Medicaid Income Limits for 2026
Medicaid eligibility is based on the 2026 Federal Poverty Level (FPL), which the Department of Health and Human Services updates annually.
2026 Federal Poverty Guidelines (48 contiguous states and D.C.)
| Household Size | Annual FPL | 138% FPL (Expansion States) |
|---|
| 1 | $15,960 | $22,025 |
| 2 | $21,580 | $29,780 |
| 3 | $27,200 | $37,536 |
| 4 | $32,820 | $45,291 |
In the 40 states that expanded Medicaid under the Affordable Care Act, adults with incomes up to approximately 138% FPL qualify. In the 10 states that have not expanded, income limits for adults are often much lower, sometimes below 50% FPL, and single adults without dependents may not qualify at all.
For homeless individuals, income is counted differently. If you have no income, you qualify at 0% FPL, which is well below any state threshold. If you receive sporadic income from day labor or gig work, that is averaged over the month and compared against limits.
If you are unsure whether you qualify, the Benefits Navigator screener checks your eligibility for Medicaid and 10 other programs in under two minutes.
Mailing Address Options When You Have No Home
You have several options for establishing a mailing address for your Medicaid application. Use whichever one is most reliable and accessible for your situation.
Option 1: Use a Shelter or Service Provider Address
This is the most straightforward route. Shelters, day centers, transitional housing programs, and Health Care for the Homeless clinics routinely allow individuals to use their address for government benefit correspondence. All you need is permission from the organization.
When you apply, list the shelter address as your mailing address. Most state applications have separate fields for "residential address" and "mailing address." If there is only one address field, use the shelter address and note in any comment field that you are currently experiencing homelessness.
Option 2: Use a Friend or Family Member's Address
Any trusted person can let you use their mailing address. You do not need to live there. You just need reliable access to the mail that arrives. Make sure the person knows to save any letters from your state Medicaid agency.
Option 3: USPS General Delivery
The U.S. Postal Service offers a free service called General Delivery. Mail addressed to you at "General Delivery" is held at your local post office for pickup. No application is required. Just go to your nearest post office, tell them you need General Delivery service, and confirm which branch handles it.
Use this format on your application:
[Your Name]
General Delivery
[City, State, ZIP]
Mail is typically held for 30 days. This works best if you are near a post office with regular hours and can check for letters at least once a month. Note that some states may not accept General Delivery as a permanent mailing address for ongoing Medicaid renewals, so it is most useful for the initial application while you establish a more stable mailing option.
Option 4: Designate an Authorized Representative
An authorized representative is a person or organization that manages your Medicaid case on your behalf, including receiving correspondence. Case managers, social workers, patient advocates at Federally Qualified Health Centers (FQHCs), and Health Care for the Homeless programs can often serve in this role. They receive your mail, notify you of any action needed, and help with renewals.
Ask any outreach worker, shelter staff member, or community health worker whether their organization offers this.
Option 5: P.O. Box
A P.O. Box at a post office or UPS Store is a reliable, long-term option. Prices range from roughly $10 to $50 per quarter depending on location and box size. Many states accept a P.O. Box as a mailing address on Medicaid applications, though some require a separate residential address or description of where you sleep.
How to Apply for Medicaid Without an Address: Step by Step
Step 1: Gather What You Have
You do not need a lease or utility bill to prove where you live. What helps:
- Photo ID (driver's license, state ID, passport, or tribal ID)
- Social Security number or documentation
- Proof of income, or a written statement that you have no income
- A mailing address (see options above)
If you lack a photo ID, that is a separate barrier but not insurmountable. Many Health Care for the Homeless programs can help you obtain an ID.
Step 2: Find the Right Application for Your State
You have three ways to apply:
Online: Go to your state's Medicaid website or HealthCare.gov. Most states allow online applications and include a checkbox or field for "experiencing homelessness." If the form requires a residential address and you have none, put the address of your shelter, where you sleep most nights, or an intersection near where you stay. Be honest and accurate.
In Person: Visit your local Department of Social Services, Medicaid office, or FQHC. In-person applications are often faster for homeless individuals because a caseworker can help you document your situation and navigate the address question on the spot.
By Phone: Most states have a Medicaid phone line. You can complete the application verbally and have forms mailed to your mailing address.
Through a Navigator or Outreach Worker: Certified application assisters, Health Care for the Homeless staff, and community health workers can submit applications on your behalf and serve as your contact point with the state.
Step 3: Complete the Application
When asked for a residential address, choose the most accurate option:
- Check "homeless" or "no fixed address" if available
- Enter the address where you sleep most nights
- Enter the shelter address if you are in a shelter
- Write "General Delivery" if that is your arrangement
In the mailing address field, enter the address where you can receive mail reliably.
For income, report your average monthly income honestly. If you have none, write $0.
Step 4: Submit and Follow Up
Submit the application online, in person, or by mail. States are required to process Medicaid applications within 45 days for most applicants. Keep checking your mailing address for any requests for additional information. Missing a request for documentation is the most common reason applications are denied.
Step 5: Keep Your Contact Information Current
Once enrolled, Medicaid requires annual renewals. States will send renewal notices to your mailing address. If your mailing address changes, notify your state Medicaid agency immediately. Missing a renewal notice is the most common reason homeless individuals lose coverage they are still eligible for.
