Medicaid Income Limits 2026: Who Qualifies & How to Apply

Medicaid is the largest source of free or low-cost health coverage in the United States. This guide covers who qualifies in 2026, the income limits (including the 138% of poverty rule for adults in expansion states), and how to apply through your state or the Health Insurance Marketplace — any time of year.

What Is Medicaid?

Medicaid is a joint federal and state program that pays for health care for people with limited income and resources. The federal government sets the broad rules and helps pay the cost, but each state runs its own Medicaid program and sets its own requirements within those rules, according to USA.gov.

There is also a companion program, CHIP (the Children’s Health Insurance Program), which covers children and teens up to age 19 when a family earns too much for Medicaid but still needs help paying for coverage. When you apply, your state checks you for both programs at once.

Who Qualifies for Medicaid?

USA.gov lists the main groups Medicaid covers:

• Adults with a low income
• Children
• Pregnant women
• People age 65 or over
• People with disabilities

Whether you qualify depends on your age, income level, family size, and whether you are pregnant or have a disability. Because each state sets its own income cutoffs, the same income can qualify you in one state and not in another. The clearest single rule is the one for adults in states that expanded Medicaid, explained next.

Medicaid Income Limits for 2026

In the states that adopted Medicaid expansion, adults ages 19–64 qualify based on income alone. HealthCare.gov explains that if your household income is at or below 133% of the federal poverty level, you qualify — and because of the way the income is counted (a 5% disregard), this works out to 138% of the federal poverty level.

Applying that 138% rule to the 2026 federal poverty guidelines gives these approximate yearly income limits for the adult expansion group in the 48 contiguous states and D.C.:

Household size	2026 federal poverty level	Medicaid adult limit (138%)
1	$15,960	about $22,025
2	$21,640	about $29,863
3	$27,320	about $37,702
4	$33,000	about $45,540
Each additional person	+$5,680	+$7,838

The 138% figures are calculated from the verified 2026 poverty guidelines — treat them as a close guide, not an exact cutoff, and confirm your state’s number when you apply. For the full table — all eight household sizes, month-by-month amounts, and the regulation-level math behind the 138% — see our 2026 Medicaid income table guide. A few important points:

• These limits apply to the adult expansion group. Children, pregnant women, seniors, and people with disabilities are often covered at higher income levels or through different pathways.
• Not every state expanded Medicaid, and the count changes. HealthCare.gov says only that “some states have expanded their Medicaid programs” and that states “are continuing to make coverage decisions,” so we do not print a state count here — use its state checker instead. HealthCare.gov also notes that a few states use a different income limit than 138%.
• If your state did not expand, there is a gap — and you should still apply. HealthCare.gov describes adults in non-expansion states whose income is below the poverty level as falling into a coverage gap: too much income for their state’s Medicaid, too little for Marketplace savings. Its own advice is to fill out a Marketplace application anyway, because states have other coverage paths — particularly if you have children, are pregnant, or have a disability — and more detailed income information can move you into the savings range.
• Income is measured using Modified Adjusted Gross Income (MAGI) for most groups — with no asset or savings test. People applying through the 65+ or disability pathways may be assessed differently.

How to Apply for Medicaid

Applying is free, and there is no enrollment deadline — USA.gov says you can apply anytime. There are two ways to apply:

1. Apply through your state Medicaid agency. This is the most direct route. USA.gov links to a state-by-state directory of where to get help with Medicaid and CHIP.
2. Apply through the Health Insurance Marketplace. Create an account at HealthCare.gov and fill out one application. If it looks like you qualify for Medicaid or CHIP, the Marketplace sends your information to your state, which contacts you about enrollment.

Either way, you fill out one application and your state checks you for both Medicaid and CHIP.

What to have ready. According to USA.gov, a Medicaid application may ask for:

• Your name and date of birth
• Your Social Security number
• Proof of income
• Citizenship or immigration documents

Exact requirements vary by state, so your state agency will tell you what it needs.

Nobody Can Charge You to Apply

There is no application fee for Medicaid or CHIP, and no legitimate agency or helper will ask you for money to file one. HealthCare.gov puts it in one line: “We’ll never ask you for payment to apply for or keep coverage.” The same page states that “the Marketplace, assisters, and your state will never threaten you or your household or ask for your credit card information or payment to keep or qualify for health coverage.”

Free help with the paperwork is part of the system, not an upsell. Assisters — also called navigators, enrollment assisters, or certified application counselors — are described by HealthCare.gov as “people trained & certified by the Marketplace to provide free help.”

So the test is simple. A real Medicaid application asks you for documents — your name and date of birth, your Social Security number, proof of income, citizenship or immigration papers. It never asks you for a payment. HealthCare.gov specifically warns against giving “Credit card payment, gift cards, cash, prepaid debit card, or cryptocurrency – to anyone claiming you must pay them to keep or apply for coverage.”

If that happens, stop and go to the official route yourself: your state Medicaid agency, or HealthCare.gov. The Marketplace Call Center is 1-800-318-2596.

Medicaid vs. CHIP: Which One Covers Your Family?

If your income is low enough, the whole family may qualify for Medicaid. If you earn a little too much for Medicaid but still can’t easily afford coverage, your children may qualify for CHIP, which reaches higher income levels and covers kids and teens up to age 19, per USA.gov. You do not have to guess — one application checks for both.

After You Apply

Your state reviews your application and verifies your information. If you qualify, coverage can begin quickly, and there is no yearly window to worry about — you can apply the day you need it. Medicaid coverage is renewed periodically, so watch for renewal notices from your state and respond on time to keep your coverage.

Getting one benefit often opens the door to others. If your household qualifies for Medicaid, you may also qualify for the Lifeline phone and internet discount — up to $9.25 off your monthly bill. If you are also struggling with food or energy costs, see our guides to food stamps (SNAP) and help paying heating and cooling bills (LIHEAP). And if you’re not sure where to start, dialing 211 connects you to local help.

How We Checked This

The figures here were re-read at their source on August 22, 2026, not copied from a summary. The 138% rule comes from HealthCare.gov’s Medicaid expansion page, which explains the arithmetic most articles skip: the law’s threshold is 133% of the federal poverty level, and “because of the way this is calculated, it turns out to be 138%.” The same page is where the coverage gap is described, and where the Supreme Court’s ruling that made expansion voluntary for states is noted. The “apply any time of year” rule and the two application routes come from HealthCare.gov’s getting-coverage page.

What we removed in this update, and why. Earlier versions of this guide said 40 states and D.C. had expanded Medicaid. We could not re-source that count from a primary federal page today, and HealthCare.gov itself declines to give a number, saying instead that states “are continuing to make coverage decisions.” A number we cannot stand behind is worse than no number, so it is gone. Check your own state with the official tool rather than trusting any count on any website, including this one.

The dollar amounts in the table are calculated, not quoted: they are 138% of the published 2026 HHS poverty guidelines for the 48 contiguous states and D.C. Alaska and Hawaii use higher guidelines, states may count income slightly differently, and the non-expansion pathways (age 65+, disability, pregnancy, children) run on different limits entirely. Treat the table as a close guide and let your state give you the exact answer.

Income limits shown are for 2026 in the 48 contiguous states and D.C.; the 138% figures are calculated from the official federal poverty guidelines, and your state’s exact limits and covered groups may differ. Information verified on official government websites as of July 19, 2026.