Does your income qualify for Medicaid? Expansion states cover adults up to 138% of the federal poverty level; most non-expansion states set a lower bar. Enter your household size and income to check.
🏥 Your Household
💰 Eligibility Result
Federal Poverty Level (2025)$15,650
Income Limit$21,597
Income as % of FPL115%
Monthly Income$1,500
📊 Worked Examples
Scenario
Household
Annual Income
Income Limit
Result
Single adult, expansion state
1
$18,000
$21,597
Eligible
Family of four, expansion state
4
$44,000
$44,367
Eligible
Couple, 100% FPL test
2
$21,150
$21,150
At limit
Single adult, non-expansion state
1
$13,000
$15,650
Depends on state
The 2025 federal poverty level for a household of one is $15,650 (48 contiguous states), rising by about $5,500 per additional person. Expansion states cover adults up to 138% FPL; most non-expansion states set a lower bar and often exclude childless adults entirely.
📖 How Medicaid Income Eligibility Works
Medicaid eligibility is primarily an income test tied to the federal poverty level (FPL), though assets, residency, and category (children, parents, disabled, seniors) also matter. The Affordable Care Act let states expand coverage to adults under 65 with income up to 138% of the FPL, using the Modified Adjusted Gross Income (MAGI) methodology.
Key rules
The 138% FPL threshold: in expansion states, adults qualify if household MAGI is at or below 138% of the FPL. Congress includes a built-in 5% income disregard, so the effective limit is often described as 138% of FPL.
Non-expansion states: the roughly ten states that did not expand Medicaid generally cover only traditional categories — children, pregnant women, parents of minor children, and the disabled — at thresholds that are frequently well below 100% FPL, and often exclude childless adults regardless of income.
Household size matters: the FPL rises with each person. For 2025, add about $5,500 for each person beyond the first in the 48 contiguous states (higher in Alaska and Hawaii).
MAGI methodology: eligibility uses adjusted gross income plus tax-exempt interest and certain foreign income, with a 5% FPL disregard. Most traditional asset tests do not apply to MAGI-based groups.
The coverage gap: in non-expansion states, adults below 100% FPL may earn too little to qualify for ACA marketplace subsidies but too much (or be in the wrong category) for Medicaid — a gap many states are closing through ballot measures.
Not just income: even below the threshold, you must meet non-financial rules such as state residency, citizenship or qualifying immigration status, and (for some groups) disability or age.
How to use it
Choose whether your state expanded Medicaid, enter your household size and annual household income, and the calculator compares your income to the applicable FPL limit. Use the result as a first screen — then apply through your state Medicaid agency or HealthCare.gov for an official determination.
Frequently Asked Questions
What income level qualifies for Medicaid?
In expansion states, adults under 65 qualify at or below 138% of the federal poverty level using MAGI. In non-expansion states, thresholds are lower and vary by category, often below 100% FPL and frequently unavailable to childless adults.
What is the 2025 federal poverty level for a household of one?
For the 48 contiguous states, the 2025 FPL is $15,650 for a household of one, increasing by roughly $5,500 for each additional household member. Alaska and Hawaii have higher figures.
Does Medicaid count assets?
For MAGI-based eligibility groups (most non-elderly adults and children), there is no asset test. Asset and resource limits do apply to some long-term-care and aged, blind, or disabled categories.
What is the Medicaid coverage gap?
In states that did not expand Medicaid, adults whose income is below 100% FPL may earn too little to receive ACA marketplace subsidies but still not qualify for Medicaid. This is the coverage gap, and some states have closed it by ballot initiative.
How do I actually apply for Medicaid?
Apply through your state Medicaid agency or through HealthCare.gov, which routes your application to your state. Eligibility is based on monthly income at the time of application, so a recent pay change matters more than last year's tax return.
⚠️ Important: This calculator compares household income to the 2025 federal poverty level using the 138% (expansion) or 100% (non-expansion) thresholds. Medicaid rules vary significantly by state and category, and eligibility uses monthly MAGI with a 5% disregard plus non-financial requirements. This is an educational estimate — apply through your state agency for an official determination.