Medicaid Income Limits: What is the lowest and highest income to qualify?

Medicaid is one of the most important government policies in the USA, with this federal-run and state-run program helping to cut healthcare costs for those with limited income and resources. While many Americans are covered by the Medicaid program, the eligibility criteria can be quite complicated, so we break down a few aspects of it in this Medicaid guide.

Who qualifies for Medicaid?

Medicaid claims to provide at least some form of coverage to over 72.5 million Americans. That includes children, pregnant women, parents, seniors and individuals with disabilities.

There are three main groups who qualify for coverage through Medicaid. There is financial eligibility, as there is often a need to be earning below a certain level. There are non-financial factors, such as residency status within a certain state. Then, there are medically needy programs in some states.

What is the lowest and highest income to qualify for Medicaid?

Whether your income is at the right amount or not to qualify for Medicaid will vary based on the state where you live. In each case, though, it is based on the Federal Poverty Level, which is a measure of income issued every year by the Department of Health and Human Services.

In 2022, the Federal Poverty Level is $13,590 for individuals. The government then breaks down your relationship with that amount as follows:

• Income above 400% FPL: If your income is above 400% FPL, you may now qualify for premium tax credits that lower your monthly premium for a 2022 Marketplace health insurance plan.
• Income between 100% and 400% FPL: If your income is in this range, in all states you qualify for premium tax credits that lower your monthly premium for a Marketplace health insurance plan.
• Income at or below 150% FPL: If your income falls at or below 150% FPL in your state and you're not eligible for Medicaid or CHIP, you may qualify to enroll in or change Marketplace coverage through a Special Enrollment Period.
• Income below 138% FPL: If your income is below 138% FPL and your state has expanded Medicaid coverage, you qualify for Medicaid based only on your income.
• Income below 100% FPL: If your income falls below 100% FPL, you probably won't qualify for savings on a Marketplace health insurance plan or for income-based Medicaid.