Medicaid Income and Asset Limits by State

Most people searching "Medicaid income limits" type in a dollar figure and expect an answer, but the number that comes back often belongs to a completely different eligibility track than the one they're actually on. Medicaid is not one program with one set of rules. It runs on three separate tracks, each with its own income test, its own asset rules, and its own logic, and figuring out which track applies has to happen before any state-specific number means anything at all.

The confusion is structural. The program is a joint federal-state one, which means the federal government sets a floor and a framework, and each state then builds its own income and asset standards on top of it. So the answer to "what's the limit in my state" depends first on a separate question: which of the three tracks are you even asking about? That depends on age, disability status, Medicare enrollment, and whether the person needs nursing-home-level care, not on income by itself. This piece works through that identification step first, then walks through the state-level numbers for each track in turn.

How the three eligibility tracks divide the Medicaid universe

Track 1 runs on Modified Adjusted Gross Income, or MAGI, the same income concept used on a federal tax return. It covers working-age adults, parents and caretakers, pregnant women, and children. Income is counted the way a tax preparer would count it, and under federal law, states cannot apply an asset test to this group. That last point matters enormously and gets its own treatment later on, because it is the single sharpest line dividing this track from the other two.

Track 2 covers people who are aged, blind, or disabled, often shortened to ABD, or referred to as the non-MAGI track. This includes people 65 and older and people who meet disability criteria. Income here gets measured against SSI-based calculations, not tax-return income, and an asset test applies. This is the track most seniors run into first, often without realizing they've switched tracks at all.

Track 3 is long-term care Medicaid, covering nursing home stays and home- and community-based services (HCBS) waivers for people who need that level of care whether they receive it in a facility or at home. It carries the highest income ceiling of the three tracks, the strictest asset scrutiny, and a look-back period that reviews financial transfers made before the application.

A smaller group of states, including Illinois, Minnesota, and Missouri, fall into what's called the 209(b) category. These states use income or resource criteria for the ABD track that are somewhat stricter than the SSI standard, though federal rules require them to offer a spend-down option so people with high medical costs aren't shut out entirely (per BenefitsUSA).

Someone can turn 65 with no change in income, no change in job, no change in anything financial, and move from Track 1 straight into Track 2. Someone can turn 65 with no change in income, no change in job, no change in anything financial, and move from Track 1 straight into Track 2. Suddenly there's an asset test in the picture that never existed before. That's not a glitch in the system. It's just how the tracks are built, and it's exactly the kind of thing that catches people off guard when they assume Medicaid works like a single sliding scale.

Track 1: MAGI expansion, income ceilings for working-age adults, parents, children, and pregnant women

In the 41 states plus DC that adopted ACA expansion, adults ages 19 to 64 qualify with income up to 138% of a federally set income threshold used to determine eligibility for assistance programs. In 2026, that works out to $22,025 a year, or roughly $1,835 a month, for a single person, and $45,540 a year for a family of four (per BenefitsUSA). That threshold is set federally, so it's identical in California's Medi-Cal, New York, Illinois, Ohio, Michigan, North Carolina, Virginia, Arizona's AHCCCS, Pennsylvania, and every other expansion state. The number doesn't shift by geography here, only by household size.

The remaining 10 states, Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming, did not adopt expansion. In most of them, adults without children generally can't qualify for Medicaid no matter how low their income runs, unless they're pregnant, disabled, or 65 and older (per BenefitsUSA). Wisconsin is a partial exception, covering adults up to 100% FPL under a state waiver, which isn't full ACA expansion but does close the coverage gap that exists in the other nine.

That coverage gap is not a hypothetical. In those nine states, someone can earn too little to qualify for ACA marketplace subsidies, while also falling into the wrong category for Medicaid. As a result, this band of people is, on paper, simply uninsurable through either route. It's a structural gap, not a processing error, and it's one of the clearest consequences of how state-by-state expansion decisions actually play out.

Children fare better almost everywhere. Most states set children's eligibility well above the federal floor. New Jersey reaches 350% FPL and DC reaches 319% FPL at the high end, while Utah sits among the lower published levels at 139% FPL (per the CMS compiled eligibility table via medicaideligibilitycalculator.com). Pregnant women see similarly generous treatment: all 50 states cover at 138% FPL or above, with Iowa listed at 375% FPL and Connecticut at 258% FPL among the higher published figures (per CMS compiled table). Postpartum coverage now extends to 12 months in most states and DC, a change connected to federal legislation expanding that coverage window.

None of these income-scale-track numbers involve an asset test. That bears repeating, because it's the detail that trips people up when they cross into Track 2 later: federal law simply doesn't allow states to apply one to MAGI groups.

