIP, depending on your state.

Pregnant Applicant With One Child

Some states count the pregnancy as two people for household size. That can shift the 138% line upward. Many states also set a higher band during pregnancy. Apply and let the caseworker run the exact test.

Worker With Fluctuating Hours

Your monthly pay swings with overtime. One month you’re over; the next you fall under. States can look at current monthly income and projected annual income. If you have a short-term dip, you might qualify now even if your year-end number lands higher.

Quick Rules By Coverage Group

Coverage Group	Typical Income Test	Notes
Adults, 19–64 (Expansion)	Up to 138% FPL	Applies in expansion states.
Parents/Caregivers	State-set FPL band	Can be below 138% in some states.
Children (Medicaid)	Higher FPL bands	Varies; CHIP covers above Medicaid.
CHIP	State-set bands	Small premiums/copays in some states.
Pregnant People	Higher FPL bands	Postpartum coverage window common.
SSI-Related	Non-MAGI rules	Income and assets both tested.
Long-Term Care	Special LTC rules	Many states use 300% of SSI FBR.
Medically Needy	Spend-down	Some states only; meet a monthly need.

How To Check Your State And Apply

Step 1: Find Your FPL Line

Use the 2025 table linked above. Match household size, then note 100% FPL.

Step 2: Match The Right Band

Pick the band for your group. Adults in expansion states use 138% FPL. Parents, kids, and pregnant people use the bands your state lists. Disability and long-term care follow their own tests.

Step 3: Compare Annual Income

Grab last year’s AGI and update with this year’s changes. Add in non-taxable Social Security and tax-exempt interest. That gives you MAGI for this test.

Step 4: Apply Online

Start at your state agency site or through the federal portal. If you’re near a line, send the application anyway. Agencies check data sources, and you can upload pay stubs to show a change.

Why Your Answer Can Differ From A Friend’s

Two families with the same income can get different answers because of household size, age, pregnancy, disability status, and state rules. That’s why the tables help, but the official pages decide. If a letter says no and your income shifts, apply again.

Final Pointers Before You Apply

• Use annual income for the MAGI test unless your state asks for a monthly snapshot.
• Match household size to your tax filing plan for the year.
• Check kids’ CHIP bands even when the adults miss the cut.
• If you need long-term services, read your state’s LTC income and asset rules.
• If you’re above Medicaid limits, check Marketplace savings next.

Keep copies of all documents and receipts securely.

Now you’ve seen how the math works, where the limits sit, and how to check the official pages. If you were asking, “How Much Money Can You Make To Get On Medicaid?”, the answer rests on your household size, group, and state. Run the steps, then file the application.