Medicaid and CHIP Income Limits 2026 by State: Who Qualifies and Where a Raise Ends It

Medicaid and CHIP cover people whose household income is under a limit their state sets, as a percent of the federal poverty line. In the 40 states and DC that expanded Medicaid, adults aged 19 to 64 qualify with income up to 138% of the poverty line, and in the other 10 states most adults without children cannot qualify at any income. Children’s limits are higher than adults’ in every state, so a raise can end a parent’s Medicaid while the children keep theirs. Put your household in the calculator to see who in it would likely be covered.

What are the Medicaid and CHIP income limits for 2026?

They differ by state and by group, and the table below shows every state and DC. Each row is a state. Each number is the most income that group of people can have and still qualify, as a percent of the federal poverty line for the size of the household. The numbers include the 5 points of income that federal rules let a state ignore, which a later section explains, so 138% means income up to 138% of the poverty line.

Counted as modified adjusted gross income, the figure from a tax return. A pregnant woman counts the baby she expects. Each state's page has its limits in dollars, and says when the figures are from.

Here is how to read the columns:

• Adults 19 to 64: the limit for adults in the state’s adult group. In a state that did not expand Medicaid this is usually “Not covered”, because the state has no regular group for adults without children.
• Parents: the limit for parents and other caretaker relatives. In a state that expanded Medicaid a parent can also qualify as an adult, so the table shows the higher of the two. “Dollar limits” means the state sets a dollar amount for each family size instead of a percent. The state’s page on this site shows the amounts.
• Pregnant women: the limit for a pregnant woman, which in every state in the table is at least as high as the adult limit. Some states cover pregnancy through CHIP at an even higher limit, which the table does not show; the calculator uses it where we have it. She counts herself plus the babies she expects when the household size is set (42 CFR 435.603).
• Children to 18 (with CHIP): the highest limit for a child aged 6 to 18, counting CHIP. A state can set different limits for babies and for children 1 to 5. Each state’s page lists them.

Where do these numbers come from? The federal government’s own table of these limits, on Medicaid.gov, blocked our automated checks on October 31, 2026, and so did CMS, Medicare.gov and HealthCare.gov. So the table starts from the July 2025 figures of MACPAC, the federal commission that advises Congress on Medicaid and CHIP: its Exhibit 35 for children and pregnant women and its Exhibit 36 for adults. We then checked each state against its own pages.

For 40 of the 51 (the 50 states and DC) we read the state’s own pages, rules or budget papers, and they agreed with MACPAC’s figures once the 5 points are allowed for, or the difference is explained in our notes for that state. For Kentucky, Utah and Wyoming we could read only part of the state’s pages. For Hawaii, Indiana, Louisiana, Massachusetts, Missouri, Nebraska, New Hampshire and South Carolina, the state’s website blocked our checks, so those rows are MACPAC’s figures from July 2025. There is one exception. For South Carolina’s parents, MACPAC says 95% and a second source says 62%. The table uses the lower figure, and the true limit may be higher. Each state’s page on this site lists the sources we used for it. Where a state’s own newer page differed from MACPAC’s table, the table uses the state’s figure. DC is one: it lowered its limits for parents and for adults without children to 138% on January 1, 2026, and MACPAC’s July 2025 table still shows higher ones (DC’s Medicaid letter 25-02).

To turn a percent into dollars, take the poverty line for the household’s size, multiply it by the percent and divide by 12. The table below does it for 138%, the adult limit in the states that expanded Medicaid, and for 200% and 400%. It uses the 2026 poverty guidelines (91 FR 1797). A state switches to each year’s new poverty line on its own date, between January and April (42 CFR 435.4), so its own chart can show slightly lower dollars until then.

Programs use these lines as a yardstick: Medicaid for adults at 138%, many child care and energy programs at 150% to 200%, and so on.

Source: Annual Update of the HHS Poverty Guidelines (91 FR 1797-1798, FR Doc. 2026-00755, 15 Jan 2026) (Federal Register / HHS Office of the Secretary). Checked October 31, 2026.

