Medicaid Eligibility Calculator 2026
State, household size, income: find out if you qualify for Medicaid or CHIP in 2026.
Medicaid Eligibility Calculator
Free estimate · 2026 rules · All 50 states
Total before taxes from all household members. Enter 0 if no income.
Free estimate · No personal info stored · 2026 federal Medicaid guidelines
2026 Key Numbers
- Single adult (138% FPL)
- $1,835/mo
- Family of 4 (138% FPL)
- $3,795/mo
- Expansion states
- 40 + DC
- Non-expansion states
- 10
How Medicaid Eligibility Works
Medicaid Expansion States (40 states + DC)
These states cover most adults with income up to 138% FPL. For a single person in 2026, that's about $1,835/month. Adults covered through the expansion may need to show work, school or volunteering to get and keep coverage, starting as early as January 2027 depending on your state. Nebraska and Montana already require it, and Iowa starts December 1, 2026.
Non-Expansion States (10 states)
TX, FL, GA, AL, MS, SC, TN, KS, WI, and WY have not expanded Medicaid. In eight of them, most adults ages 19 to 64 do not qualify at any income unless they are pregnant, caring for dependent children, have a disability, or are age 65+. Wisconsin covers adults up to 100% FPL through BadgerCare Plus, and Georgia Pathways covers adults 19 to 64 up to 100% FPL who complete at least 80 hours a month of work, school, job training or volunteering.
Children & Pregnant Women — Protected in All 50 States
Children under 19 and pregnant women have their own eligibility thresholds in all 50 states, typically ranging from 190% to 405% FPL for children, counting CHIP, which covers families that earn too much for Medicaid but can't afford private insurance.
2026 Medicaid Income Limits — Quick Reference
| Household Size | Adults (138% FPL) | Pregnant (185% FPL) | Children (200% FPL) |
|---|---|---|---|
| 1 person | $1,835/mo | $2,461/mo | $2,660/mo |
| 2 people | $2,489/mo | $3,336/mo | $3,607/mo |
| 3 people | $3,142/mo | $4,212/mo | $4,553/mo |
| 4 people | $3,795/mo | $5,088/mo | $5,500/mo |
| 5 people | $4,448/mo | $5,963/mo | $6,447/mo |
| 6 people | $5,101/mo | $6,839/mo | $7,393/mo |
Monthly gross income limits. State-specific limits may vary. Alaska and Hawaii have higher thresholds. Actual children's limits range from 190% to 405% FPL depending on the state.
Frequently Asked Questions About Medicaid
Do I qualify for Medicaid?
Whether you qualify for Medicaid depends on your state, income, household size, age, and life situation. In the 40 states (plus DC) that expanded Medicaid under the ACA, most adults with income up to 138% of the Federal Poverty Level qualify — that's about $22,025/year for a single person in 2026. Children qualify at higher income levels (often 200–300% FPL), and pregnant women have their own thresholds. Use the calculator above to get a state-specific estimate.
What is the income limit for Medicaid in 2026?
The 2026 Medicaid income limit for adults in expansion states is 138% of the Federal Poverty Level (FPL). For a single person, that's about $1,835/month ($22,025/year). For a family of four, it's about $3,795/month ($45,540/year). Children and pregnant women qualify at higher limits that vary by state, often 200% to 300% FPL. In the 10 states that haven't expanded Medicaid, adults typically do not qualify unless they are pregnant, caring for children, elderly, or have a disability. The exceptions are Wisconsin, which covers adults up to 100% FPL through BadgerCare Plus, and Georgia, where Georgia Pathways covers adults 19 to 64 up to 100% FPL who complete at least 80 hours a month of work, school, job training or volunteering.
Does my state matter for Medicaid eligibility?
Yes, significantly. Medicaid is jointly funded by the federal government and states, and states set their own eligibility rules within federal guidelines. The biggest difference is whether your state has expanded Medicaid under the ACA. 40 states and DC have, meaning adults up to 138% FPL qualify. In 8 of the 10 non-expansion states (TX, FL, AL, MS, SC, TN, KS, WY), most adults without children or disabilities cannot get Medicaid at any income. The other two cover adults up to 100% FPL: Wisconsin through BadgerCare Plus, and Georgia through Georgia Pathways, which requires at least 80 hours a month of work, school, job training or volunteering. Children and pregnant women have protections in all 50 states.
What does Medicaid cover?
Medicaid covers a comprehensive set of health services including doctor visits, hospitalization, emergency care, prescription drugs, mental health treatment, substance use treatment, lab tests, X-rays, and preventive care. Most Medicaid enrollees pay little or nothing in premiums or copays. Some states also cover dental and vision care. The exact benefits vary by state, but federal law requires all states to cover a core set of "mandatory" services.
How does Medicaid differ from CHIP?
Medicaid and CHIP (Children's Health Insurance Program) are sister programs that together cover uninsured children and some adults. Medicaid covers children from low-income families, while CHIP covers children from families that earn too much for Medicaid but can't afford private insurance. The income limits for CHIP are higher — often 200–400% FPL depending on the state. Most states administer both programs together and screen for both automatically when you apply.
How do I apply for Medicaid?
You can apply for Medicaid through your state's Medicaid agency (online, by phone, or in person), through the ACA marketplace at healthcare.gov, or through a local enrollment assister. The application asks for proof of identity, state residency, income, and household composition. Most states must process applications within 45 days (90 days if disability is a factor). If approved, coverage can often be backdated to the first day of the month you applied.
Can I get Medicaid if I have a job?
Yes. Having a job does not disqualify you from Medicaid; your income level does. Many working adults, including part-time workers, seasonal workers, and gig economy workers, qualify for Medicaid because their wages are below the income threshold. In expansion states, a single person earning up to about $1,835/month qualifies even while employed. Work can also help: adults covered through the expansion may need to show work, school or volunteering to get and keep coverage, starting as early as January 2027 depending on your state.
What if I'm in the coverage gap?
The "coverage gap" affects people in non-expansion states who earn too little to qualify for ACA marketplace subsidies (which start at 100% FPL) but don't qualify for their state's Medicaid. This gap can be addressed by applying through a navigator or community health center, who may be aware of limited state programs or changes in law. Congress has periodically addressed this gap, so it's worth checking current federal rules.