Medicaid is a jointly funded, state and federal government program that provides health insurance coverage to eligible low-income individuals and families. The income limit for Medicaid varies by state, as each state sets its own eligibility criteria. However, the Affordable Care Act (ACA) expanded Medicaid eligibility to include adults with incomes up to 138% of the federal poverty level (FPL). In this article, we will provide a comprehensive overview of the income limits for Medicaid, including the federal poverty level, expanded Medicaid eligibility, and state-specific income limits.
Federal Poverty Level (FPL)
The federal poverty level is a measure of income that is used to determine eligibility for various government programs, including Medicaid. The FPL is updated annually by the Department of Health and Human Services (HHS) and is based on the Consumer Price Index (CPI). For 2022, the FPL for an individual is 12,880, and for a family of four, it is 26,500. The FPL is used to calculate the income limits for Medicaid, as well as other government programs, such as the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF).
Expanded Medicaid Eligibility
The Affordable Care Act (ACA) expanded Medicaid eligibility to include adults with incomes up to 138% of the FPL. This expansion aimed to increase health insurance coverage among low-income individuals and families. As of 2022, 38 states and the District of Columbia have expanded their Medicaid programs to include adults with incomes up to 138% of the FPL. The expanded eligibility criteria include:
- Adults with incomes up to 138% of the FPL
- Pregnant women with incomes up to 138% of the FPL
- Parents with incomes up to 138% of the FPL
- Children with incomes up to 213% of the FPL
State-Specific Income Limits
While the federal government sets the overall guidelines for Medicaid eligibility, each state has the flexibility to set its own income limits. Some states have more generous income limits, while others have more restrictive limits. The following table provides a summary of the income limits for Medicaid in each state:
| State | Income Limit (Individual) | Income Limit (Family of Four) |
|---|---|---|
| Alabama | 13% of FPL | 24% of FPL |
| Alaska | 206% of FPL | 213% of FPL |
| Arizona | 138% of FPL | 138% of FPL |
| Arkansas | 138% of FPL | 138% of FPL |
| California | 138% of FPL | 213% of FPL |
Calculating Income
To determine eligibility for Medicaid, the state will calculate an individual’s or family’s income based on their modified adjusted gross income (MAGI). MAGI includes income from all sources, including:
- Wages and salaries
- Self-employment income
- Interest and dividends
- Capital gains
- Rental income
The state will then compare the individual's or family's MAGI to the applicable income limit to determine eligibility for Medicaid.
What is the income limit for Medicaid in my state?
+To find the income limit for Medicaid in your state, you can visit the Medicaid website or contact your local Medicaid office. They will be able to provide you with the most up-to-date information on income limits and eligibility criteria.
Can I apply for Medicaid if I have a job?
+Yes, you can apply for Medicaid even if you have a job. Medicaid eligibility is based on income, not employment status. However, your income will be taken into account when determining eligibility, and you may need to provide proof of income as part of the application process.
How do I apply for Medicaid?
+To apply for Medicaid, you can visit the Medicaid website, contact your local Medicaid office, or apply through the Health Insurance Marketplace. You will need to provide documentation, such as proof of income, citizenship, and residency, as part of the application process.