Each state also has its own page here with its limits in dollars for households of 1 to 4 people, its own names for these programs and, where we have it, where to apply:

• Arizona
• Arkansas
• Colorado
• Connecticut
• District of Columbia
• Florida
• Illinois
• Massachusetts
• Michigan
• Minnesota
• Montana
• North Carolina
• North Dakota
• Ohio
• Oklahoma
• Pennsylvania
• Rhode Island
• South Dakota
• Vermont
• Washington
• West Virginia
• Wisconsin
• Wyoming

Do I qualify for Medicaid or CHIP?

You qualify when you are in a group your state covers, your household income is under that group’s limit, and you meet the state’s other rules. Four steps work out the income test:

1. Find your group. Medicaid and CHIP have separate limits for babies, children 1 to 5, children 6 to 18, pregnant women, parents and caretaker relatives, and other adults 19 to 64. People 65 or older, or with a disability, follow different rules, covered below.
2. Count your household. For these groups Medicaid counts your tax household (42 CFR 435.603): you, your spouse if you are married, and the children you claim on your taxes. A pregnant woman counts herself plus the babies she expects.
3. Count your income. Medicaid counts modified adjusted gross income, or MAGI: the adjusted gross income on your tax return, plus Social Security that is not taxed, tax-exempt interest and any foreign income you left out. When you apply, it looks at your income for the current month, not for the whole year (42 CFR 435.603).
4. Compare. Divide the month’s income by the poverty line for your household size, shown by the month in the table above. If the result is at or under your group’s limit, you pass the income test.

You must also meet your state’s other rules, such as the rule on immigration status explained below. Starting by January 1, 2027 (and earlier in some states), adults in the expansion group must also meet a work rule, which a later section explains.

What is the 5-point income disregard?

It is 5 percentage points of the poverty line that a state ignores when it decides whether you qualify, and you get it once. Federal rules say the state subtracts the 5 points only for the one group with the highest income limit that you could qualify under, not for every group and not twice (42 CFR 435.603(d)(4)). That is why a limit of 133% works as 138%, and why many state charts print 138 where federal tables print 133. The table above already includes the 5 points.

Take a parent in a state that expanded Medicaid. The parent could qualify as a parent, at a lower limit, or as an adult, at 133%. The adult group has the higher limit, so the 5 points are added there, and the parent qualifies up to 138%.

Which states expanded Medicaid, and what is the coverage gap?

Forty states and DC expanded Medicaid to adults 19 to 64 with income up to 138% of the poverty line, and ten states did not. The federal rule for the adult group is 42 CFR 435.119.

The states that expanded are Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington and West Virginia. The ten that did not are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming. That is MACPAC’s July 2025 list, checked against state pages where we could read them. For Hawaii, Indiana, Massachusetts, Mississippi, South Carolina and Wyoming, no state page we could read says in words whether the state expanded, so MACPAC’s table is the main source. In anything we read, no state’s expansion had ended as of October 31, 2026.

In the ten states that did not expand, parents can qualify but only at low limits, and most adults without children cannot qualify at all. The Parents column in the table shows how low: in most of these states it is well under the poverty line, and in Florida, Georgia, Mississippi and Texas the state sets dollar amounts instead of a percent. Two of the ten cover some adults without children anyway, under a special permission called a waiver. Wisconsin covers adults without children up to the poverty line under a waiver that runs through December 31, 2029 (Wisconsin’s page). Georgia’s Pathways program covers adults 19 to 64 up to the poverty line, but only if they complete 80 hours a month of work or other approved activities. Its approval runs through December 31, 2026, and Georgia says its rules change on January 1, 2027 (Georgia’s page). The table shows both states at 100%.

That leaves a gap. In a state that did not expand Medicaid, an adult who is not a parent or in another covered group can have no Medicaid. If that adult’s income is under the poverty line, there is no marketplace tax credit either, because the credit starts at 100% of the poverty line (26 U.S.C. 36B). This is often called the coverage gap. Take one adult with no children in Texas, earning $1,000 a month. Over a year, that pay is under the poverty line of $15,960 for one person, and the calculator shows no Medicaid and no tax credit. When the gap applies to you, the calculator’s marketplace card says so. The guide to the marketplace tax credit explains the credit.

