How to Qualify for Medicaid in 2026: Income Limits & Application Guide

How you qualify for Medicaid depends heavily on your state. In the 40 states plus Washington D.C. that have expanded Medicaid under the Affordable Care Act, adults under 65 qualify if their household income is at or below 138% of the Federal Poverty Level. For 2026, that's approximately $22,025 annually for a single person or $45,540 for a family of four. In the 10 non-expansion states (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming), eligibility is much stricter. The 2025 federal budget law also adds work requirements starting in May 2026 for some states, with the Congressional Budget Office estimating up to 5.3 million people could lose coverage by 2034. According to Medicaid.gov, approximately 80 million Americans are currently enrolled in Medicaid or CHIP.

This guide explains how to qualify for Medicaid in 2026, including income limits by category, asset rules, the differences between expansion and non-expansion states, and how to apply. Information comes from Medicaid.gov, CMS, and state Medicaid programs.

2026 Medicaid income limits

Medicaid uses two different income-eligibility frameworks depending on which category applies to you:

MAGI Medicaid (Modified Adjusted Gross Income). Used for adults, children, pregnant women, parents, and ACA expansion adults. No asset test applies to MAGI Medicaid. Income is calculated as a percentage of the Federal Poverty Level.

In Medicaid expansion states (40 states + DC), the limit for adults is 138% FPL:

• Single adult: $22,025/year ($1,835/month)

• Couple: $29,720/year ($2,477/month)

• Family of three: $37,440/year ($3,120/month)

• Family of four: $45,540/year ($3,795/month)

Non-MAGI Medicaid. Used for seniors (65+), people with disabilities, and long-term care applicants. Includes income limits AND asset tests:

• Long-term care Medicaid income limit (2026): $2,982/month single, $5,964/month married

• Federal Benefit Rate (FBR) 2026: $994 single, $1,491 married

• Asset limit (most states): $2,000 single

• Community Spouse Resource Allowance: up to $162,660

State-specific variations. Some states allow MAGI Medicaid above 138% (Connecticut, DC, Maine, Maryland, Massachusetts), while others restrict to lower percentages. Asset limits in non-MAGI Medicaid vary: Connecticut, Delaware, Louisiana, Maine, Mississippi, Vermont, and others have no asset limits. California has higher asset limits ($130,000 single / $195,000 married for 2026).

For state-specific Medicaid information, see our Medicaid Illinois guide and (forthcoming) state-specific articles for California, Pennsylvania, Michigan, and North Carolina.

Medicaid expansion vs non-expansion states

Where you live determines whether you qualify based on income alone or face stricter rules:

Expansion states (40 states + DC): Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, DC, 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 (since December 2023), North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia.

In expansion states:

• Adults qualify based on income alone (138% FPL)

• No asset test for MAGI Medicaid

• Childless adults qualify regardless of family status

• Single-application process through state Medicaid agency

Non-expansion states (10): Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, Wyoming.

In non-expansion states:

• Adults typically need to be parents, seniors, or disabled to qualify

• Texas limits parents to about 17% FPL (~$273/month for family of three)

• Alabama limits parents to about 18% FPL

• Childless adults generally don't qualify regardless of income

The coverage gap. About 1.4 million uninsured adults in non-expansion states earn too much for Medicaid in their state but too little (below 100% FPL) for ACA Marketplace premium tax credits. Approximately 97% of these affected residents live in Southern states, with Texas alone accounting for 42% of the entire coverage gap.

For Medicaid expansion details and how the Medicare vs Medicaid systems relate, see our pillar guides.

What Medicaid covers

Medicaid covers a comprehensive range of health services. Specific benefits vary by state but federally mandated services include:

• Inpatient and outpatient hospital care

• Physician services

• Laboratory and X-ray services

• Federally Qualified Health Center services

• Family planning services

• Nurse midwife services

• Pediatric services

• Pregnant women care

• Nursing facility services for adults

• Home health services

• Long-term care services

• Emergency medical transportation

Optional benefits that vary by state include dental coverage, prescription drugs, eyeglasses, mental health services, physical therapy, hospice care, dentures, and various rehabilitation services.

For specialty coverage details, see our guides on Medicaid dental for adults, dentists that accept Medicaid, and eye doctors that accept Medicaid.

How to apply for Medicaid

You can apply for Medicaid at any time of year. There's no open enrollment period. Five-step application process:

Step 1: Confirm you're in an eligibility category. Most adults in expansion states qualify based on income alone. Non-expansion state residents need to be parents of dependent children, pregnant, seniors, or disabled.

Step 2: Gather your documents. Required for most applications:

• Social Security cards for all household members

• Photo ID or driver's license

• Proof of income (recent pay stubs, tax returns, Social Security benefit letter)

• Proof of residency (utility bill, lease)

• Proof of citizenship or immigration status

• For pregnant women: medical confirmation of pregnancy

• For non-MAGI categories: bank statements, asset documentation

Step 3: Choose how to apply. Options vary by state but typically include:

• Online through your state Medicaid portal

• Online through HealthCare.gov (for states using federal marketplace)

• By phone with your state Medicaid agency

• By mail with paper application

• In person at a local Medicaid office or community health center

Step 4: Submit your application and respond to requests. Most states process applications within 30-45 days. Disability-based applications may take up to 90 days. Respond promptly to any document requests to avoid delays.

Step 5: Receive your eligibility determination. If approved, you'll receive notification by mail with start date and Medicaid ID. You may be enrolled in a managed care plan automatically if your state uses one.

If denied, you have appeal rights. Generally, you can request a hearing within 30-90 days of denial depending on your state.

2026 Medicaid work requirements

The 2025 federal budget law (signed July 4, 2025) adds Medicaid work requirements for expansion adults that take effect in 2026:

• Nebraska: Starting May 2026, expansion adults must document 80 hours per month of qualifying activity

• Montana: Starting July 2026, similar 80-hour requirement

Qualifying activities include employment, job training, volunteering, education, or caregiving. Exemptions typically apply for:

• Pregnant women

• People with disabilities

• Caregivers of young children

• Students enrolled at least half-time

• People in substance use disorder treatment

Final federal guidance on exemptions is expected from CMS by June 2026. The Congressional Budget Office estimates 5.3 million people could lose Medicaid coverage from work requirements alone by 2034.