Every one of these calculations traces back to the 2026 baseline for that federally set income threshold: $15,960 for a one-person household and $21,640 for a two-person household across the 48 contiguous states and DC, a 2.6% increase reflected in the CMS informational bulletin covered by McKnight's Senior Living. Alaska and Hawaii run higher, as they always do given cost-of-living adjustments: Alaska sets $19,950 and $27,050 for one- and two-person households, while Hawaii sets $18,360 and $24,890.

Track 2: Aged, Blind, and Disabled, the SSI-linked income and asset rules most seniors encounter first

SSI eligibility triggers automatic Medicaid eligibility in most states, and the 2026 SSI Federal Benefit Rate is $994 a month for an individual and $1,491 a month for a couple (per BenefitsUSA). One might assume that anyone above $994 a month is simply out of luck on this track. That's not quite right, and the gap between that assumption and reality is exactly why the next section on Medicare Savings Programs matters so much.

Most retirees drawing Social Security already earn more than $994 a month, so landing on Track 2 doesn't automatically mean landing over every limit that track offers.

The asset side is where things tighten. Most states apply the SSI default of $2,000 for an individual, a figure that hasn't moved in decades even as the cost of everything else has climbed. This limit puts Medicaid out of reach for people who'd otherwise qualify purely on income, simply because the asset ceiling never kept pace with how much even modest savers accumulate over a working life.

Some assets don't count against that limit. A primary home (with conditions attached), household furnishings and appliances, one vehicle, clothing, irrevocable burial or funeral trusts up to a state-specific cap, and life insurance policies below a certain face value are all generally exempt (per Medicaid Planning Assistance). IRAs and 401(k)s are trickier: some states exempt them, others count them as available resources, and this inconsistency catches a lot of people who spent years doing exactly what financial advisors told them to do. Saving into a 401(k) is good financial planning. It can also be a Medicaid planning trap, depending entirely on which state someone lives in.

The 209(b) states, including Illinois and Missouri among others, apply income or resource tests stricter than the SSI standard but are required to provide a spend-down pathway for people with heavy medical expenses. Connecticut holds the distinction of the strictest published asset limit in the country on this track: $1,600 for singles, $2,400 for couples (per Choice Mutual).

Medicare Savings Programs: the income bridge for seniors who earn too much for SSI-linked Medicaid

So what happens to the senior who earns more than the SSI Federal Benefit Rate but still can't easily absorb Medicare's premiums and cost-sharing? That's the gap Medicare Savings Programs, or MSPs, exist to fill. They don't provide full Medicaid coverage. They cover Medicare premiums and, in most cases, cost-sharing, for beneficiaries whose income and savings fall within a wider band than SSI-linked Medicaid allows.

The federal 2026 MSP income limit for an individual is $1,816 a month, with an asset limit of $9,950 (per KFF survey). That's nearly double the SSI Federal Benefit Rate on the income side, which means a meaningful number of Social Security recipients who assumed they earned too much for any help tied to this kind of program actually fall well within range.

A narrower category, Qualified Disabled Working Individuals (QDWI), carries its own limits: $5,405 a month for an individual, up $103 from 2025, and $7,299 for a couple, up $164. Asset limits for QDWI held steady from the prior year at $4,000 for individuals and $6,000 for couples (per McKnight's Senior Living).

Geography matters here too. Thirty-three states stick with the federal MSP eligibility criteria, but the other 18 expanded eligibility beyond the federal floor, meaning coverage reaches further up the income scale in those states than the national numbers suggest (per KFF). MSP enrollment only helps with costs tied to the other program in this pair, not full benefits under this one, and that distinction matters for anyone who also needs long-term care coverage, the subject of the next track.

Track 3: Long-term care Medicaid, the income and asset rules that govern nursing home and HCBS coverage

Long-term care Medicaid runs the widest income ceiling of the three tracks. Most states use 300% of the Federal Benefit Rate, which in 2026 comes out to $2,982 a month for a single applicant and $5,964 a month for a married couple applying together, up from the 2025 cap of $2,901 (per Jarvis Law Office).

But qualifying on income doesn't mean keeping that income. Nursing home residents can have income up to $2,982 a month and still qualify, yet nearly all of it has to go toward the cost of care. What's left over is called a Personal Needs Allowance, a modest monthly amount that varies state by state (per Medicaid Planning Assistance). The income ceiling determines eligibility. It doesn't determine what someone actually gets to keep in their pocket.

HCBS waiver programs, which let people receive that same level of care at home instead of in a facility, often use the identical $2,982 monthly limit, though some states set waiver-specific standards slightly above or below that figure. Financial eligibility is only half the equation on the HCBS side, too: enrollment caps and waiting lists can apply regardless of whether someone qualifies financially.