What are the CHIP income limits?

Each state sets its own, and they are higher than Medicaid’s limit for children. CHIP, the Children’s Health Insurance Program, covers children whose family income is too high for Medicaid, and the “Children to 18 (with CHIP)” column in the table shows the highest limit for a child aged 6 to 18, Medicaid and CHIP together. Babies and children under 6 reach higher in some states, and each state’s page lists them. A separate CHIP program generally starts where Medicaid ends for a child (MACPAC Exhibit 35), so a child can be covered at an income well above the limit for a parent. In every state in the table, the limit for children is higher than the limit for adults. CHIP counts income the same way Medicaid does (42 CFR 457.315).

States run CHIP in different ways. Some have a separate program with a name of its own, such as Child Health Plus in New York, PeachCare for Kids in Georgia and Hawki in Iowa. Others use CHIP money to pay for a higher band of Medicaid, so the child is on Medicaid and may never see the word CHIP. Some do both. Some states also use CHIP to cover pregnancy care from conception, an option once called the unborn child option. Premiums or cost sharing often apply to a child in a separate CHIP program, especially at higher incomes. Your state’s page on this site names its programs, and the state’s own office says what it charges.

Will a raise make me lose Medicaid?

It can: if a raise takes your household income over your group’s limit, your Medicaid ends, but a child’s Medicaid or CHIP often goes on, because children’s limits are higher. This is one kind of benefits cliff, and the guide to the benefits cliff explains the rest. Medicaid looks at your income when you apply and at every renewal, and from 2027 adults in the expansion group are checked every six months. Ask your state’s Medicaid office when you must tell it about a raise.

Here is how it looks in Ohio, which expanded Medicaid. Take a single parent with one child, aged 6, in Ohio, earning $2,000 a month. At that pay the calculator shows Ohio Medicaid covering the parent and the child. The adult limit for two people is in the 2-person row of the 138% column in the poverty line table above. For an adult who lives alone, read the 1-person row. The first dollar of pay over it is $2,490 a month, and there the parent’s Medicaid ends. The child stays covered at a much higher pay, because Ohio’s limit for children is higher.

The calculator does not put a dollar value on Medicaid, because coverage is not cash. What you lose shows up as the price of the marketplace plan you would buy instead, once you type a benchmark price from HealthCare.gov’s tax tool. For the arithmetic, say the benchmark plan costs $600 a month. That price is made up, only to show the sum. Real prices depend on where you live and how old you are. With it, the calculator counts what the parent would pay for the plan after the marketplace tax credit. That is about $102 a month when pay is $2,600 a month. At the first dollar over the line, pay goes up by one dollar and what the household has left each month falls by $87.56, because the parent’s share of the plan’s price starts to count.

That is a step, not the whole picture. At $2,600 a month in pay, this household has $2,935 a month left after taxes, the plan’s price and the help it loses, against $2,742 at $2,000 a month. The calculator shows your own case: type your pay, then use the “What if you earn more?” box to see what a raise would leave you. It counts the plan’s premium only. It does not count what you would pay when you use care.

A raise that stays under the limit changes nothing for Medicaid. A raise that crosses it for a parent leaves the children covered until they cross their own, higher limit. When an adult’s Medicaid ends, the usual next step is a marketplace plan with a tax credit. In four states it is a Basic Health Program, explained next. A child over the Medicaid limit may move to CHIP.

What is a Basic Health Program, and why is there no marketplace credit with one?

A Basic Health Program, or BHP, is a state plan for people whose income is just above Medicaid’s limit. A person who can get one is not allowed to buy a marketplace plan, so they get no marketplace tax credit. Federal rules say a person can be in a BHP when their income is above 133% and up to 200% of the poverty line, they are 64 or younger and they have no other coverage that counts (42 CFR 600.305). Someone who is eligible cannot enroll in a marketplace plan (42 CFR 600.300). HHS’s 2027 payment notice names the four states that run a BHP: Minnesota, New York, Oregon and the District of Columbia.

