Medicaid Income Limits by State 2025

Many residents would say that one of the biggest problems in the United States is the state of healthcare. Not only is healthcare expensive, but not everyone has access to insurance that makes it more affordable. While the Affordable Care Act did help some low-income households, other individuals and families still struggle without healthcare.

One of the nation’s programs that strives to help low-income individuals have access to healthcare is Medicaid. This federal program allows children, parents, pregnant women, and adults to receive the care they need despite having a low income.

Qualifying for Medicaid varies by state. The primary difference is the income level required to qualify. If you earn too much income, you will not qualify for this federal program and will need to seek other forms of assistance for healthcare.

For this article, we’re going to look at the income limits by state for parents of one child, as well as other adults. All numbers are based on the Federal Poverty Level, or FPL. The FPL is determined by the Department of Health and Human Services. This number is used to determine who is eligible for programs like Medicaid and other benefits, such as low-income government housing programs and food stamps. This rate is adjusted every year in January based on inflation.

As of 2019, the FPL for a family of three is $21,330 in the 48 contiguous states plus the District of Columbia. In Alaska, this number rises to $26,600. In Hawaii, the FPL for a family of three is $24,540. For an individual, the contiguous U.S. has determined the FPL to be $12,490. In Alaska, this number rises to $15,600, while Hawaii has an FPL for individuals at $14,380.

The state with the highest income limits for both a family of three and individuals is Washington, D.C. If you live in this area, a family of three can qualify for Medicaid if their income is at 221% of the FPL. For other adults, the limit is set at 251% of the FPL.

The next state with the highest income limits is Connecticut, which has limits of 155% of the FPL for parents and 138% for other adults. Indiana comes in third with limits of 139% of the FPL for parents and adults.

A large number of states have set income limits for both parents and adults at 138% of the FPL. These states include West Virginia, Washington, Vermont, Rhode Island, Pennsylvania, Oregon, Ohio, North Dakota, and New York, just to name a few.

On the other side of the coin, Texas has the lowest income limits of all of the U.S. states. Income limits for Medicaid for parents is 17% of the FPL. Alabama doesn’t come far behind with income limits of 18%. Other states with Medicaid income limits that fall below 100% of the FPL include Missouri, Idaho, Mississippi, Florida, Georgia, Kansas, Virginia, North Carolina, Oklahoma, South Dakota, Wyoming, Utah, Nebraska, South Carolina, and Tennessee.