What Counts as "No Fixed Address" for Medicaid Purposes
Different states have different language for this. Common designations include:
- Homeless or experiencing homelessness: stays in shelters, transitional housing, cars, parks, or other places not meant for human habitation
- Couch surfing or doubled up: staying temporarily with others due to housing instability (this counts as homelessness under federal McKinney-Vento definitions)
- Fleeing domestic violence: special protections apply; many states expedite coverage
If any of these describe your situation, state it clearly on the application. Some states have expedited processing for homeless applicants.
2026 Policy Changes That Affect Homeless Medicaid Applicants
Two significant federal changes took effect or are being implemented in 2025-2026 that directly affect homeless Medicaid applicants.
Community Engagement (Work) Requirements
The One Big Beautiful Bill (H.R. 1), signed on July 4, 2025, requires states to implement community engagement requirements for certain Medicaid enrollees. Starting no later than January 1, 2027, adults aged 19-64 covered through the ACA Medicaid expansion must complete at least 80 hours per month of qualifying activity, which can include employment, job training, education, or community service.
Important exemptions apply. You are likely exempt if you are:
- Medically frail (this includes people with serious or complex medical conditions, physical or developmental disabilities, or disabling mental health conditions)
- Homeless and unable to meet requirements due to your housing situation (states are required to consider this)
- A parent or caretaker of a child age 13 or younger
- A disabled veteran
Many homeless individuals will qualify for exemptions, but you must report your status to the state to receive one. Contact your state Medicaid agency or a navigator as these requirements roll out.
Address Verification Requirements
H.R. 1 also requires states to design and implement a federally approved address verification process, with full implementation due by January 1, 2029. This is a new challenge for people without permanent addresses.
The National Alliance to End Homelessness and similar organizations are actively advocating for states to accept shelter addresses, drop-in center addresses, and Health Care for the Homeless clinic addresses as valid. Many of these organizations serve hundreds or thousands of individuals at a single address, and advocates are pushing states to train caseworkers to recognize these as legitimate.
If you are denied Medicaid coverage because of an address issue, you have the right to appeal. Ask for a fair hearing.
Where to Get Help Applying
You do not have to navigate this alone. These organizations specialize in helping homeless individuals access Medicaid:
- Health Care for the Homeless programs: Federally funded clinics in most major cities. Provide both healthcare and enrollment assistance.
- Federally Qualified Health Centers (FQHCs): Serve patients regardless of housing or insurance status. Many have Certified Application Counselors on staff.
- Legal aid organizations: Can help with appeals if your application is denied.
- 211: Call or text 211 to find local social services, including Medicaid enrollment help.
- National Health Care for the Homeless Council (nhchc.org): Maintains a directory of Health Care for the Homeless programs nationwide.
You can also use the Benefits Navigator screener to confirm which programs you likely qualify for before you apply. It checks Medicaid alongside SNAP, SSI, and other benefits at the same time.
States With Notable Programs for Homeless Medicaid Applicants
Several states have taken additional steps to make Medicaid enrollment easier for people experiencing homelessness:
- California (Medi-Cal): Offers CalAIM, a program that funds housing navigation and transitional housing as covered benefits for high-need Medi-Cal members.
- New York: Has specific guidance allowing Health Care for the Homeless sites, soup kitchens, and drop-in centers as valid addresses.
- Massachusetts (MassHealth): Has a dedicated homelessness page and allows homeless individuals to designate service organizations as their address.
- Colorado: Offers supportive housing services through its Medicaid program for individuals experiencing chronic homelessness.
Check your state's Medicaid agency website for any specific guidance for homeless applicants.
Frequently Asked Questions
Does being homeless automatically disqualify me from Medicaid?
No. Housing status is not a Medicaid eligibility criterion. Eligibility is based on income, household size, age, disability status, and citizenship. Being homeless can actually make the application process more straightforward since you are likely to meet income requirements.
What if I do not have a Social Security number?
Undocumented individuals are generally not eligible for full Medicaid in most states, but emergency Medicaid covers immediate life-threatening conditions in all states. Some states, including California, New York, Illinois, and Washington, have extended full Medicaid coverage to income-eligible immigrants regardless of documentation status.
Can I use a shelter address even if I only stay there sometimes?
Yes. If you use a shelter as your primary sleeping location, even part-time, you can list it as your address. Be honest on the application about your situation.
What happens at renewal if my address has changed?
You must notify your state Medicaid agency when your mailing address changes. Most states let you update your address online, by phone, or in person. If you miss a renewal notice and lose coverage, you can reapply, and some states allow reinstatement without a new waiting period.
Will the new work requirements affect me if I am homeless?
Possibly, but many homeless individuals will qualify for exemptions based on being medically frail or unable to meet requirements due to their circumstances. These requirements do not take effect until at least January 1, 2027. Stay in contact with a case manager or navigator as implementation details become clearer.
What if my Medicaid application is denied?
You have the right to appeal any denial. Request a "fair hearing" in writing within the timeframe noted in your denial letter (usually 30 to 90 days). Free legal aid organizations can help you through this process.
Can I get Medicaid if I am living in my car?
Yes. Living in a vehicle is considered homelessness under federal definitions and does not affect Medicaid eligibility. You can use a shelter address, a friend's address, or USPS General Delivery as your mailing address.