• Minnesota: MinnesotaCare, for income above 133% and up to 200% of the poverty line (Minnesota Statutes 256L.04). Minnesota’s brochure says most members pay a monthly premium.
• New York: the Essential Plan, for income above Medicaid’s limit and below 200% of the poverty line. New York went back to Basic Health Program rules on July 1, 2026 (New York’s announcement), and the part of the Essential Plan above 200% ended that day (New York’s later announcement).
• Oregon: OHP Bridge, for income from 133% to 200% of the poverty line. Oregon’s page says it has no premiums, copays or deductibles.
• DC: the Healthy DC Plan, for income from 138% to 200% of the poverty line, which began on January 1, 2026, the day DC lowered its Medicaid limit for adults to 138%.

If you live in one of these states and your income is in the BHP’s range, the calculator shows the BHP in place of a marketplace plan with a tax credit. Above the top of the range, the usual marketplace rules apply again. In every other state there is no BHP.

What changes for Medicaid in 2027?

Public Law 119-21, signed on July 4, 2025, changes Medicaid in three ways that start by January 1, 2027. Adults in the expansion group get a work rule and checks every six months. Everyone who applies gets a shorter look back for old medical bills. People also call it H.R. 1 or the One Big Beautiful Bill Act, and CMS calls it the Working Families Tax Cut legislation. You can read the law on govinfo.gov.

Who has to meet the Medicaid work rule, and when does it start?

Adults aged 19 through 64 in the expansion adult group (the adults a state covers because it expanded Medicaid) must show that they work or take part in an approved activity. The law and CMS call this the community engagement requirement, and most people call it Medicaid work requirements. It is section 71119 of the law, and a rule CMS published on June 3, 2026 (91 FR 33348) fills in the details; it took effect on July 31, 2026. The rule also covers adults in similar coverage under a waiver, such as Wisconsin’s adults without children. It does not apply to people who are pregnant or on Medicare, or to the groups listed below. States must start it for care on or after January 1, 2027, and a state may start sooner.

Some states started early. CMS’s rule says Nebraska began on May 1, 2026. Montana’s rule took effect on July 1, 2026 (Montana’s announcement). Arkansas had a soft start on July 1, 2026, with no penalties until January 1, 2027 (Arkansas’s page). Iowa starts on December 1, 2026 for people who apply on or after that day (Iowa’s page). Georgia’s Pathways program already has a work rule.

Most other expansion states start on January 1, 2027, and some bring in people who are already enrolled later, at their next renewal: Vermont on March 1, 2027 and Virginia from March 31, 2027. Wisconsin does the same for its waiver group from March 2027. HHS may give a state more time if it shows a good-faith effort, but never past December 31, 2028. In anything we read, no state had been given more time. Your state’s page on this site gives its start date.

What counts toward the work rule, and who is exempt?

You meet the rule with 80 hours a month of work, community service, a work program or any mix of work, community service and work program hours that adds up to 80. School counts on its own when you are enrolled at least half time. You can also meet it with income of at least 80 times the federal minimum wage, which the rule states as $580 a month. Seasonal workers can use their average monthly income over the previous six months instead (section 71119).

Some adults are outside the rule altogether:

• former foster youth;
• American Indians and Alaska Natives;
• parents and caregivers of a child 13 or younger or of a person with a disability;
• veterans with a 100% disability rating;
• people who are medically frail, which includes people who are blind or disabled and people with a substance use disorder or a disabling mental disorder;
• people who meet TANF’s work rules, and people in a SNAP household that is held to SNAP’s work rule;
• people in addiction treatment, and people held in a public institution such as a jail;
• people who are pregnant or in postpartum Medicaid.

A state may also excuse people for a short-term hardship, such as a hospital stay, or living in a county hit by a disaster or with high unemployment.

What happens if I do not meet the work rule?

You get a notice and 30 days to show that you meet the rule or an exception. If you are already enrolled, your coverage goes on during those 30 days. If you show nothing, the state denies or ends your coverage by the end of the month after those 30 days, once it has checked whether you qualify another way. You get a written notice and the right to a fair hearing. Applicants are checked for the 1, 2 or 3 months before the month they apply, as the state chooses. People already enrolled are checked at their first renewal after the state starts the rule. The rule cannot be waived.

