Medicaid Eligibility Calculator

Check if you qualify for Medicaid based on income, household size, and state. See ACA alternatives if over the limit.

By Konstantin Iakovlev · Updated September 2026 · Source: Benefits.gov

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Use the Medicaid Eligibility Calculator above to calculate your results. Enter your values and see instant results — all calculations run in your browser.

Disclaimer: This calculator is for informational purposes only and does not constitute tax, financial, or legal advice. Results are estimates based on the information you provide and current rates. Always consult a qualified tax professional or financial advisor for advice specific to your situation.

How It Works

Knowing whether your income clears your state's Medicaid threshold for the 2026 benefit year is the difference between guessing about coverage and acting on it. This tool gives an immediate read against current federal and state guidelines, and if your income lands above the limit, it points you toward Affordable Care Act (ACA) marketplace plans whose subsidies can bring your costs back down.

Eligibility here runs on the Modified Adjusted Gross Income (MAGI) method, the standard used for most adult determinations. Your reported household income and size are measured against your state's 2026 Federal Poverty Level (FPL) percentages, which sit at 138% in Medicaid expansion states. Forty states and the District of Columbia have adopted the expansion; the ten that have not are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming, and they apply their own thresholds, generally set well below 138%. Wisconsin is the closest call of the ten, because a waiver covers childless adults up to 100% of the poverty level, but it has not taken the ACA expansion and its enrollees do not get expansion-level federal funding. Georgia also covers adults to 100% of the poverty level through its Pathways program, which comes with a work requirement.

Counting every source of taxable income in your household is essential to a correct MAGI, and it is the step people most often get wrong. Rules also diverge for specific groups, including pregnant women, children, and people with disabilities, so a state may treat them differently than the general population. Treat the output as a general estimate and confirm the result with your state's Medicaid agency before relying on it.

Example: A Family of Four in a Medicaid Expansion State

  1. 1 Susan and John, with their two children, have a combined household income of $45,000 annually. They reside in a state that has expanded Medicaid, and their household size is 4.
  2. 2 For 2026, the HHS poverty guideline for a household of 4 in the 48 contiguous states is $33,000. In a Medicaid expansion state, the income limit is 138% of that figure: 138% of $33,000 is $45,540.
  3. 3 Since Susan and John's household income of $45,000 is below $45,540, they would likely be eligible for Medicaid in their state. The margin is thin, about $45 a month, so a raise or a second job could push them over.
  4. 4 This example demonstrates how a family within the FPL threshold can qualify for Medicaid. If their income were above this limit, they would be directed to explore ACA marketplace plans where they might qualify for subsidies to reduce their premium costs.

Source: Benefits.gov · Last updated: September 2026

Frequently Asked Questions

What are the Medicaid income limits for 2026?
In states that expanded Medicaid, adults qualify with income up to 138% of the federal poverty level. Against the 2026 HHS guidelines for the 48 contiguous states, that is $22,025 for a single person and $45,540 for a household of four. The ten non-expansion states have much lower limits, often covering only very-low-income parents and pregnant women.
What is the difference between Medicaid and Medicare?
Medicaid is a state-federal program for low-income individuals of any age. Medicare is a federal program for people 65+ (or younger with disabilities). Some people qualify for both (dual eligible). Medicaid eligibility is income-based; Medicare is age/disability-based.
Can I get Medicaid if I have a job?
Yes. Medicaid eligibility is based on income, not employment status. If your household income falls below your state's Medicaid threshold (138% FPL in expansion states), you can qualify even while employed.

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