Medicaid Eligibility Calculator (by State)

Medicaid eligibility is not based on a single national income number. Instead, it's calculated as a percentage of the Federal Poverty Level (FPL), which is updated annually. Your state then sets an FPL percentage as the income limit for different groups (e.g., adults, pregnant women, children).

First, here are the projected 2026 Annual Federal Poverty Levels for various household sizes.

Projected 2026 Federal Poverty Level (FPL)

For families/households with more than 8 persons, add $5,400 for each additional person.

Next, this table shows the corresponding annual income limits based on the FPL percentage your state uses. The 138% level is the most common limit for adults in states that expanded Medicaid.

2026 Annual Income Limits by FPL Percentage (Household of 1)

A common point of confusion is that Medicaid operates under two distinct sets of financial rules. The program you apply for determines whether your assets—like savings and investments—are counted. This calculator focuses on MAGI Medicaid, which is the more common pathway for people under 65.

1. MAGI (Modified Adjusted Gross Income) Medicaid

This is the system for most children, pregnant women, parents, and adults under 65 in states that expanded Medicaid. The rules are streamlined:

• Eligibility is based almost entirely on income. Your MAGI, which includes wages, self-employment income, retirement account distributions, and Social Security benefits, is compared to the FPL limit.
• Assets are NOT counted. This is a critical point. Your bank account balance, the value of your IRA, or your brokerage account do not affect your eligibility for MAGI Medicaid.

2. Non-MAGI ("Aged, Blind, and Disabled") Medicaid

This system applies to individuals who are 65 or older, blind, or have a qualifying disability. It is also the pathway for most long-term care coverage, such as nursing home care. The rules are much stricter:

• Eligibility is based on both income AND assets.
• Assets are strictly limited. The limit for countable assets is typically just $2,000 for an individual and $3,000 for a couple. Certain assets like your primary home (up to an equity limit) and one vehicle are usually exempt. Retirement accounts may or may not be counted depending on the state and whether you are taking distributions.

Understanding this distinction is vital for retirement planning. While an early retiree might qualify for MAGI Medicaid to bridge the gap to Medicare, a person over 65 seeking help with long-term care costs will face the much more restrictive non-MAGI asset tests.

The single biggest factor determining Medicaid eligibility for adults under 65 is whether their state chose to expand Medicaid under the Affordable Care Act (ACA).

Medicaid Expansion States

As of 2026, the vast majority of states have expanded Medicaid. In these states, eligibility for adults aged 19-64 is extended to those with household incomes up to 138% of the Federal Poverty Level. This creates a clear path to coverage for low-income working adults and early retirees who may not have access to employer-sponsored insurance before they turn 65 and qualify for Medicare. If you are planning an early retirement, living in an expansion state can be a critical part of your healthcare bridge strategy.

Non-Expansion States

In the handful of states that have not expanded Medicaid, the rules are significantly more restrictive.

• Childless adults generally do not qualify, regardless of how low their income is. There is no income-based pathway for them.
• Parents only qualify at extremely low income levels, often below 50% of the FPL. For a family of three in 2026, this could mean an income limit of just over $13,000 per year.

This creates a "coverage gap" in non-expansion states. Individuals may earn too much to qualify for Medicaid but not enough to receive subsidies to buy a plan on the ACA Marketplace. Checking your specific state's rules is essential.

The calculator determines your potential eligibility by running a few straightforward calculations based on projected 2026 Federal Poverty Level data.

First, it calculates the annual FPL for your specific household size.

Annual Federal Poverty Level = FPL for One Person + ((Household Size - 1) × FPL for Additional Person)

Where:

• FPL for One Person = The projected 2026 Federal Poverty Level for an individual, which is $15,320.
• Household Size = The number of people in your tax household.
• FPL for Additional Person = The amount added to the FPL for each extra person in the household, which is $5,400.

Next, it calculates your state's specific income limit based on the FPL percentage you provide.

Annual Medicaid Income Limit = Annual Federal Poverty Level × (State FPL Percentage / 100)

Where:

• Annual Federal Poverty Level = The result from the first formula.
• State FPL Percentage = The percentage limit for your category (e.g., 138% for an ACA expansion adult, 200% for a pregnant woman).

Finally, it determines if you are over or under the limit.

Monthly Income Difference = (Annual Medicaid Income Limit / 12) - Your Monthly Gross Income

Where:

• A positive result indicates your income is below the limit, suggesting you are likely eligible.
• A negative result indicates your income is above the limit.

What is the difference between Medicaid and Medicare?

Medicaid is a joint federal and state program that provides health coverage to millions of Americans with limited income and resources. It is needs-based. Medicare is a federal health insurance program primarily for people who are 65 or older, regardless of their income, as well as some younger people with disabilities. You can explore Medicare Part B premium costs with our specific tool.

What is the asset limit for Medicaid in 2026?

It depends on the program. For MAGI-based Medicaid (for adults under 65, children, etc.), there is no asset limit. For non-MAGI Medicaid (for those 65+, blind, disabled, or needing long-term care), the asset limit is very strict, typically around $2,000 for an individual.

Can I have a retirement account like a 401(k) or IRA and still qualify for Medicaid?

For MAGI Medicaid, yes. Since assets are not counted, the balance in your 401(k) or IRA is irrelevant. However, any distributions you take from these accounts count as income. For non-MAGI Medicaid, the rules are complex. A retirement account may be considered a countable asset unless it is in "payout status" (i.e., you are taking regular, periodic withdrawals).

Is Medicaid considered taxable income?

No. Medicaid benefits are not considered income for tax purposes. You do not have to report the value of your Medicaid coverage on your federal tax return.

Does my primary home count as an asset for Medicaid?

For MAGI Medicaid, it doesn't matter because there is no asset test. For non-MAGI/long-term care Medicaid, your primary residence is generally an exempt asset up to a certain equity value (over $700,000 in most states for 2026), provided you, your spouse, or a dependent child lives there.

How does Medicaid work for early retirees before they are eligible for Medicare?

In states that expanded Medicaid, an early retiree under 65 can qualify for MAGI Medicaid if their income is below 138% of the FPL. This can be a viable healthcare bridge. Planning your retirement drawdown strategy to keep your MAGI low is key. If your income is too high for Medicaid, you would likely seek coverage through the ACA Marketplace.

What is a Medicaid "spend-down"?

A Medicaid spend-down applies to non-MAGI applicants whose income or assets are too high to qualify. It allows you to "spend down" your excess resources on medical bills and long-term care costs. Once your income/assets are reduced to the Medicaid eligibility level, Medicaid will begin to cover your costs. This is a common strategy in long-term care planning.

Determining your eligibility is the first step in securing affordable healthcare coverage. Your financial situation can change, so it's wise to reassess your options annually.

• Use the Retirement Healthcare Cost Calculator to project your medical expenses throughout retirement.
• See how different withdrawal strategies impact your income and potential eligibility with the Retirement Drawdown Calculator.
• Model different scenarios to see how long your money will last with various income and expense assumptions.

Last updated: July 2026