A person who loses Medicaid this way is still treated as able to get Medicaid when the marketplace tax credit is decided, so they cannot claim the credit on that basis (section 71119). The guide to the marketplace tax credit explains what that means.

How often will Medicaid be checked from 2027?

Every six months, for adults in the expansion group. Section 71107 of the law makes states re-check these adults’ eligibility once every six months, for checks scheduled on or after January 1, 2027. American Indians and Alaska Natives who are outside the work rule are outside this one too. CMS has told states how to do it in a letter dated March 6, 2026. We could not open the letter, because medicaid.gov blocked our checks.

How far back will Medicaid pay for care after I apply?

One month for an adult in the expansion group, and two months for everyone else, for applications made on or after January 1, 2027. Medicaid will pay for covered care from the month before the month you apply if you are an expansion adult, and from the second month before for anyone else. Before this change it was three months (section 71112). So an expansion adult who applies in March can have care paid back to February, and anyone else back to January. A state that offers retroactive CHIP coverage may not go back further than the second month before the month of the application.

Will Medicaid cost more later?

For some adults, yes, from October 1, 2028. States must then charge adults in the expansion group with income above 100% of the poverty line a copay or a similar charge on some services, of up to $35 for an item or service. There are no premiums, and the charges cannot add up to more than 5% of family income. They may never be charged for primary care, mental health care, substance use disorder care or care at community health centers and similar clinics (section 71120).

Does immigration status change whether I qualify?

Yes. Since October 1, 2026, the federal government pays its share of Medicaid and CHIP only for certain people: U.S. citizens and nationals, lawful permanent residents (green card holders), Cuban and Haitian entrants, and people who live in the United States under a Compact of Free Association (section 71109). Other lawfully present immigrants, such as refugees and asylees, are outside that payment unless an exception applies. Several states, including Maine, New Jersey and New York, list changes that began on that date. Ask your state’s Medicaid office how the change applies to you. If you give each person’s status (it is optional), the calculator applies this rule person by person: Emergency Medicaid only, where that is all the rule leaves; the state’s option for lawfully residing children and pregnant people, where the state’s own page says it has it; and CHIP for an unborn child, where the state covers one. Left blank, a person is worked out as a citizen.

What about Medicaid for people 65 or older or with a disability?

It follows different rules from the ones in the table. The table is for the groups counted by MAGI. For a person 65 or older, or with a disability and on Medicare, the state sets income and savings limits of its own, and MAGI methods do not apply (42 CFR 435.603). The calculator does not have those limits yet, so it shows Medicaid for such a person as “Not checked yet” and does not guess. Where you get SSI, it assumes Medicaid comes with it; the guide to SSI says more. People on Medicare with low income can also get help with Medicare costs: see the guide to the Medicare Savings Programs.

How does the calculator work out Medicaid and CHIP?

It compares each person’s household income with your state’s limit for that person’s group, then adds up who is likely covered:

1. It adds up the household’s income for the month from what you type: the pay, Social Security, unemployment and other income of you and your spouse. A child’s pay is left out of the parents’ income. It treats your pay as steady all year.
2. It counts the household as a tax household: you, your spouse and the children you claim. A pregnant woman adds the baby she expects. A person outside the tax household, such as a grandparent who lives with you, is counted alone, on their own income.
3. It turns the income into a percent of the poverty line for that household size, to the nearest tenth of a point, using the poverty guidelines in force on the day.
4. For each person it takes the state’s limit for their group: babies under 1, children 1 to 5, children 6 to 18, pregnant women, or adults. For a parent it takes the higher of the parent limit and the adult-group limit. It adds the 5 points.
5. If a child is over the Medicaid limit, it checks the state’s separate CHIP band. For a pregnant woman it checks the state’s CHIP limit for pregnancy, where the state has one.
6. A person who gets SSI counts as covered by Medicaid.

Medicaid and CHIP then appear under “Likely”, with the names of who is covered, or under “Not at this income” when no one is. Under an adult’s Medicaid it shows your state’s note on the 2027 work rule, but it cannot know your hours or your exemptions. In a state that did not expand Medicaid, if an adult aged 19 to 64 is not covered and income is under the poverty line, the marketplace card describes the coverage gap.