The asset limit on this track holds at the SSI default of $2,000 for an individual in most states, unchanged for 2026 even as the income ceiling rose. The five-year look-back period applies here specifically, scanning financial transfers made in the prior five years for signs of asset transfers designed to artificially qualify for benefits.

When one spouse enters a facility and the other stays home, the Community Spouse Resource Allowance lets the at-home spouse keep a portion of the couple's countable assets, with the exact amount varying by state. Home equity gets its own separate ceiling: in 2026, most states cap it at $713,000, while states with higher property values can go as high as $1,130,000, and some states apply that higher threshold. California's Medi-Cal program stands apart entirely, applying no home equity limit at all for eligibility purposes.

For people whose income or assets run over standard limits, 34 states in 2026 offer a medically needy, or spend-down, pathway. It allows applicants to subtract qualifying medical expenses from their income until they fall under the eligibility line. The median medically needy income limit climbed from $511 in 2025 to $563 in 2026 (per KFF). Kansas made a notable structural change, tying its medically needy income limit directly to the SSI rate, currently $994 a month, so the figure now updates automatically instead of requiring separate legislative action each year (per KFF).

Financial eligibility and medical eligibility are two different gates. Applicants also need a clinical determination that they require nursing-home-level care, a functional assessment entirely independent of how much money sits in their bank account.

Asset limits state by state: where the default $2,000 rule holds

The SSI standard of $2,000 for an individual and $3,000 for a married couple functions as the default asset limit governing both the ABD and long-term care tracks. But default isn't the same as mandatory. States are free to set higher limits, and several have, which creates real, practical differences in who can apply without first doing spend-down planning.

Connecticut is at the strict end, at $1,600 for individuals and $2,400 for couples (per Choice Mutual). California moved in the opposite direction. Starting January 2026, Medi-Cal reinstated an asset test for most non-MAGI enrollees, but set the bar at $130,000 for individuals and $195,000 for couples, among the most permissive asset limits of any state that applies a test at all (per Choice Mutual). SSI-linked enrollees in California remain subject to the lower federal SSI limits regardless.

What counts as an asset, and what doesn't, follows a fairly consistent pattern across states. Bank balances, CDs, stocks, and bonds count. The primary home, one vehicle, household furnishings, clothing, and qualifying burial trusts generally don't, at least while the person is alive. The home's exempt status doesn't survive death, though: it becomes subject to estate recovery once the Medicaid recipient passes, a separate mechanism that operates on its own terms and doesn't mean exempt is permanently protected.

IRAs and 401(k)s remain one of the messiest areas of state-by-state variation. Some states exempt them while the owner is still working. Others count them as available resources the moment they become accessible, regardless of employment status. For families doing advance planning, this single distinction can carry more weight than almost any other line item on the asset worksheet, simply because retirement accounts tend to be where a lot of middle-class savings actually sit.

For people over the asset ceiling, the limit is often the more binding constraint, more so than income, since asset thresholds respond directly to legal planning tools like irrevocable trusts. That kind of planning has to happen outside the five-year look-back window for long-term care Medicaid to actually count, which is a timing detail that trips up families who start planning only after a health crisis has already begun.

Medicaid Buy-In for working adults with disabilities: a separate income and asset structure that most people don't know exists

Forty-seven states run a Medicaid Buy-In program in 2026, and it solves a specific problem: what happens when someone with a qualifying disability wants to work, but earned income would otherwise push them over standard Medicaid limits? Buy-In lets them pay a premium and stay enrolled instead of losing coverage the moment a paycheck grows (per KFF).

Buy-In programs vary widely in their income ceilings across states, a considerably higher ceiling than either the ABD or standard MAGI tracks allow. Asset limits vary by state, and KFF's 2026 survey reports them only in qualitative terms, but most states set them well above the SSI default of $2,000, another sign that this track was built with different assumptions in mind.

Premiums are common but not universal. Many states charge premiums for Buy-In enrollees, with amounts varying by state and income level, a modest cost relative to what continued Medicaid coverage is worth.

This track carries particular weight for family caregivers, a group that often gets overlooked in these conversations. Many caregivers have disabilities of their own, and income from caregiving wages or other part-time work can push them toward or past standard eligibility limits. The Buy-In pathway exists precisely so that earning a bit more doesn't mean losing Medicaid entirely, though enrollment isn't automatic. Applicants have to apply into the program specifically, which means the same structural lesson from the start of this piece applies here too: knowing the track exists is the precondition for using it at all.