Medicaid and CHIP have no dollar value in the calculator’s total. A marketplace plan’s premium does, once you type a benchmark price, and so it shows up as a cliff where Medicaid ends and the plan begins. People the calculator does not find covered by Medicaid or CHIP, and who are not on Medicare, go on to the marketplace tax credit, unless a Basic Health Program covers their income range or a job offers affordable coverage. The guide to the marketplace tax credit explains that part.

What does the calculator leave out?

• Immigration status. It assumes everyone has a status that qualifies.
• Medicaid for people 65 or older or with a disability, which has its own limits and savings tests. The calculator does not have them yet, so it says “Not checked yet”.
• The work rule. It shows your state’s note but cannot know your hours or whether you are exempt.
• The poverty line a state is using. A state that has not yet switched to the new year’s line may still use the old one. The calculator uses the line in force today.
• Changes during the year. It works out one steady month, so a bonus, a gap in work or a raise later in the year is not in it until you type it.
• What you pay when you use care. It counts a marketplace plan’s premium only.
• Any other rule your state’s office applies.

Each answer is an estimate from the published rules. Only your state’s Medicaid office decides whether you qualify, and it can ask for more than the calculator does. Nothing here is legal, tax or financial advice.

How do you apply for Medicaid or CHIP, and how do you avoid a scam?

You apply with your state’s Medicaid agency, and applying is free. No one may charge you to apply, and no one can sell you coverage, move you up a list or promise that you will be approved. Your state’s page on this site names its Medicaid and CHIP programs and, where we have it, links to where the state takes applications. HealthCare.gov has a page on Medicaid and CHIP; it blocked our checks, so we could not open it.

Be careful with anyone who says otherwise. Give your Social Security number, bank details or other personal details only on your state’s own application, reached from your state’s agency page, not from a call, a text or an advertisement. A state’s application site does not always end in .gov, so follow a link from the agency’s page and do not trust a web address alone. If a website, a caller or a text asks you to pay to apply, it is not your state’s program.

This site takes no applications and sends nothing to any office. It never asks for your name, Social Security number or bank details, and the calculator keeps what you type in your browser.

Figures checked October 31, 2026.

Questions people ask

What is the income limit for Medicaid in 2026?

It depends on your state and on who is applying. In the 40 states and DC that expanded Medicaid, an adult aged 19 to 64 can have household income up to 138% of the poverty line, and the poverty line table above shows that in dollars for each household size. Children, pregnant women and parents have limits of their own, which are in the state table.

Can I get Medicaid if I have a job?

Yes. Having a job does not stop you from qualifying, as long as your household income is under the limit for your group. From 2027, adults in the expansion group must also show 80 hours a month of work or another approved activity, or income of at least 80 times the federal minimum wage, unless they are exempt.

Will a raise make me lose Medicaid?

It can, if the raise takes your household income over your group’s limit. A child’s coverage often goes on, because children’s limits are higher. The calculator’s “What if you earn more?” box shows what a raise would leave you.

What are the CHIP income limits?

Each state sets its own, and they are higher than Medicaid’s limit for children. The “Children to 18 (with CHIP)” column in the table above shows the highest limit for a child aged 6 to 18 in each state, Medicaid and CHIP together. In some states a child over the Medicaid limit moves to a separate CHIP program, which may charge premiums.

Can my children keep Medicaid or CHIP if I lose mine?

Usually, yes. Children are covered under their own, higher limits, so a parent can lose Medicaid at a pay where the children are still covered. In every state in the table, the limit for children is higher than the limit for adults.

Can I get Medicaid in a state that did not expand it?

Sometimes. Children, pregnant women, parents and caretaker relatives, and people who are 65 or older or have a disability can qualify, but most adults without children cannot, whatever their income. Wisconsin and Georgia cover some adults without children up to the poverty line, and Georgia requires 80 hours a month of work or other activity.

Can I sign up for Medicaid on this site?

No. This is an independent calculator, not a government website, and it takes no applications. To apply, go to your state’s Medicaid agency. The page for your state on this site links to where it takes applications, where we have it.

Updated November 1, 2026